Facteurs de risque et de protection de la douleur chronique après un traumatisme craniocérébral modéré/sévère


Caroline Arbour

CIUSSS du Nord-de-l'Île-de-Montréal


Domaine : neurosciences, santé mentale et toxicomanies

Programme Chercheurs-boursiers - Junior 1

Concours 2019-2020

Year after year, chronic pain remains among the most commonly reported sequelae 12 months after moderate to severe traumatic brain injury (TBI). In addition to undermining the quality of life, persistent and disabling pain affects the work reintegration of patients who survive TBI. The human and monetary costs of pain are therefore enormous for these individuals. However, not all patients will develop chronic pain after major trauma. Unfortunately, we are currently unable to identify patients who will develop pain syndrome after moderate to severe TBI. Still, we know that the pathophysiological changes related to persistent pain begin within the first 3 days of TBI, while most patients are comatose in the intensive care unit. Conversely, rapid recovery of consciousness (detected through assessment of eye movements) would be a protective factor against these pains.

This project aims to shed light on the risk factors and protective factors involved in the development of chronic pain after moderate to severe TBI. A secondary goal is to contribute to the validation of a non-pharmacological method to prevent the pain chronicity in this patient group. To achieve this, clinical variables related to the management of acute pain, the severity of trauma (TBI and spinal cord), and inflammation will be collected. Age, sex, as well as analgesic and sedative medication will also be documented. The ability of these variables to predict chronic pain at 12 months post-TBI will be assessed. The ultimate goal of this project is to establish an early and standardized assessment protocol to identify TBI patients at risk of chronic pain within the first days of hospitalization in order to assign them to targeted preventive therapies.