Canadian Pain Society

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Event Schedule:

See conference agenda below. During registration indicate the sessions you wish to attend.

Social Events

		Start Date	End Date	Start Time	End Time
Welcome Reception		2016-05-24	2016-05-24	6:30 PM	8:00 PM	2016-05-24 6:30 PM - 8:00 PM Please join the CPS board, Annual Scientific Program Speakers and other delegates for a welcome reception in the Trade Show. This will be in the Regency Ballroom on the Convention Level (Third floor). Two beverage tickets and h'ors d'ouvres will be provided.

May 24, 2016

	Start Date	End Date	Start Time	End Time
Education SIG	2016-05-24	2016-05-24	4:30 PM	6:00 PM	2016-05-24 4:30 PM - 6:00 PM
Interventional Pain SIG	2016-05-24	2016-05-24	4:30 PM	6:00 PM	2016-05-24 4:30 PM - 6:00 PM

May 25, 2016

	Start Date	End Date	Start Time	End Time
Breakfast	2016-05-25	2016-05-25	7:00 AM	9:00 AM	2016-05-25 7:00 AM - 9:00 AM
Annual General Meeting	2016-05-25	2016-05-25	7:30 AM	8:45 AM	2016-05-25 7:30 AM - 8:45 AM Presenter: CPS Board The AGM is a closed meeting which may only be attended by CPS members.
Opening Remarks	2016-05-25	2016-05-25	8:45 AM	9:00 AM	2016-05-25 8:45 AM - 9:00 AM
Mary Ellen Jeans Lecture: Drugs and placebos: what’s the difference?	2016-05-25	2016-05-25	9:00 AM	9:45 AM	2016-05-25 9:00 AM - 9:45 AM Presenter: Dr. Fabrizio Benedetti As modern placebo research is digging into the details of the placebo phenomenon more and more, our knowledge about the impact of placebo effects on clinical trials and medical practice is increasingly growing. In the past few years, the study of placebo effects has provided a detailed framework of the many factors that are involved, such as brain mechanisms of expectation, anxiety, and reward, as well as a variety of learning phenomena, such as Pavlovian conditioning, cognitive and social learning. There is also some experimental evidence of different genetic variants in placebo responsiveness. The most productive models to better understand the neurobiology of the placebo effect are pain and Parkinson’s disease. In these medical conditions, the neural networks that are involved have been identified: that is, opioid, cannabinoid, cholecystokinin, dopamine modulatory networks in pain and part of the basal ganglia circuitry in Parkinson’s disease. Important clinical implications emerge from these recent advances in placebo research. First, as the placebo effect is basically a psychosocial context effect, these data indicate that different social stimuli, such as words and therapeutic rituals, may change the chemistry and circuitry of the patient’s brain. Second, the mechanisms that are activated by placebos are the same as those activated by drugs, which suggests a cognitive/affective interference with drug action. Understanding similarities and differences between drugs and placebos represents an exciting scientific enterprise that will lead to better medical practice, better clinical trial designs, and better knowledge of human biology.
Poster Pitches	2016-05-25	2016-05-25	9:45 AM	10:00 AM	2016-05-25 9:45 AM - 10:00 AM
Poster Session	2016-05-25	2016-05-25	10:00 AM	11:00 AM	2016-05-25 10:00 AM - 11:00 AM
Good News in Ontario: Partnering with government to address chronic pain	2016-05-25	2016-05-25	11:00 AM	12:30 PM	2016-05-25 11:00 AM - 12:30 PM Presenter: Garry Salisbury, Fiona Campbell, Allan S. Gordon In Canada 1 in 5 people live with chronic pain including children. Access to comprehensive interdisciplinary care is the gold standard for those with debilitating pain. However, there is a lack of these specialized clinics and most clinics have 1-2 year waiting lists. Furthermore, there is a lack of intensive rehabilitation programs for those most severely disabled by their pain and some patients have been sent to the United States to receive this care. Compounding this problem is the fact that community health care providers have little training in assessment and management of chronic pain and that there has been an opioid prescribing crisis in Ontario. Consumer groups have also been actively lobbying the provincial government for more chronic pain services for pediatric and adult populations. All of these factors created the perfect storm to facilitate the MOHLTC, OMA and clinicians from the pediatric and adult academic centres to come together to develop Pediatric and Adult Chronic Pain Advisory Networks. This session will describe the factors that lead to the development of the Networks, work to date, and future directions. Challenges and lessons learned will also be discussed.
