The project  “Fédération Hospitalo-Universitaire” (FHU) is an effective collaboration focused on the characterization of refractory chronic pain (rCP) patients,  development of new assessment tools and therapeutic solutions, justifying the denomination “Innovative Solutions in Refractory Chronic Pain” (INOV-PAIN).

This FHU project offers a unique opportunity to aggregate to 2 core teams several other local teams (already involved in pain or not yet focusing on pain but with great potential applications in this field), to build strong and synergistic collaborations and to federate clinical practice, research and teaching activities in a comprehensive program centered on rCP, mainly focused on neuropathic pain and chronic daily headache.

The Health care project

The Health care project aims to structure a regional medico-surgical platform dedicated to the management of rCP patients, providing:

  • a multidisciplinary expertise to validate operational and multimodal diagnosis criteria of the refractory character of chronic pain, allowing a more relevant definition and recognition of rCP.
  • an expert advice to detect the phenotype of resistance in rCP patient. Early identification of refractory patients will prevent the multiplication and abuse of ineffective treatments.
  • a multidisciplinary expertise to propose the most appropriate and individually tailored therapeutic solution, based on best medical practice supported by evidence and recent therapeutic developments, including, if relevant, new analgesic drugs and neuromodulation techniques.
  • a follow-up of rCP patient’s cohort through data collection with shared database.

The research project

The research project interacts closely with the health care project to build an effective translational program:

  • to develop new tools for the evaluation of rCP patients including cognitive, behavioral and emotional evaluations and connected devices.
  • to identify clinical, cognitive and psychosocial, neuro-imaging and biological biomarkers of the refractory phenotype of chronic pain patients, using data extracted from the rCP patient’s cohort database and from a tissue collection.
  • to develop and evaluate in animals and patients new pharmacological innovative solutions with high translational potential.
  • to develop and/or evaluate neuromodulation techniques in rCP patients, including occipital nerve stimulation (ONS) and other peripheral targets in primary headache, and deep brain stimulation (DBS) and peripheral nerve stimulation (PNS) in refractory neuropathic pain.
  • to use 1) ex vivo & in vivo modeling in animals 2) statistical modeling and machine learning and 3) anatomical and functional neuro-imaging studies (structural connectivity via diffusion MRI and tractography, functional MRI and PET scan studies) to better understand the mechanisms of action of neuromodulation techniques and to optimize the stimulation parameters.
  • to promote “proofs of concept” clinical studies in rCP patients and facilitate technological transfer in the domain of chronic pain, through enhanced partnership with main neuromodulation companies (Medtronic, ST Jude Medical, ATI) or emerging local companies (Orphit, Axonic).

The education project

The education project aims :

  • to reinforce our participation in and/or the coordination of the regional and national education programs dedicated to pain management in the medical studies, which currently undergo a deep transformation
  • to promote a multi-disciplinary training track dedicated to 3 rCP and innovative solutions and to integrate this track in several education programs, including regional and national master courses
  • to develop international pain undergraduate education programs for medical and scientific students (using MOOCs and SPOCs) and a postgraduate teaching program, through the organization of an annual seminar focusing on Innovation in rCP management
  • to develop a patient’s education program dedicated to neuromodulation for rCP patients
  • to diffuse information to the large public about chronic pain in general, and more specifically about rCP, neuropathic pain, migraine, CCH and neuromodulation, trough several events, conferences and a website.
Altogether, the INOVPAIN project propose a multidisciplinary, synergistic and regionally organized network focusing on the characterization of rCP patients, the constitution of a large clinical database and tissue collection, the development of new assessment tools and therapeutic solutions in rCP.
This network help to bridge the gap between research and its clinical applications, facilitate preclinical and clinical studies in chronic neuropathic pain and primary headaches, help to promote more ambitious nationwide or European projects, improve the training of medical students and surgeons and subsequently promote the international visibility of our CHUs, university and region in the field of chronic refractory pain.