Chronic pain is one of the most common reasons to seek healthcare and miss work or school. One in five Canadians is living with chronic pain, and suffer profound adverse impacts on their physical, emotional and occupational functions. In North America alone, chronic pain costs at least $600 billion annually, exceeding costs associated with heart disease, cancer and diabetes. Though progress has been made in pain research, there are many issues that still need to be addressed.
Within the Chronic Pain Network, patients partners help inform research priorities. Network projects include population, behavioural and basic studies, as well as clinical trials, with the goal of creating transformational change in the areas of preclinical, behavioural, clinical, health services, population health and patient engagement research.
Below is a listing of all current Chronic Pain Network affiliated projects.
Leader(s): Margot Latimer (Co-PI), Sharon Rudderham (Co-PI)
National Community Engagement & Research Coordinator: John R. Sylliboy
Institution(s): IWK Health Centre, Centre for Pediatric Pain Research, Eskasoni Health Centre, Dalhousie University
Other Members: Finley, A.; Harman, K.; Mushquash, C.; Paul, K.; Chorney, J.; Hutt-MacLeod, D.; Perley-Dutcher, L.
Expansion of the Aboriginal Children’s Hurt & Healing initiative to encompass six additional communities, including four more First Nations (Alberta, BC, Ontario and Quebec), one Inuit (Labrador) and one Metis (Manitoba) community. The Aboriginal Children’s Hurt & Healing (ACHH) Initiative was created out of a need to better understand the issue of chronic pain in Aboriginal pediatric populations. Aboriginal children experience higher rates of painful conditions including, but not limited to, dental pain, ear pain and headaches. However, pain management and treatment remains inadequate. ACHH Initiative has engaged four Atlantic Canadian First Nations communities (3 Mi’kmaq, 1 Maliseet) to begin to better understand the prevalence, experience and conceptualization of pain.
Leader(s): Karine Toupin Avril (PI)
Institution(s): children's Hospital of Eastern Ontario Research Institute, University of Ottawa
Other Members: Stinson J, Huber AM, Couchman D, Ragusa M, Sachs H, Sivakumar A, Gaboury I, Duffy CM, Morgan E, Brosseau L, Li LC, Brinkman W, Bisch M, Cohen J, Stringer E, Légaré F, Proulx L, Sirois A, Junkin L, Cavallo S, Fortin PR, Tugwell P
Creation of a biobank of biological samples, including DNA, RNA and plasma proteins, obtained from patients in the registries of SPOR Network grant partners. Samples will be used to identify molecular markers of the chronicity of pain conditions and their response to specific treatments.
Leader(s): Ian Gilron, Luda Diatchenko, Nader Ghasemlou, Elizabeth Vandenkerkhof and Scott Duggan
Institution(s): Queen’s University, McGill University, University of Manitoba
Other Members: Dongsheng Tu, Ronald Holden, Roumen Milev, Alan
Jackson, Tanveer Towheed
This study is a double-blind, double-dummy, randomized, controlled, 3 period crossover clinical trial comparing a combination of the anticonvulsant, pregabalin (PGB), with the non-sedating antioxidant, alpha-lipoic acid (ALA) to each monotherapy in chronic pain. Project outputs will advance knowledge about rational combination
Leader(s): Dr. Krista Baerg (PI), Susan Tupper (co-PI) and Dr. Allen Finley (co-PI)
Institution(s): University of Saskatchewan/Saskatoon Health Region, Dalhousie University
Other Members: Canadian Pediatric Pain Clinics
A population study exploring Complex Regional Pain Syndrome (CRPS) cases, in children and youth, presenting to paediatricians and pediatric chronic pain centres across Canada. With a proposed surveillance duration of two years, and utilizing the established methodology of the Canadian Paediatric Surveillance Program, research will provide important incidence data and describe pediatric case characteristics. This foundational data will promote early recognition and treatment of CRPS in childhood and adolescence, as well as inform the education of pain health professionals both nationally and internationally.
This study seeks to examine how chronic pain is handled in the Emergency Department; ascertain the proportion of patient with chronic pain, who are frequent users of the Emergency Department, who have had access to self-management, inter-disciplinary interventions or to a pain specialist; ascertain stakeholders’ expectations of how chronic pain should be managed in the Emergency Department; and to explore the different reasons for presentation, care provided, care expectations and access to self-management, interdisciplinary program or pain specialists. The study also seeks to describe characteristics of patients with chronic pain who frequently use the Emergency Department to address their pain.
