New Aalborg University center to study link between maladaptive central nervous system, chronic pain

A new research center at Aalborg University in Denmark will investigate how a maladaptive central nervous system can be responsible for the enduring or chronic pain that affects one in five adult Danes. If this major ambition is fulfilled, it may turn the understanding of the pain system on its head and improve treatment.

The Danish National Research Foundation has just announced its support for the effort with up to DKK 60 million. Professor Thomas Graven-Nielsen has been appointed head of the new Center of Excellence with a total budget of DKK 90 million (EUR 12 million) that will bring together technology, engineering competences and neuroscience:

- This is a really great thing for the university and for our research, and, in the long run, it could make a difference for pain patients. We will do basic research into how we can measure and evaluate these mechanisms from an engineering perspective. In addition, we will look at how we can develop models that reflect the flexibility of the central nervous system around pain mechanisms, explains Thomas Graven-Nielsen.

His hope is that greater understanding can pave the way for much-needed change in the management of pain:

- If we understand the mechanisms then we can better influence them. Pain treatment today is certainly not optimal. In principle we can relieve pain, but this is associated with enormous side effects. This is also why many people end up with long-lasting pain, because we're not good at treating them, says Thomas Graven-Nielsen.

Unfortunate adaptability

Flexibility or neuroplasticity in the human central nervous system - the focus of the pain researchers in the new center - is a useful property in other contexts. For example, stroke patients can regain lost skills because other parts of the system take over. But flexibility can create disorder in the pain system.

- Under normal circumstances the pain system protects us from damage. But flexibility may lead to increased amplification, which may explain the transition from acute to chronic pain. Although the injury is healed and no longer provides pain input, this maladaptive neuroplasticity may be the reason that pain becomes chronic, says Thomas Graven-Nielsen.

The hypothesis that he and the other researchers are working from is that with increased understanding and the right technologies it will be possible to pull the maladaptive neuroplasticity in the opposite direction. This will pave the way for the next generation of pain management - without the current side effects:

- We know that we can induce neuroplastic changes by stimulating other parts of the sensory system. So we propose that we can use the advantageous neuroplasticity to move the maladaptive neuroplasticity back to normal. If we understand the basic factors, perhaps we can develop some new technological methods in terms of the engineering aspect, which in the long run can provide better pain management. This will be a paradigm shift and an alternative to the current pharmacological solution and the major side effects, says a hopeful Thomas Graven-Nielsen.