Task 1: Consensus process
This task aims to elaborate a definition of refractory chronic pain through a consensus process assisted by litterature review and French pain experts survey. This is an emerging concept without consensus at the present time, because the “refractory character” cannot be limited only to the drug resistance.
Combinated with the first work-package, the identification of refractory patients will simplify the future rCP patient’s care pathway, by allowing a faster dispatch to a pain specialist or a tertiary center.
Task 2: Clinical and psychosocial biomarkers
Task 2 aims to identify markers predictive of pain chronicization, response and resistance to a given pharmacological or neuromodulation treatment, and multi-treatment resistance.
Task 3: Biological biomarkers
We explore potential biological markers of resistance and response to given pharmacological analgesic or modulation technique. We explore genetic biomarkers from constitutional DNA, blood proteome and auto-antibodies.
Task 4: Neuroimaging biomarkers
Resting state brain metabolism and structural brain connectivity could be predictive of the therapeutic efficacy of some modulation techniques. These two neuroimaging markers are studied in two subpopulations of rCP patients.