Pain is a multidimensional sensory experience produced by complex activity in the nervous system triggered from the periphery through the spinal cord and on to the brain. Under healthy conditions, pain is essential for protecting us from harm, however, in the context of injury or disease of the nervous system, pain loses its defensive role and instead produces persistent suffering and disability, constituting a pathological disease state termed neuropathic pain that affects ~10% of the population worldwide (van Hecke et al., Pain, 2014).
Neuropathic pain is categorized by both stimulus-evoked pain and spontaneous pain which possess distinct pathophysiological mechanisms. Of note, the majority of patients complain more of spontaneous pain than evoked pain (Bouhassira et al., Pain, 2005). However, to date preclinical studies are sharply geared only towards studying evoked pain. This is because while an evoked behavioral pain readout can be readily correlated with a stimulus, spontaneous neuropathic pain (SNeuP) arises without an external stimulus and possesses complex dynamics, rendering quantitative study very difficult, and in consequence the fundamental neurobiological mechanisms are essentially unknown (Mogil, Nat. Rev. Neurosci., 2009).
I now aim to mechanistically interrogate the cellular circuits responsible for SNeuP in a rodent model of neuropathic pain developed in my host lab (Decosterd and Woolf, Pain, 2000). Importantly, we will leverage a novel behavioral readout in mice: brief awakenings from sleep, which is causally linked to, and a biomarker of SNeuP (unpublished data). We hypothesize that there are specific cortical areas whose neural activity are associated with brief awakenings and SNeuP. To test this, we will combine brain-wide functional imaging with miniaturized microscope-based neuronal calcium imaging in freely behaving mice to determine which cortical activity pattern is associated with brief awakenings. We will also examine whether this pattern is present only in specific cortical areas or occurs globally. Based on the spatiotemporal features of cortical activation, we will further classify the activity patterns in fully awake mice using support-vector machine algorithm, and determine which activation patterns are similar to those occurring during SNeuP-evoked brief awakenings in sleeping mice. Next, we will employ a spinal window to chronically image ascending neural pathways emanating from spinal cord nociceptive output circuitry that drive cortical activation. Electrophysiological alterations in the pathways will be studied to identify the source of the ectopic neural activity associated with SNeuP. Our goal is to link this neural activity to spontaneous pain behaviors, using optogenetics and machine learning-based behavioral analyses.
In conclusion, this project aims, for the first time, to tease out the precise circuits underlying SNeuP, which will pave the way for exploration of novel therapeutic interventions.