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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...

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Updated: Jul 16, 2026

Multi-Modal Signals for Analyzing Pain Responses to Thermal and Electrical Stimuli
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Rethinking Pain Assessment: Subjective Scales, Biomarkers, and Multimodal Integration.

Aifeng Liu1,2,3, Longyao Zhang2,3, Enyan Xue2,3

  • 1Tianjin International Joint Research Center for Neural Engineering, Academy of Medical Engineering and Translational Medicine, Medical School, Tianjin University, Tianjin, People's Republic of China.

Journal of Pain Research
|July 15, 2026
PubMed
Summary

Standardizing pain assessment is crucial. This review proposes a four-layer framework (subjective, behavioral, biosignal, integrated) to improve pain measurement across diverse patient populations and settings.

Keywords:
multimodal integrationneuroimagingpain assessmentpain biomarkerssubjective scales

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Area of Science:

  • Pain medicine and anesthesiology
  • Clinical trial methodology
  • Translational pain research

Background:

  • Pain assessment is fundamental but lacks standardization across diseases, populations, and settings.
  • Current methods struggle to capture the full spectrum of pain experience.
  • Reliable pain endpoints are essential for clinical decisions and trials.

Purpose of the Study:

  • To propose a layered framework for organizing and understanding pain assessment methods.
  • To guide the interpretation of diverse pain indicators within clinical and research contexts.
  • To highlight the importance of context, feasibility, and validation in pain measurement.

Main Methods:

  • Review and synthesis of existing literature on pain assessment.
  • Organization of pain assessment into four interrelated layers: subjective experience, behavioral/functional proxies, mechanistic biosignals, and multimodal integration.
  • Discussion of recent technological advances and their role in pain phenotyping and monitoring.

Main Results:

  • A four-layer framework is presented to structure pain assessment.
  • Patient-reported outcomes are central but have limitations in specific populations.
  • Behavioral proxies and advanced biosignals (e.g., neuroimaging, AI) offer complementary data.
  • These tools require careful interpretation and validation, not as replacements for self-report.

Conclusions:

  • A task-oriented, layered framework enhances clarity in pain assessment.
  • Integrating subjective, behavioral, and biosignal data improves pain phenotyping and monitoring.
  • Emphasis on feasibility, reproducibility, validation, and clinical context is critical for reliable pain measurement.
  • This approach supports interpretable endpoints for clinical trials and practice.