Dr. Annina Schmid
2015 IASP Early Career Research Grant Winner
Institution: Oxford University, Oxford, United Kingdom
Project: "A novel approach to understanding injury and regeneration in patients with entrapment neuropathies"
Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy and is also a unique model to study the pathophysiology of peripheral neuropathies because of the accessibility of the median nerve and its innervation territory. Currently, 25% of patients do not benefit from surgery and continue to suffer from debilitating neuropathic pain, but it is not possible to make an accurate preoperative prognosis. We have recently identified degeneration of small nerve fibers and changes to myelination in the skin of patients with CTS. A limited regeneration capacity of these variables may explain poor prognosis in some patients. This project will therefore investigate small and large nerve fiber dysfunction in the evolution of CTS and their resolution after surgical decompression using a multidisciplinary approach (histology, MRI, neurophysiology, quantitative sensory testing). If changes in these variables are linked with patients’ symptomatology, new biomarkers and therapeutic targets will have been identified. This project will also provide groundbreaking insights in the fundamental biology of peripheral nerve regeneration and neuropathic pain. The results of this project will provide a solid basis for future studies in larger patient cohorts, which will determine the prognostic value of the identified biomarkers for CTS and other painful entrapment neuropathies.