Pain Regulatory Mechanisms and Neuroadaptability to Pain: Relevance for Chronic Pain Vulnerability?

Session Title: Pain Regulatory Mechanisms and Neuroadaptability to Pain: Relevance for Chronic Pain Vulnerability?

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Description: The inability to predict treatment trajectories and co-incidence of chronic pain following injury indicates a major unmet need for methods to predict potential vulnerability. A fundamental characteristic of the central nervous system is the ability to adapt to changes within the body and surroundings. When an injury results in pain, the nervous system produces a dynamic neuroplastic response which normalises through healing. Such nervous system changes likely serve a protective role, but in susceptible individuals, these injury-related changes may become dysfunctional, with functional loss that cease to correlate with tissue injury and frequently persisting despite injury resolution. Recent breakthrough findings and novel methodologies have progressed our understanding of the neuroadaptability to pain. In this workshop different neuroadaptive mechanisms will be presented based on electrophysiological, psychophysical, and brain imaging studies. It is outlined as five concise presentations on various expressions of pain neuroadaptability and a panel discussion to end.

Dr. Bannister will discuss novel endogenous mechanisms underpinning nociception in animals and pain in humans, focusing on approaches to harness or reinstate activity in modulatory pathways activated upon stimulus offset, onset and conditioning, with a focus on pharmacological and anatomical signatures of spinal transmission inhibitory and facilitatory neuroadaptive processes.

Dr. Crawford will continue with a similar topic, discussing the relative expression rates and likely cortico-brainstem systems underlying significant expression of neuroadaptability mechanisms like conditioned pain modulation, offset and placebo analgesic responses in a large cohort of pain-free humans, alongside their interactions with pain sensitivity, demography, and psychological factors. Extending these ideas, he will then discuss their utility for assessing chronic pain vulnerability.

Dr. Davis will discuss individual differences in bottom-up (temporal summation of pain) and top-down (conditioned pain modulation) behavioural neuroadaptability measures and neural activity related to pain and its modulation based on fMRI and MEG. She will discuss how the variability and modulation of state and trait features of brain-behaviour relationships can inform the development of individualised treatment of chronic pain using neuromodulation.
Dr. Schabrun will illustrate how neuroadaptability in the somatosensory domain is related to the transition from acute to chronic low back pain. Using measures of sensory evoked brain potentials and data from a prospective longitudinal cohort study, she will discuss the finding that low somatosensory cortex activity predicts chronic pain vulnerability and highlight future opportunities for treatment.

Finally, Dr. Graven-Nielsen will show unique data linking various types of neuroadaptability to pain in the somatosensory, motor, cognitive-affective and pain-regulatory domains. This will include data based on cutting-edge human neurophysiological assessments of brain neuroadaptability in the sensory and motor domains, pain-regulatory behavioural assessments (e.g. conditioned pain modulation and offset analgesia), and psychological profiling (e.g. psychological flexibility). Preliminary data on traits across different neurobehavioral domains will be illustrated and used to hypothesise chronic pain vulnerability.

This workshop will provide exciting and novel insights across the spectrum of neuroadaptability to pain and will allow the audience to explore important future directions in the field.

Speakers

Siobhan Schabrun School of Physical Therapy, University of Western Ontario; Gray Centre for Mobility and Activity, Lawson Research Institute, St. Joseph’s HealthCare, London
Canada

Professor Siobhan Schabrun conducts research in the School of Physical Therapy at Western University and at Lawson Research Institute, St. Joseph's Healthcare London, Canada. Her work focuses on neuroplasticity, chronic pain, and neuromodulation, particularly the use of non-invasive brain stimulation to understand, treat and prevent musculoskeletal pain. She investigates how maladaptive changes in the brain contribute to persistent pain and how they can be reversed through targeted therapy. Holding a Doctor of Philosophy from the University of Adelaide, she is The William and Lynne Gray Endowed Research Chair in Mobility and Activity at the Gray Centre for Mobility and Activity, Lawson Researh Institute, St. Joseph's Healthcare, London and a core member of the Western Institute for Neuroscience.

