Book of Abstracts

“

TL;DR

This document is a collection of abstracts from a pain conference, covering diverse topics such as fibromyalgia pathophysiology, neuroimmune interactions in pain, sleep and chronobiology, pediatric chronic pain, cancer pain, pain education, sex differences, early life trauma, gut microbiome, and policy development. The main finding is that pain is a complex biopsychosocial phenomenon requiring interdisciplinary approaches for effective management. The clinical significance lies in highlighting the need for personalized, multimodal treatments and the importance of addressing psychosocial factors, sex differences, and early life experiences in pain care.

Full summary

5,388 CHARS

**Background:** This document is a book of abstracts from a pain conference, likely the Canadian Pain Society or similar, featuring keynote, plenary, and concurrent sessions. The abstracts cover a wide range of topics in pain research and clinical practice, including basic science, translational research, clinical trials, and policy. The overarching theme is the complexity of pain, emphasizing the need for biopsychosocial models, interdisciplinary care, and consideration of individual differences such as sex, age, and lived experience.

**Methods:** The document is a compilation of abstracts, each describing different study designs. These include: a keynote on fibromyalgia pathophysiology using neurological examination, questionnaire assessment, neurophysiology, and small fiber tests (skin punch biopsy, corneal confocal microscopy, microneurography, quantitative sensory testing, pain-related evoked potentials) in a large dataset of women with FMS; a plenary on neuroimmune interactions reviewing evidence from animal and human studies; a concurrent session on sleep and chronobiology using Drosophila, rodent, and human studies (including ecological momentary assessment in chronic low back pain); a session on pediatric chronic post-surgical pain (CPSP) including systematic reviews and meta-analyses (n=2864 for prevalence/risk factors, n=3820 for psychological interventions) and a randomized controlled trial; a session on cancer pain including a systematic review of CIPN measures (93 studies, 39 PROM, 32 ClinROM) and ACTTION expert consensus; a session on pain education using a cross-sectional survey and development of a competency-based assessment tool (PCAT); a session on sex differences using fMRI in rats and humans; a session on early life trauma using rodent models, clinical cohorts (birth cohort n=3000, clinical cohort n=150, prospective cohort n=439 dyads), and qualitative interviews; a session on ICD-11 classification; a session on non-neuronal cells using rodent models; a session on diagnostic and sensory uncertainty using operant conditioning, longitudinal cohort (TKR patients), and qualitative interviews; a session on non-pharmacological methods using fMRI and clinical trials (n=30 mindfulness, n=29 placebo-mindfulness, n=277 CP, n=189 HC); a session on pediatric pain program solutions describing implementation and feasibility; a session on gut microbiome using germ-free mice, metabolomics, and clinical trials (n=50 women with fibromyalgia); a session on pain in neurodevelopmental disabilities using micro-longitudinal analysis (n=43 youth with CP), qualitative interviews, and RCT; a session on pain and addiction; a session on pain and time using transcriptomics, animal models, and human studies; a session on childhood trauma using rodent models, fMRI in youth, and pilot data; a session on clinical trials; a session on Indigenous youth using qualitative focus groups and pilot evaluation; a session on translational approaches using electrophysiology in rats and humans; a session on mobile health; a session on young athletes using survey data (n=305) and qualitative data; a session on placebo effects; a session on prenatal/neonatal pain using trajectory analysis and neuroimaging; a session on neuromodulation; a session on policy; and a session on perceived injustice using qualitative interviews and prospective studies.

**Key Results:** Key findings include: In fibromyalgia, 63% of patients had reduced intraepidermal nerve fiber density (IENFD) at any biopsy site, with four distinct patterns of skin innervation. In chronic low back pain, approximately one quarter experience constant mild pain, another quarter constant severe pain, one fifth show a rhythmic pattern, and 30% have unclear/mixed rhythmicity. For pediatric CPSP, approximately 20% of youth develop CPSP, and psychosocial factors (e.g., youth anxiety, parent catastrophizing) play a large role. In CIPN, 14 (35.9%) PROM and 0 ClinROM were developed with input from research participants with lived experience. In the gut microbiome study, colonization of germ-free mice with microbiota from fibromyalgia patients caused pain hypersensitivity. In the placebo study, chronic pain participants with poor sleep quality exhibited significantly smaller placebo effects (p < 0.001). In the perceived injustice study, scores increased for 23% of the sample, and bidirectional influences were found between perceived injustice, pain, and depression.

**Clinical Implications:** The findings underscore the importance of a biopsychosocial approach to pain management. For fibromyalgia, small fiber pathology may be a target for diagnosis and treatment. For chronic low back pain, identifying pain rhythmicity can help tailor interventions. For pediatric CPSP, early identification of psychosocial risk factors and provision of psychological interventions are crucial. For CIPN, measures need to be developed with patient input. The gut microbiome may be a novel therapeutic target for fibromyalgia. Sleep quality should be considered when evaluating placebo effects and pain management. Perceived injustice is a modifiable risk factor that should be addressed in rehabilitation. Overall, the conference highlights the need for personalized, interdisciplinary, and patient-centered care, as well as the importance of addressing social determinants and health equity.