Leader(s): Nader Ghasemlou, PhD & Ian Gilron, MD
Institution(s): Queen’s University
Other Members: Luda Diatchenko, PhD (McGill); Elizabeth vandenKerkhof, PhD (Queen’s University); Scott Duggan, MD (Queen’s University); non-CPN members: Qingling Duan, PhD (Queen’s University), Brian Kwon, MD (UBC)
The study seeks to identify novel mechanisms underlying chronic pain that are affected by circadian rhythms by describing fluctuations in the intensity of pain reported by chronic pain sufferers, and identifying the molecular cues responsible for the generation of central pain in spinal cord injury patients
A series of epidemiological investigations will aim to understand the complex relationship between chronic pain conditions and psychiatric disorders. In both population-based Canadian and US samples, we will establish co-morbidity trends, mechanisms to elucidate co-occurrence, and health and disability-related implications of co-morbidities.Publications:
Vun, E., Turner, S., Mota, N., Afifi, T., Sareen, J., & El-Gabalawy, R. (2018). Prevalence of comorbid chronic pain and mental health conditions in Canadian Armed Forces active personnel: Analysis of a cross-sectional survey. CMAJ Open, 6(4), E528-E536. doi: 10.9778/cmajo.20180093
Csupak, B., Sommer, J. L., Jacobsohn, E., & El-Gabalawy, R. (2018). An examination of the co-occurrence and functional correlates of chronic pain and generalized anxiety disorder. Journal of Anxiety Disorders, 56, 74-80. doi: https://doi-org.uml.idm.oclc.org/10.1016/j.janxdis.2018.04.005Bilevicius, E., Sommer, J. L., Asmundson, G. J. G., & El-Gabalawy, R. (2018) Posttraumatic stress disorder and chronic pain are associated with opioid use disorder: Results from a 2012-2013 nationally representative survey. Drug and Alcohol Dependence, 188(1), 119-125. doi: https://doi.org/10.1016/j.drugalcdep.2018.04.005
Leader(s): Jennifer Stinson
Institution(s): Hospital for Sick Children (site lead), Centre for Global eHealth Innovation (University Health Network), Alberta Children’s Hospital, Mount Sinai Hospital, IWK Health Centre, Queen Elizabeth II HealthSciences Centre, Alberta Health Services, Stollery Children’s Hospital
Other Members: Lalloo, C.; Campbell, F.; Gordon, A.; Chorney, J.; Clark, J.; Simmonds, M.; Rashiq, S.; Jibb, L.; Dick, B.; Forgeron, P.; Ingelmo, P.; Montgomery, L.; Ruskin, D.; Tupper, S.; Victor, C.; Ware, M.; Palermo, T.
The project seeks to develop and evaluate iCanCope, the first integrated smartphone and web-based pain management program for AYA with persistent pain.
A basic research study that uses patient-derived sensory neurons to compare cellular changes in leukemia patients who are susceptible or resistant to chemotherapy-induced neuropathy. The long term results are intended to help develop patient-specific treatments against neuropathic pain.
Leader(s): Karen D. Davis, PhD; Cyril Schneider, PhD
Institution(s): University Health Network; Universite Laval & CHU of Quebec
Other Members: Dwight Moulin, Petra Schweinhardt, McGill Research Group
A basic study seeking to identify key indicators of the dynamic pain connectome, representing individual pain sensitivities; genotypic characteristics; changes of brain structure and function; changes of sensorimotor control (body manifestations); changes in behaviour (e.g., kinesiophobia); resilience and treatment response. A multidisciplinary approach will link pain perception with brain findings derived from task/resting-state fMRI and static/dynamic connectivity in patients before and after treatment. Data will be used to develop a machine learning model that links the dynamic pain connectome in each individual and their behavioural deficits and pain. This can then be used to determine treatments best suited to each patient. A framework for neuroethics, legal and societal challenges related to brain imaging/function and physiopathology proxies of pain will also be established.
This behavioral study will assess the application of computer-based automatic assessment of pain, expanding the application of the system to infants, children with developmental disabilities and adults with cognitive impairment. Utilizing the Facial Action Coding System, Computer Vision and Machine Learning reliably characterize video recorded facial displays without requiring time or potential for human error associated with manual coding.
