PROJECT: JTC 2025 - Pain: PNS_SCI-NP

Neuropathic pain is a common and debilitating consequence of spinal cord injury (SCI). Current treatments offer limited relief, highlighting the need to better understand underlying mechanisms. Our project investigates structural and functional peripheral nervous system changes (PNS) post-SCI as key drivers for neuropathic pain, challenging the traditional central nervous system-centric perspective. Our research consortium integrates clinical and preclinical expertise across three countries into three work packages: WP1 - Retrospective Analysis: Using existing multicenter SCI trial data, we will analyze neurophysiological (nerve conduction), neuroimaging (ventral horn MRI), and serum biomarkers (e.g., CHIT-1, peripherin) to identify PNS alterations linked to neuropathic pain. WP2 - Observational Human Study: A bicentric study will track 30 SCI patients over 6 months, using skin biopsies (nerve fiber density, myelination), neurophysiology (axon reflex flare, nociceptor excitability), and protein biomarker profiling to determine temporal PNS changes related to neuropathic pain. WP3 - Experimental SCI Models: Reverse translation to preclinical models (mouse thoracic contusion, rat motoneuron lesion) will assess pain behavior, PNS histology, ex-vivo nociceptor excitability, and test neuromodulatory protein candidates. Findings will improve early diagnostics and identify novel targets within the PNS to pave the way towards personalized pain management in SCI.