Large scale registries and databases: harnessing "big data" in the study of pain	2016-05-25	2016-05-25	11:00 AM	12:30 PM	2016-05-25 11:00 AM - 12:30 PM Presenter: Jennifer Stinson, Manon Choinière, Mark A. Ware There is an increasing interest in the use of 'real world' data to understand the impact of pain across the lifespan. Technological advances in data capture and management using electronic medical records and mobile devices have allowed considerable access to people suffering with chronic pain to be able to systematically capture their experiences and responses to therapy. This symposium offers an opportunity to interact with researchers who have considerable experience in designing, developing and implementing registries in the pediatric and adult populations and around the medical use of cannabis. A wide range of pragmatic issues will be covered. This symposium will be of interest to anyone who is considering, or who is in the process of, setting up a registry; who wishes to know how registries can be accessed and used; and who is interested in the research implications in this relatively new approach to pain research and management.
Opioid Analgesics: Bridging the Preclinical and Clinical Perspectives	2016-05-25	2016-05-25	11:00 AM	12:30 PM	2016-05-25 11:00 AM - 12:30 PM Presenter: Lori Montgomery, Louis Gendron, Tuan Trang Opioid analgesics are essential pharmacological tools for treating pain. The consumption of opioids is highest in Canada and the United States, and its increasing prevalence has resulted in a striking rise in opioid related deaths. Chronic opioid use can result in a loss of pain reliving effects (tolerance), paradoxical pain (hyperalgesia), and dependence. This workshop brings together basic scientists and clinicians to discuss recent advances in understanding the cellular underpinnings of these adverse opioid effects, and the clinical translation of such discoveries in patients.
Physiological Indicators of Pain: Uncovering the Benefits and Challenges Using the Context of Infancy.	2016-05-25	2016-05-25	11:00 AM	12:30 PM	2016-05-25 11:00 AM - 12:30 PM Presenter: Ruth Grunau, Liisa Holsti, Jordana Waxman Across the lifespan, the first step in managing pain is accurate assessment. Much work has been conducted using multi-modal assessment that integrates behavioural, state, and physiological indicators. However, literature has found divergence among different types of indicators. This symposium is aimed at clinicians and researchers who would benefit from a detailed discussion of what current physiological indices and techniques for capturing these indices provide to advance our understanding of pain experience. Infancy is an excellent developmental stage to use to stimulate discussion because, as a result of the lack of self-report, a plethora of work has been done on measurement of physiological indices in the pain context. Despite the proliferation and validation of multiple physiological indicators of infant pain, there has been a lack of consolidation in studies investigating pain experience using these various physiological variables. This lack of synthesis in pain research limits our ability to interpret, assess, and manage infant pain. The overall goals of this symposium are to discuss the divergence and convergence of early life responses to, and measures of early procedural pain using state-of-the-art physiological indices, such as functional magnetic imaging (fMRI), electroencephalography (EEG), near infrared spectroscopy (NIRS), and cardiac measures. The benefits and challenges of using these physiological indices in acute pain in preterm and term born infants will be discussed. The chair of the symposium will act as a discussant following the final talk to pose bigger picture questions regarding the measurement of physiological indices of pain and their role in future pain research. Key questions for discussion will encompass the lack of pragmatic and conceptual congruence between different indicators of pain (i.e. physiological, neurochemical, behavioural, cognitive, affective) across infancy.
Lunch/Posters/Tradeshow	2016-05-25	2016-05-25	12:30 PM	1:30 PM	2016-05-25 12:30 PM - 1:30 PM
Advances in Acute Pain Research: Evidence in Improving Patient Pain-related Outcomes	2016-05-25	2016-05-25	1:30 PM	3:00 PM	2016-05-25 1:30 PM - 3:00 PM Presenter: Dr. Celine Gelinas, Dr. Mona Sawhney, Dr. Sheila O'Keefe-McCarthy Historically, much attention in pain science has focused on clinician's understanding of basic pain mechanisms, the complexity of nociception and sensitization and the development of persistent or chronic pain syndromes. This symposium will present current data on the latest acute pain research and discuss potential implications for pain assessment and management in clinical practice. Delegates will have the opportunity to hear from three Canadian researchers who examine acute pain within the acutely ill, post-operative and cardiovascular context.
