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Diagnostics
Special Issues
Progress in Chronic Pain: Bridging Basic and Clinical Research
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Progress in Chronic Pain: Bridging Basic and Clinical Research

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 3953

Special Issue Editors

Dr. Helder Cardoso-Cruz

E-Mail Website
Guest Editor
1. Pain Neurobiology Research Group, Institute of Research and Innovation in Health, University of Porto, 4200-135 Porto, Portugal
2. Biomedicine Department, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
Interests: chronic pain; biomarkers in chronic pain; neurochemistry; pain-related cognitive im-pairments; neurophysiology; neuropathic pain; inflammatory pain
Dr. Clara Monteiro

E-Mail Website
Guest Editor Assistant
1. Pain Neurobiology Research Group, Institute of Research and Innovation in Health, University of Porto, 4200-135 Porto, Portugal
2. Biomedicine Department, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
Interests: chronic pain; biomarkers in chronic pain; neurochemistry; pain-related cognitive impairments; neurophysiology; neuropathic pain; inflammatory pain

Special Issue Information

Dear Colleagues, 

Chronic pain, a complex and persistent condition lasting longer than three months, affects millions worldwide and significantly diminishes their quality of life. Over recent decades, scientific and clinical advancements have transformed our understanding of how chronic pain develops, persists, and manifests across individuals. In particular, the integration of advanced diagnostic techniques, including structural and functional neuroimaging, quantitative sensory testing, and molecular biomarker analysis, has revealed abnormal patterns of brain activity, altered connectivity, and systemic physiological dysregulation in affected individuals. These insights have led to the growing recognition of chronic pain not merely as a symptom, but as a distinct pathological condition of the nervous system, involving maladaptive neuroplasticity, neuroinflammation, and impaired emotional processing.

This expanding body of knowledge is reshaping the clinical landscape, enabling more precise characterization of pain phenotypes and supporting a multidisciplinary, systems-based approach to treatment. Medicine, biotechnology, and neuroengineering increasingly converge to address both the symptomatic and psychobiological dimensions of chronic pain. Such a paradigm shift facilitates earlier detection, better prognostic stratification, and more personalized, mechanism-targeted interventions that extend beyond temporary relief to long-term functional restoration.

This Special Issue aims to showcase recent advances in chronic pain research with direct relevance to clinical practice. We welcome original research articles, case studies, case reports, and reviews that explore the following topics: neurophysiological mechanisms and risk factors; diagnostic innovations; neuromodulation strategies; emerging pharmacological and non-pharmacological therapies; digital health and wearable technologies; and personalized treatment approaches.

We look forward to your submissions.

Dr. Helder Cardoso-Cruz
Guest Editor

Dr. Clara Monteiro
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic pain
  • pain prevention
  • new biomarkers in chronic pain
  • personalized treatment approaches
  • sensory and cognitive dimensions
  • neuropathic pain
  • inflammatory pain

