Motivation and reward learning in people with chronic neuropathic pain

Motivational Behavioral and Functional MRI Impairment in Patients With Chronic Neuropathic Pain

It tests whether people with chronic neuropathic pain have a reduced capacity for reward learning by measuring behavior and brain activity during a reward-learning task.

Quick facts

• Study type: Observational
• Enrollment: 50 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Fondation Ophtalmologique Adolphe de Rothschild (Research network)
• Locations: 1 site (Paris)
• Trial ID: NCT05701852 on ClinicalTrials.gov

What this trial studies

This observational study compares people with chronic neuropathic pain to age- and sex-matched healthy controls using a computerized reward-learning task performed during functional MRI. Researchers will measure behavioral performance on the task and corresponding BOLD responses in key reward-system regions to probe alterations in reward circuitry. The work targets the dopaminergic-dependent mechanisms thought to underlie motivational deficits in chronic pain. Standard exclusions include neurodegenerative or inflammatory neurological disease, clinical depressive syndrome, high-dose opioid use, cognitive inability to perform tasks, and contraindications to MRI.

Who should consider this trial

Good fit: Adults with chronic neuropathic pain treated at the neurosurgery department or CETD of the sponsoring center who can undergo MRI, do behavioral tasks, and do not have major depression, neuroinflammatory/degenerative disease, or high-dose opioid use.

Not a fit: People with clinical depressive syndrome, high-dose opioid treatment, significant cognitive impairment, or any absolute contraindication to MRI are excluded and therefore unlikely to benefit from the protocol's findings or participation.

Why it matters

Potential benefit: If successful, the findings could clarify why some patients with chronic neuropathic pain have motivational deficits and guide development of treatments targeting reward processing.

How similar studies have performed: Previous fMRI and behavioral studies have reported altered reward processing in chronic pain, so this approach builds on existing evidence rather than being entirely novel.

Eligibility criteria

Inclusion Criteria:

* For cases: patients managed in the neurosurgery department or at CETD for chronic neuropathic pain, of central or peripheral origin.
* For controls: matched to a case on age (±5 years) and sex

Exclusion Criteria:

* Neurodegenerative or inflammatory neurological pathology
* Clinical depressive syndrome
* High doses of opioid treatment (greater than 100 mg/day of morphine equivalent)
* Impaired judgment or inability to receive information that does not allow the performance of behavioral tasks
* Absolute contraindication to MRI (e.g. pacemaker, implantable pacemaker, metallic intra-orbital foreign body)

Where this trial is running

Paris

• Hôpital Fondation Adolphe de Rothschild — Paris, France (Recruiting)

Conditions Chronic Pain