Precision diagnostics for chronic pain

Chronic pain is one of the most complex challenges in medical care. The symptoms often arise from various biological and neurological mechanisms that can only be partially captured using traditional diagnostic methods. Research institutions and hospitals are therefore working on approaches that more closely integrate diagnostics and treatment. The goal is to tailor treatments more precisely to individual patients and to support decision-making directly within the clinical care pathway.

At the Mannheim Center for Neuromodulation and Neuroprosthetics at Mannheim University Medical Center, High-Intensity Focused Ultrasound (HIFU) technology may be used in the future. The procedure uses focused ultrasound waves to treat specific brain regions affected by disease. MRI-guided planning and monitoring enables precise localization of the target structures during the procedure and helps physicians tailor treatments more accurately to each patient’s individual situation.

In addition, researchers are working on AI-supported methods that analyze diagnostic data from imaging and clinical examinations. In the future, these are intended to help identify suitable candidates for neuromodulatory therapies and support treatment planning. This could allow decisions to be made on a more data-driven basis even before the procedure and shorten the path to an appropriate therapy.

Patient-specific planning is also becoming increasingly important in electrical spinal cord stimulation. Researchers at Friedrich-Alexander University Erlangen-Nuremberg, in collaboration with international partners, have investigated how different stimulation parameters affect neural structures.

To do this, they combined measurements taken from test subjects with detailed computer simulations. The models show which nerve pathways are activated by specific settings. For the clinical workflow, this means more targeted preparation for treatment. Instead of trying out parameters step by step, treatment decisions can be based more heavily on simulated and measurable effects.

In addition to imaging and simulation, biological markers are also gaining importance for the precision diagnosis of chronic pain. In the EU project RESOLVE, scientists, including researchers from Essen University Hospital, are investigating chronic nerve pain associated with persistent inflammatory processes.

The focus is on extracellular vesicles, which act as natural messengers between cells. In the future, they could provide clues to individual disease mechanisms and help detect inflammatory processes earlier and more precisely. Such diagnostic information could be directly incorporated into treatment decisions and support the selection of appropriate treatment approaches for individual patients, a central goal of precision diagnostics in everyday clinical practice.

Rather than relying solely on symptoms, the approaches presented here draw on patient-specific data from imaging, simulation, and molecular biology. Imaging, digital models, and biological markers not only provide additional information but also support specific treatment decisions. Diagnostics thus turns into an integral part of the treatment pathway. This allows clinics to more closely integrate analysis and intervention in treatment and make decisions based on patient-specific data.

Sources: University Medical Center Mannheim (German only), Friedrich-Alexander University, University of Duisburg-Essen