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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13 pages, 397 KB  
Article
Spinal Cord Stimulation Real-World Outcomes: A 24-Month Longitudinal Cohort Study
by Giuliano Lo Bianco, Alexandra Therond, Francesco Paolo D’Angelo, Leonardo Kapural, Sudhir Diwan, Sean Li, Paul J. Christo, Jamal Hasoon, Timothy R. Deer and Christopher L. Robinson
Diagnostics 2025, 15(24), 3149; https://doi.org/10.3390/diagnostics15243149 - 11 Dec 2025
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Abstract
Background/Objectives: Spinal cord stimulation (SCS) is an established therapy for chronic pain, but uncertainties remain regarding long-term real-world outcomes and the role of standardized selection pathways. This study aimed to evaluate real-world, longitudinal outcomes of SCS over 24 months within a structured clinical [...] Read more.
Background/Objectives: Spinal cord stimulation (SCS) is an established therapy for chronic pain, but uncertainties remain regarding long-term real-world outcomes and the role of standardized selection pathways. This study aimed to evaluate real-world, longitudinal outcomes of SCS over 24 months within a structured clinical pathway, focusing on pain intensity, neuropathic symptoms, and health-related quality of life. Methods: A single-center, retrospective observational cohort study was conducted at the Fondazione Istituto G. Giglio (Cefalù, Italy). Data were drawn from the continuing, prospective institutional “SCS Pathway” and included consecutive patients implanted between May 2021 and September 2024. Eligible patients were ≥18 years of age with chronic pain refractory to conventional medical management. Outcomes included pain intensity (VAS, visual analog scale), neuropathic features (DN4, douleur neuropathique 4), and health-related quality of life (EQ-5D, EuroQol 5 Dimensions), assessed at baseline and 3, 6, 12, 18, and 24 months post-implantation. Multilevel models with full information maximum likelihood (FIML) were applied to repeated measures. Results: Seventy-six patients were included (mean age 67.3 ± 10.3 years; 39.5% female). The most frequent diagnoses were post-surgical pain syndrome (42.1%, 32/76) and chronic back and leg pain (40.8%, 31/76). 42.1% (32/76) had previous spine surgery, and 78.9% (60/76) reported neuropathic pain. Across 452 observations, mean VAS scores decreased from 7.9 ± 0.7 at baseline to 3.1 ± 1.1 at 3 months (61% reduction, p < 0.001), with sustained benefit at 24 months (4.5 ± 1.5; 43% reduction, p < 0.001). DN4 scores improved from 7.4 ± 0.8 to 3.2 ± 1.0 at 3 months (56% reduction, p < 0.001), with persistent decreases at 24 months (4.2 ± 1.2; 43% reduction, p < 0.001). EQ-5D improved from 22.8 ± 6.6 at baseline to 70.2 ± 10.6 at 3 months (increase of 208%, p < 0.001), with clinically meaningful gains sustained at 24 months (55.4 ± 13.7, increase of 143%, p < 0.001). Conclusions: In this real-world cohort, SCS therapy results in sustained, clinically significant improvements in pain, neuropathic symptoms, and quality of life. Findings highlight the value of structured selection and follow-up pathways. These data provide a benchmark for multicenter studies linking standardized referral frameworks to long-term, patient-centered outcomes. Full article
(This article belongs to the Special Issue Progress in Chronic Pain: Bridging Basic and Clinical Research)
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Review

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16 pages, 1814 KB  
Review
Descending Pain Modulation in Fibromyalgia: A Short Review of Mechanisms and Biomarkers
by Bruno Daniel Carneiro, Sandra Torres, José Tiago Costa-Pereira, Daniel Humberto Pozza and Isaura Tavares
Diagnostics 2025, 15(21), 2702; https://doi.org/10.3390/diagnostics15212702 - 25 Oct 2025
Viewed by 3082
Abstract
Fibromyalgia is a prevalent chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, cognitive dysfunction, and sleep disturbances, with high impact in quality of life. Despite extensive research, the pathophysiological mechanisms of fibromyalgia remain partially understood, complicating the diagnosis and treatment. Some evidence [...] Read more.
Fibromyalgia is a prevalent chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, cognitive dysfunction, and sleep disturbances, with high impact in quality of life. Despite extensive research, the pathophysiological mechanisms of fibromyalgia remain partially understood, complicating the diagnosis and treatment. Some evidence underscores the central role of abnormal pain processing, particularly central sensitization and defective descending pain modulation pathways. This review synthesizes and discusses current findings on the neurobiological underpinnings of pain in fibromyalgia, with focus on descending inhibitory control mechanisms and on the role of biomarkers. We integrate data from neurochemical, neuroimaging, and clinical studies to explain how impaired descending modulation contributes to enhanced pain sensitivity and discuss the putative biomarkers associated with changes in descending modulation. A better understanding of descending pain modulation dysfunction in fibromyalgia and related biomarkers is crucial for improving clinical outcomes and developing novel and more effective treatments. Full article
(This article belongs to the Special Issue Progress in Chronic Pain: Bridging Basic and Clinical Research)
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