Chasing Moving Targets: Challenges & Opportunities to Enhance Pain Management Practices Targeting Healthcare Professionals, Families & Policy Makers	2016-05-25	2016-05-25	1:30 PM	3:00 PM	2016-05-25 1:30 PM - 3:00 PM Presenter: Bonnie Steven, Christine T. Chambers, Anna Taddio Despite decades of research to establish effective pain-relieving interventions, inadequate pain management persists for acute procedural pain in hospital and community settings. Reversing this trend and enhancing pain assessment and management practices to improve individual and organizational outcomes requires novel knowledge translation strategies developed specifically for key groups of stakeholders. In this symposium, we will highlight research and knowledge translation projects designed to engage three different groups of stakeholders including healthcare professionals, families and policy makers in targeted practice change initiatives. Targeting is important as it allows for tailoring of key messages and knowledge translation approaches that will be most relevant and meaningful for the particular audiences. Implementation and intervention effectiveness outcomes to enhance pain practices and outcomes will be discussed.
Cognitive Dysfunction, Disruption and Biases in Pain	2016-05-25	2016-05-25	1:30 PM	3:00 PM	2016-05-25 1:30 PM - 3:00 PM Presenter: David Seminowicz, Melanie Noel, Bruce Dick As an evolutionary warning signal, pain by its very nature captures attention, engages retrieval of memories, and leads to learning, problem solving, and decision-making. Consequently, as a priority stimulus, pain can also serve to disrupt cognitive processes, which can further shape the pain experience. The field of pain research is establishing the important role of cognitive dysfunction, disruption, and biases in trajectories of pain over time; however, underlying mechanisms are only beginning to be understood. Attentional and memory biases, expectancies, executive functioning and working memory disruption function at conscious and unconscious levels to influence the individual in pain. These cognitive processes are also targeted in and altered by pain treatments. Better understanding of the connection between cognition and pain could lead to improved treatment and address the growing epidemic of chronic pain in childhood and adulthood. This workshop will present the current state-of-the-science on the relationship between cognition (attention, expectancies, memory, executive functioning) and pain across childhood, adolescence, and adulthood. It will consist of a panel of scientists from Canada and the United States examining this topic using a variety of innovative methodologies and approaches (clinical, experimental, neuroimaging; quantitative, qualitative), populations (pediatric, adult; acute and chronic pain), and perspectives (neuroscience, clinical, developmental).
Novel Strategies aimed at addressing common Chronic Pain problems patients present with in the Primary, Tertiary and Palliative Care Settings	2016-05-25	2016-05-25	1:30 PM	3:00 PM	2016-05-25 1:30 PM - 3:00 PM Presenter: Marc Klasa, Hance Clarke, Cindy Shobbrook Chronic pain conditions are common, affecting nearly 1/3 of Canadians, & likely to increase with increasing average age of our Canadian population. Team-based Chronic Pain management is expanding with patient care in Family Medical Homes with Primary Care Network support, & that encompasses: physical, psychosocial, & pharmacological therapies. Pharmacological therapy may include use of opiate medications, which can serve a role in allowing patients to expand participation in the physical therapy that's essential for functioning. However, a common side-effect of opiate therapy can impact patients quality of life & limit comfort in participating in non-pharmacological therapies, namely opiate-induced constipation. It is therefore essential that practitioners be cognizant of this, & be aware that because patient's primary symptoms of their pain condition improve with opiate therapy they are often averse to bring up this side-effect. This session will discuss assessment for potential presence of opiate-induced constipation & review novel therapeutic options.
Coffee/Posters/Tradeshow	2016-05-25	2016-05-25	3:00 PM	4:00 PM	2016-05-25 3:00 PM - 4:00 PM
Complex pelvic pain in women: the BC experience	2016-05-25	2016-05-25	4:00 PM	5:30 PM	2016-05-25 4:00 PM - 5:30 PM Presenter: Dr. Christina Williams, Dr. Catherine Allaire, Dr. Paul Yong Since 2011, the government of British Columbia has funded the BC Women’s Centre for Pelvic Pain and Endometriosis, a tertiary referral centre and interdisciplinary clinic for women with pelvic pain (womenspelvicpainendo.com). The centre integrates gynaecologic management (including advanced laparoscopic endometriosis surgery) with pain education, pelvic physiotherapy, and psychological approaches to pain management. The goal of this symposium is to discuss recent advances and controversies in the pathophysiology, diagnosis, and treatment of complex pelvic pain in women. Talks will cover gynaecologic pelvic pain, non-gynaecologic pelvic pain, and sexual pain (dyspareunia). We will review the literature, results from our prospective research cohort (~1000 patients), and our clinical experience.