Leaders: Allan Gordon (MD, FRCP(C)), Lee Bartel (PhD)
Institutions: Wasser Pain Mangement Centre, Mount Sinai Hospital, University of Toronto, Faculty of Music, Fred A Litwin and Family Centre in Genetic Medicine
Other members: Larry Picard (MD), Thenille Braun Janzen (PhD), Denise Paneduro (MA), Veronica Vuong (BMus), Marilyn Galonski (RN), Leah Pink (NP), Azar Azad (MLD, PhD), Ana Andreazza (PhD), Jed Meltzer (PhD), Hanna Faghfoury (MDCM, FRCPC)
An examination of the effects of a non-medical and self-administered therapy option for the management of chronic pain, i.e., Rhythmic Sensory Stimulation and Music. Research will also investigate the mechanisms underlying the use of low-frequency rhythmic sensory stimulation and music as a complementary treatment for chronic pain.
This work focuses on three areas:
This projects seeks to:
Leader(s): Nader Ghasemlou, PhD (Queen’s University); Luda Diatchenko, PhD (McGill); Ian Gilron, MD (Queen’s University)
Institution(s): Queen’s University
Other Members: Scott Duggan, MD (Queen’s University); Elizabeth VanDenKerkhof, PhD (Queen’s University); Qingling Duan, PhD (Queen’s University), Brian Kwon, MD (UBC), Judith Steen, PhD (Boston Children’s Hospital)
The project seeks to identify patients for proteomic characterization who have already undergone genomic screening and to identify patients most closely grouped in terms of age, sex, race and disease progression/pain outcomes.
Leader(s): Cyril Schneider
Institution(s): Université Laval
Other Members: CEGDC (Center for Excellence of Chronic Pain Management, Province of Québec), including pain centres; all Canadian pain researchers with neurostimulation and MRI
A randomized control trial of neuromodulation, aiming to collect evidence-based data on noninvasive brain stimulation and noninvasive peripheral stimulation after-effects in chronic lower back pain and complex regional pain syndrome and detecting factors predictive of success (personalized health care).
Leaders: Serge Marchand and Louis Gendron, with Phillippe Sarret and Nicolas Beaudet
Institution(s): Université de Sherbrooke and Centre de Recherche du CHUS
Other Member(s): Quebec Pain Research Network (QPRN), Pain Research Centers and Pain Clinics in Quebec and Canada
The project seeks to develop and validate standard procedures to measure excitatory and inhibitory mechanisms in conditioned pain modulation, and to establish these procedures across Pain Centers and Pain Clinics of the network.
This study begins as a retrospective study using biobank samples to investigate biomarkers focused on breast, prostate and lung cancers that have metastasized to the bone and cause severe chronic pain. A prospective study biomarker analysis will be investigated in baseline and cancer patients with and without cancer pain, ultimately resulting in validating biomarkers before and after treatment with novel agents. This data is critical to advance future therapeutics for cancer-induced pain.
Leader(s): Melanie Noel
Institution(s): Alberta Children’s Hospital (site lead), University of Calgary/Foothills Medical Centre; Hospital for Sick Children, IWK Health Centre
Other Member(s): Syed, N.; Rasic, N.; Vinall, J.; Bray, S.; Harris, A.; Palermo, T.; Kazak, A.; Vervoort, T.; Sears, C.; Stinson, J.; Finley, A.; Latimer, M.; Chorney, J.
A multi-site, clinical research study seeking to determine the cognitive, behavioural, and biological mechanisms underlying the relationship between parental mental health issues and children’s pain outcomes in a sample of youth with chronic pain.
Leader(s): David Walton, Joy MacDermid, Jim Elliott, Walter Siqueira, Lynn Cooper, Brian Corneil, Eldon Loh, Gordon Good, Siobhan Schabrun, Jordan Miller
Institution(s): University of Western Ontario, McMaster University, McGill University, University of British Columbia,Queen’s University, Northwestern University (Chicago), Western Syndey University (New South Wales), University of North Carolina at Chapel Hill, Canadian Pain Coalition, Gordon Good Law Offices
Other Member(s): Bill Aal, David Holdsworth, Douglas Fraser, David Seminowicz, Greg Gloor, Gunter Siegmund, Jim Dickey, Jeff Dixon, Joe Gati, Kevin Shoemaker, Linda Carroll, Marnin Heisel, Paul Tremblay, Samuel McLean, Ruth Lanius, Stan Van Uum, Tim Wideman, Trevor Birmingham. Trainees: Joshua Lee, Sadia Siraj. Research Assistants: Paul Phares, Ryan Power.
The SYMBIOME databank seeks to establish a robust, rigourously-collected and maintained longitudinal acuteto-recovered or acute-to-chronic databank of biological, psychological and social indicator variables that will allow advanced exploratory and confirmatory analyses of the trajectory and causes of pain and disability following acute musculoskeletal trauma