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NIH grant 1R21NS144927-01A1: Spinal nociceptive and non-nociceptive processing of cutaneous input in people with SCI
Institute: {'code': 'NS', 'abbreviation': 'NINDS', 'name': 'National Institute of Neurological Disorders and Stroke', 'admin_org_id': '12500053', 'admin_funding_url': ''}. PI: Aiko Thompson. Award: $226500.
Start: 2026-08-21T00:00:00.
Project Summary
Neuropathic pain impacts »2/3 of people with spinal cord injury (SCI). Because multiple mechanisms and factors
(e.g., neurophysiological, psychological, and social) contribute to neuropathic pain in chronic SCI, multimodal
treatment strategies including neuromodulation, self-management, pharmacological, behavioral, and physical
therapies are likely needed to adequately manage it. At present, common methods to treat neuropathic pain are
pharmacological (e.g., opioids) or invasive (e.g., spinal stimulation), for addressing the symptoms but not
underlying causes of the pain. Because those treatments are not tied to specific neural sites or actions in
mechanisms, they can lead to unwanted side effects. Animal studies have shown that spinal neurons are
changed in neuropathic pain after SCI. Transmission and activity in the pain pathway neurons become excessive
and some non-pain pathways start to behave like pain pathways in the spinal cord. Such changes would disturb
the balance between (supposed to be) mutually suppressive pain and non-pain pathways, towards enhancing
pain. Restoring their balance could therefore alleviate pain, in theory. However, currently, there is little empirical
data on the relation between the pain and non-pain pathways in the spinal cord of people with neuropathic pain
due to SCI. Gaining better knowledge on spinal pain and non-pain pathways in people with neuropathic pain due
to SCI will likely be a key for developing and applying more effective therapy treatments.
Thus, as a step towards developing more effective strategies to treat neuropathic pain after SCI, this project will
characterize the activity and responses of spinal pain and non-pain pathways in people with chronic SCI. We
hypothesize that spinal processing of painful and non-painful cutaneous input would differ between individuals
with neuropathic pain due to chronic SCI and individuals with SCI without pain.
Aim 1 is to study spinal processing of painful and non-painful input using cutaneous nerve stimulation in
individuals with chronic SCI. Cutaneous reflexes to non-noxious stimuli in lower leg muscles and pain thresholds
will be examined by electrical stimulation of the distal tibial, superficial peroneal, and sural nerves in individuals
with neuropathic pain due to chronic SCI and individuals with SCI but no pain. Aim 2 is to study thresholds for
non-painful detection and pain sensation to different modalities of cutaneous input using Quantitative Sensory
Testing in the same individuals with SCI. To aid the interpretation of the Aim 1 and 2 data, sensorimotor function
and pain experience will also be assessed using several established tools and questionnaires.
Characterization of spinal processing of painful and non-painful cutaneous input will guide us to more effective
applications of targeted neurobehavioral training or neuromodulation interventions for pain alleviation in people
with neuropathic pain due to SCI. Understanding spinal mechanisms of pain will also help us better understand
how the central nervous system processes painful and non-painful input in people with chronic SCI.document fetched 2026-08-30 02:46