I feel your pain: The social neuroscience of empathy for pain and touch	2016-05-25	2016-05-25	4:00 PM	5:30 PM	2016-05-25 4:00 PM - 5:30 PM Presenter: Loren Martin, Robert Bonin, Philip Jackson It is well known that social context robustly affects pain levels and outcomes in chronic pain patients. Direct effects of varying social context on laboratory pain sensitivity have also been demonstrated, but prove to be complex. It is of considerable surprise to many that social contexts and social interactions affect pain sensitivity in laboratory animals but such observations have been made, and interest in the topic is growing. In particular, pain elicits behaviors in humans and nonhuman animals that serve as social cues. Pain behaviors serve a communicative function in humans, and this may be true as well in other animals. Increasingly, data supports the ability of social contact, empathy, social buffering, and social stress to modulate pain sensitivity and pain behavior in mice and rats. However, in order to understand and appreciate the social modulation of pain, studies in laboratory animals as well as humans need to be integrated. We propose a symposium to discuss the important influence of social interactions and environmental context on pain responses and empathic behaviour in mice and people. In addition to our findings, we will discuss issues related to the feasibility and conduct of animal as well as human studies examining questions pertinent to the social modulation of pain. Our goal is to engage clinicians with pain neuroscientists to address how basic and clinical scientists can best address these complex questions.
Perspectives on and Best Practices for Patient Engagement in Pain Research, Clinical Practice and Health Systems Improvement	2016-05-25	2016-05-25	4:00 PM	5:30 PM	2016-05-25 4:00 PM - 5:30 PM Presenter: Patricia Poulin, Isabel Jordan, Maria Hudspith Patient engagement is increasingly being seen as an essential element of research, knowledge translation and health system change. This session will provide diverse perspectives on patient engagement, examining it in the context of a national research initiative, patient and caregiver advocacy and empowerment, clinical practice, organizational development and systems transformation. An integrated theoretical model for patient engagement will be illustrated with examples from a diversity of initiatives in a variety of health care contexts. Panelists will discuss engagement theory and practice from three unique perspectives: a researcher, a caregiver and patient, and a community organizer/system strategist.
The Role of Families in Pain Experiences Across the Lifespan	2016-05-25	2016-05-25	4:00 PM	5:30 PM	2016-05-25 4:00 PM - 5:30 PM Presenter: Kristen Higgins, Rebecca Pillai Riddell, Lucia Gagliese Family members are key social influences on people in pain and can contribute to how pain and disability are managed. Additionally, family members of a person in pain may also be affected by that person's experiences. A number of theoretical models have addressed the ways that family members influence one another in pain (e.g., Palermo & Chambers, 2005; Sullivan, 2012). This symposium will examine the role that families play in the experience of pain in a number of different contexts. We will discuss research in multiple types of pain (acute, chronic, cancer pain), examining the roles of different family members (children, parents, spouses). We will take a developmental approach to examining this topic, including research on pain across the lifespan from preschool to older adulthood. Three different talks will present examples of the research on this topic in different pain contexts: the role of caregivers in how preschoolers approach immunization pain; parental chronic pain and its effects on offspring; and the impact of cancer pain on marital relationships and spousal well-being in younger and older adults. Directions for future research in this area will be discussed. Future pain research will benefit from increased consideration of the role that family members play in pain experiences and management. Increased understanding of these influences will also assist in developing clinical interventions to better support all family members affected by pain.
Neuropathic SIG	2016-05-25	2016-02-25	5:30 PM	7:00 PM	2016-05-25 5:30 PM - 2016-02-25 7:00 PM
Nursing SIG	2016-05-25	2016-05-25	5:30 PM	7:00 PM	2016-05-25 5:30 PM - 7:00 PM

May 26, 2016

	Start Date	End Date	Start Time	End Time
Breakfast	2016-05-26	2016-05-26	7:00 AM	8:30 AM	2016-05-26 7:00 AM - 8:30 AM
Opioids in the Management of Pain, Maintaining the Appropriate Balance. CRISM (Canadian Research Initiative on Substance Misuse)	2016-05-26	2016-05-26	7:15 AM	8:30 AM	2016-05-26 7:15 AM - 8:30 AM Presenter: Mary Lynch, Hance Clarke, Dwight Moulin The Opioid working group from CIHR, the CRISM (Canadian Research Initiative on Substance Misuse) published a commentary on the Prevention of opioid misuse in 2015 (in Pain Research and Management). It was stated that we recognize: 1) the rise in morbidity and mortality associated with opioid misuse and the risk of addiction, 2) the right of a person with pain to have access to appropriate pain treatment (http://www.iasp-pain.org/DeclarationofMontreal, including nonpharmacotherapeutic approaches (e.g. Physiotherapy, interdisciplinary care) 3) the need to provide access to other front line pharmacotherapeutic options 4) we support the 2010 Canadian Guideline for the safe and effective use of opioids for chronic non-cancer pain. http://nationalpaincentre.mcmaster.ca/opioid/. However, we also deplore inadequate access to appropriate pain care in Canada (mainly in rural or low income urban areas) and the absence of newer medications with high effectiveness and low harm. It is important to optimize pain management while addressing risk prevention.