Lewis Crawford The University of Sydney, Sydney, Australia; The Brain and Mind Centre, Sydney, Australia
Australia

Lewis is a postdoctoral researcher from the University of Sydney faculty of medicine and health, and the brain and mind centre research institute. Since completing his PhD in 2023, where he investigated the brainstem systems responsible for placebo analgesia and nocebo hyperalgesia in healthy humans, Dr Crawford has now commenced a series of studies investigating the pathophysiology of chronic neuropathic pain. Working between Sydney and Melbourne, his discovery research involves the acquisition and analysis of multiple brain imaging, behavioural, genetic, and immune markers in order to uncover the psychobiosocial underpinnings of neuropathic pain. He is keenly interested in how the brain contains its own analgesic circuitry, and how we can use new, targeted, non-invasive techniques to enable the brain to reduce incoming noxious signals and provide novel, non-pharmacological, pain relief. He was awarded the 2026 Australian Pain Society rising star award, and has recently published as first-author in Science.

Thomas Graven-Nielsen Center for Neuroplasticity and Pain (CNAP), Aalborg University
Denmark

Thomas Graven-Nielsen acquired his PhD within Biomedical Science and Engineering in 1997 (Aalborg University, Denmark). In 2006 he obtained a Doctoral degree in Medical Science (DMSc, Copenhagen University). He is Director at Center for Neuroplasticity and Pain (CNAP), Aalborg University, Denmark (since 2015), and Full Professor in Pain Neuroscience since 2008. The Danish National Research Foundation inaugurated CNAP. He is also Councillor in the International Association for the Study of Pain.
His research focuses on translational studies of pain bridging the gap between basic animal findings and clinical manifestations of pain. The scope is to identify and modulate key features of human pain neuroplasticity leading to prevention of maladaptive neuroplasticity and promote advantageous neuroplasticity. The core areas are musculoskeletal pain, referred pain, localised and widespread deep-tissue hyperalgesia, pain modulatory mechanisms, pharmacological screening, and electrophysiological techniques to assess pain physiology and brain neuroplasticity. Novel pain models, bio-markers, assessment and neuro-modulatory technologies are key biomedical tools for the translational studies.
A core research philosophy in his work is that pain research by nature is multidisciplinary, hence interdisciplinary and intersectorial collaboration is a key concept, as is collaboration with excellent researchers and students. Thomas has published 400+ peer-reviewed scientific papers (H-index: 79, approx. 21.500 citations) and received several awards, most notably the Knight of the Order of Dannebrog (2020). He reviews papers on a regular basis for high ranked journals, has presented as keynote speaker at several international conferences, and organised scientific workshops and symposia at international meetings. Multiple national and international collaborations on translational pain research have been established. Moreover, advocacy for pain research has been a cornerstone activity via dedicated involvement in e.g. the International Association for the Study of Pain.

Kirsty Bannister Imperial College London
UK

Kirsty Bannister is an Associate Professor (Reader) and Principal Investigator of the Central Modulation of Pain research group, Imperial College London. Bridging bench and bedside pain research, her team investigates the functionality of brain and spinal cord sensory circuits in clinical and pre-clinical studies incorporating electrophysiological and psychophysical approaches with funding from the Medical Research Council, Parkinson’s UK, NC3Rs, and Academy of Medical Sciences amongst others. Her translational focus has also attracted funding from the pharmaceutical industry, reflecting the direct relevance of her mechanistic work to drug discovery and development; partnerships with Grunenthal, Angelini and Eli Lilly underscore how Kirsty’s work bridges rigorous academic science with industry-relevant questions around target identification, analgesic mechanisms and patient stratification.
Kirsty is the Chair of the Scientific Programme Committee (SPC) for the 2026 World Congress on Pain, with roles on the SPC for 2022 and 2024 World Congresses, and the 2027 European Pain Federation Congress. Kirsty won 2017 EFIC-IBSA original research article publication prize, and she was awarded the 2022 International Association for the Study of Pain Patrick D. Wall prize for basic science research and the 2023 British Pain Society Patrick. D. Wall prize. She has additional editorial roles for Pain, European Journal of Pain, Pain Reports, and British Journal of Pharmacology.

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