Western Pain Medicine Program - Current Research

Our research program is coordinated through the Western Pain Medicine Program Scientific Advisory Board. Our research studies are clinically-based and most are supported by peer-reviewed funding. In keeping with our strategic plan, most of our research projects focus on neuropathic pain but also include important functional pain imaging studies that take advantage of our imaging group at Lawson Health Research Institute (LHRI). Our research can be divided into three main areas – randomized controlled trials (RCTs), observational studies and functional imaging pain studies.

Randomized Controlled Trials

  • 1. Oral methadone versus morphine for chronic neuropathic pain

    Methadone is being increasingly used for the management of neuropathic pain but the evidence for this to date is based mostly on case series. This is a multi-centre, parallel design RCT to compare oral methadone to morphine in the management of neuropathic pain. This trial is supported by Canadian Institutes for Health Research (CIHR) and by the Nova Scotia Health Research Foundation. It is scheduled to start at Western University, Dalhousie University and University of Calgary in April 2013.
     
  • 2. Long-term outcome of IV lidocaine in the management of neuropathic pain

    This crossover design RCT of IV lidocaine infusions for neuropathic pain started in Nov 2011 and is about 50% completed as of Feb 2013. It will probably take another year to complete this trial which is funded in part by Canadian Foundations for Innovation (CFI).

Observational Studies

  • 1. Neuropathic Pain Database (NePDAT) Study

    This is a multi-centre cohort study to investigate the long term outcome of management of chronic neuropathic pain using standard pharmacologic guidelines. This study was completed in December 2011 and the past year has been consumed by extensive data analysis and we are now ready to begin manuscript preparation for the major paper as well as several substudies derived from this extensive database. This includes a pharmaco-economic analysis of the impact of managing neuropathic pain including correlation with quality of life parameters.  This study has been funded by CFI and Pfizer Canada.
     
  • 2. Primary Care Neuropathic Pain Studies

    Using electronic medical records, a retrospective study of the prevalence of neuropathic pain in primary care has been carried out by the Department of Family Medicine, Schulich Medicine & Dentistry, and the results of this study will be submitted for publication in 2013. A prospective study of the management of chronic neuropathic pain in primary care will be carried out by the Department of Family Medicine at McMaster University. This will be incorporated into their electronic medical record to provide a permanent focus on neuropathic pain in primary care. This study is sponsored by Pfizer through LHRI and will begin in 2013.

Functional Imaging Pain Studies

  • 1. Fibromyalgia Study With Arterial Spin Labeling (ASL)

    This study has CIHR funding through Dr. Karen Davis in Toronto. This study is restricted to females with fibromyalgia who are off antidepressant medications for at least one month. The target enrolment is 12 active patients and 12 sex and age matched controls. To date, 6 active patients have been entered in the study and one control. Further subjects for this study will be derived from the Fibromyalgia Day Program at St Joseph's Health Care.
     
  • 2. Complex Regional Pain Syndrome (CRPS) Study With Intravenous Lidocaine

    Patients who respond to an open lidocaine infusion are randomized in blinded fashion to either a further lidocaine infusion or placebo with functional MRI imaging in each phase of the study to examine the impacts of lidocaine infusions on cerebral blood flow in these chronic pain patients. Thirteen of 15 subjects have completed the trial as of Mar 2013.
     
  • 3. CRPS Study With Arterial Spin Labeling

    This is a CIHR funded study to examine cerebral blood flow in patients with chronic pain due to CRPS. Keith St. Lawrence from the Imaging Group at LHRI is the PI for this study and he recently submitted the study to the Ethics Review Board for approval. He has also hired a full time post-doc to help with this study. Subjects for the study will be derived from the St. Joseph's Health Care Pain Clinic. This study will start in 2013.
     
Collin Clarke
  • Collin Clarke MD