Opening Remarks	2016-05-26	2016-05-26	8:30 AM	8:45 PM	2016-05-26 8:30 AM - 8:45 PM
Plenary Speaker: Does exercise increase or decrease pain? Underlying mechanisms and clinical implications	2016-05-26	2016-05-26	8:45 AM	9:30 AM	2016-05-26 8:45 AM - 9:30 AM Presenter: Dr. Kathleen Sluka Regular physical activity (exercise) can reduce pain in people with chronic musculoskeletal pain; whereas, unaccustomed exercise can exacerbate pain. This apparent dichotomy in pain response to physical activity is poorly understood, making exercise prescription for individuals with pain challenging. Dr. Sluka will present ongoing research examining the neurobiological mechanisms underlying the increased pain with an acute bout of exercise, and compare these to the mechanisms that decrease pain with regular physical activity using animal models of pain. She will translate these findings to clinical studies in people with chronic pain and provide clinical recommendations.
Early Career Award Keynote: Transitional Pain Medicine: Perioperative Care as a Model for Novel Chronic Pain Treatments	2016-05-26	2016-05-26	9:30 AM	10:00 AM	2016-05-26 9:30 AM - 10:00 AM Presenter: Dr. Hance Clarke The role of the perioperative physician continues to evolve. Research over the past decades has identified risk factors that predispose patients to the development of chronic postsurgical pain. Dr. Clarke’s program of research has taken the field of perioperative medicine to the next logical step, implementing strategies aimed not only at the reduction of acute pain, but also on effective strategies to modify/manage risk factors that are associated with the development of CPSP and long-term pain disability as a consequence of surgery/hospital interventions. Dr. Clarke will discuss the development and implementation of a Transitional Pain Program that enables close monitoring of pain, opioid medications and mental health vulnerabilities that place certain patients at a higher risk of developing chronic postsurgical pain. Beyond in-hospital interventions, he is working to scale the Transitional Pain Program post-discharge, involving community partners to tackle the current public health crises of pain and opioid addiction. Current inappropriate perioperative practice habits will be discussed and key changes in policies suggested.
Coffee/Posters/Tradeshow	2016-05-26	2016-05-26	10:00 AM	11:00 AM	2016-05-26 10:00 AM - 11:00 AM
Chronic pain hurts the pocketbook, too. Understanding the economic impact of chronic pain for the individual and the government payer.	2016-05-26	2016-05-26	11:00 AM	12:30 PM	2016-05-26 11:00 AM - 12:30 PM Presenter: Mary-Ellen Hogan , Cornelius (Neels) Groenewald, Manon Choinière There is a large economic cost associated with chronic pain, in addition to its physical, emotional, and social impacts. Despite this, little information on the cost of chronic pain is available. Understanding how much is spent on chronic pain can help organizations plan and coordinate care, inform priorities for research and expose disparities in care across subgroups or regions. Cost estimates also provide reference data for cost-effectiveness and cost-utility analyses which are important in the evaluation of new programs or technologies to manage chronic pain. We will provide attendees with an overview of measurement and costing methodology for cost-of-illness studies and the application to chronic pain. We will present results of recent research from Canada and the United States on the cost of chronic pain in adult and pediatric populations. Our research includes comprehensive costing data from the point of view of the individual, the government payer and society. We used different approaches to answer similar questions and we will compare and contrast these methods and design issues including: using patient-reported data versus large administrative datasets, patient selection or case identification, healthcare setting and data analysis. We will also discuss the application of this research to policy, planning and cost-effectiveness studies.
