"Differential diagnosis in neuropathic pain, phenotypic sensory characterization, biomarker identification, and the effect of vagus nerve stimulation as a therapeutic alternative."

• Grant number: 24/10204-7
• Support Opportunities: Regular Research Grants
• Start date: August 01, 2025
• End date: July 31, 2027
• Field of knowledge: Biological Sciences - Physiology - Physiology of Organs and Systems
• Principal Investigator: Camila Squarzoni Dale
• Grantee: Camila Squarzoni Dale
• Host Institution: Instituto de Ciências Biomédicas (ICB). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Ana Carolina Pinheiro Campos ; Carlos Otto Heise ; Gabriel Taricani Kubota ; José Pinhata Otoch ; Kleber Paiva Duarte ; Rosana de Lima Pagano

Abstract

Chronic pain imposes a significant personal and economic burden, affecting over 30% of people worldwide, according to some studies. Unlike acute pain, chronic pain can be better considered a disease, with treatment and psychological implications. Pain can be categorized as nociceptive (from tissue injury), neuropathic (from nerve injury), or nociplastic (from a sensitized nervous system), all of which impact investigation and treatment decisions across all levels. However, in practice, there is considerable overlap in different types of pain mechanisms both within and between patients, leading many experts to view pain classification as a continuum. The identification of systemic biomarkers that confirm diagnosis or predict response can guide more individualized treatment approaches. Given the low or absent efficacy of available pharmacological treatments in patients with persistent neuropathic pain, new adjunctive therapies to conventional treatments are necessary. In this regard, the application of vagal auricular stimulation, due to its prominent anti-inflammatory action, may aid in inhibiting systemic inflammation, pain, and metabolic dysfunction. With this project, we aim to elucidate a phenotypic differential diagnosis combined with the identification of systemic biomarkers that will enable a better treatment plan for each individual. Additionally, we aim to guide the application of vagal auricular stimulation in improving inflammatory, nociceptive, and metabolic symptoms in pat (AU)