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Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Next-generation precision medicine for pain.

R Bhagar1, H Le-Niculescu1, S C Corey2

  • 1Department of Psychiatry, University of Arizona College of Medicine, Phoenix, AZ, USA.

Molecular Psychiatry
|August 25, 2025
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Summary
This summary is machine-generated.

New blood biomarkers can objectively assess chronic pain severity in psychiatric patients. Top markers CD55 and ANXA1, linked to inflammation and pain, suggest personalized treatments like lithium and ketamine.

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Area of Science:

  • Neuroscience and Genetics
  • Biomarker Discovery
  • Psychiatric Research

Background:

  • Chronic pain significantly impacts general and mental health populations, with bidirectional links.
  • Objective pain assessment tools are lacking, hindering effective treatment and prevention.
  • Blood biomarkers offer a potential window into pain biology, aiding assessment and treatment.

Purpose of the Study:

  • To identify, prioritize, and validate blood gene expression biomarkers for pain.
  • To investigate these biomarkers trans-diagnostically in psychiatric patients.
  • To establish reproducible biomarkers using multiple independent cohorts and platforms.

Main Methods:

  • Conducted two independent studies using microarrays and RNA sequencing.
  • Employed a multiple independent cohorts design for biological and technical reproducibility.
  • Focused on convergent and reproducible biomarkers between the two studies.

Main Results:

  • Identified novel and known biomarkers predictive of high pain states and future emergency department visits.
  • Top decreased expression biomarker (pain-suppressor) was CD55; top increased biomarker (algogene) was ANXA1.
  • Key pathways involved cellular response to TNF and neuroinflammation, with TNF as the top upstream regulator.

Conclusions:

  • Validated CD55 and ANXA1 as key blood biomarkers for chronic pain assessment in psychiatric patients.
  • Identified potential therapeutic matches including lithium, ketamine, omega-3 fatty acids, and magnesium.
  • Developed a framework for personalized patient reports to aid objective assessment and individualized treatment matching.