Over-the-counter treatments in children and adolescents with every day, recurrent and chronic pain: Perspectives from Canada and Norway	2016-05-26	2016-05-26	11:00 AM	12:30 PM	2016-05-26 11:00 AM - 12:30 PM Presenter: Sølvi Helseth, Siv Skarstein, Jennifer Stinson Little is known about the use of over-the-counter (OTC) and complementary and alternative treatments in children and adolescents for every day, recurrent and chronic pain problems. Pain is most often managed in the school and home setting and by primary care practitioners, while a small proportion are referred to specialized multidisciplinary pain clinics. These patients often use OTC oral and topical medications to manage pain while they seek specialized treatment. It is essential that we understand the reasons and patterns of use of these therapies so that health care providers working in a variety of settings can provide appropriate education and guidance. Furthermore, no work to date has examined whether there are differences in use by country. This workshop will outline several studies in Canada and Norway that have recently examined these issues and discuss implications of this work and future directions for research.
Persistent postoperative neuropathic pain following spine surgery	2016-05-26	2016-05-26	11:00 AM	12:30 PM	2016-05-26 11:00 AM - 12:30 PM Presenter: Philip Peng, Mohammed F. Shamji, Anuj Bhatia Persistent postoperative neuropathic pain (PPNP) occurs in a significant fraction of patients following structurally corrective spinal surgery. Preoperative identification of patients prone to such condition has proven challenging, and consequently the attendant pain, disability, and economic impact of this disease is substantial. This symposium will seek to educate clinicians about the epidemiology and diagnosis of PPNP as well as interventional and surgical solutions to provide for improved quality of life.
Supraspinal Mechanisms Contributing to Chronic Pain	2016-05-26	2016-05-26	11:00 AM	12:30 PM	2016-05-26 11:00 AM - 12:30 PM Presenter: David A. Seminowicz, Marco Martina, Laura S. Stone Changes in brain structure and cortical function have been reported in many chronic pain conditions. Affected brain regions may include the prefrontal cortex, the amygdala and the nucleus accumbens; regions that are associated with pain-related co-morbidities such as depression, anxiety and impaired emotional decision-making ability. While much has been learned at the level of the dorsal root ganglia and the spinal cord, to date very little is known about mechanisms underlying pain-related structural and functional brain abnormalities. The goal of this session is to highlight recent work investigating pain-related neuroplasticity at the systems, cellular and molecular levels in supraspinal structures. Dr. Seminowicz will begin the session by providing a broad overview of current research in neuroplasticity in supraspinal structures in chronic pain followed by a discussion of how rodent neuroimaging studies can supplement the findings from human neuroimaging studies. Dr. Martina will address the involvement of the limbic system in chronic pain and focus on the prefrontal cortex and the nucleus accumbens. Dr. Stone will discuss the role of epigenetic regulation of gene expression in supraspinal structures in chronic pain. Speakers will ensure that each presentation is accessible to individuals from a wide range of backgrounds and expertise. 30 minutes will be reserved for an interactive question and answer period will follow the presentations.
Lunch/Posters/Tradeshow	2016-05-26	2016-05-26	12:30 PM	1:30 PM	2016-05-26 12:30 PM - 1:30 PM
An update on novel uses of patient-reported outcomes (PROs) for assessment, prevention, and rehabilitation of pain problems	2016-05-26	2016-05-26	1:30 PM	3:00 PM	2016-05-26 1:30 PM - 3:00 PM Presenter: David Walton, Joy MacDermid, Jordan Miller Pain is an inherently invisible experience, meaning the current "Gold Standard" is patient report of their experience. Patient-Reported Outcomes (PROs) are endorsed as key components of clinical research and treatment, but not all are created equal. PROs can be used for diagnosis, prognosis, theranosis or evaluation, with each type requiring different measurement properties. The field of PRO development, validation and implementation is wide and difficult to understand for even those intimate with measurement theory. In this session, three experts in clinical measurement of pain and pain-related disability will present pragmatic information on up-to-date evidence regarding new and established PROs. Participants will leave with greater understanding of the purpose, development, implementation and interpretation of key PROs with concrete evidence they can immediately apply and a greater understanding of how to critically appraise new pain-related PROs as they come available.
Nerve injury and pain; peripheral and central perspectives	2016-05-26	2016-05-26	1:30 PM	3:00 PM	2016-05-26 1:30 PM - 3:00 PM Presenter: Dr. Mohammed F. Shamji, Dr. Reza Sharif-Naeini, Josiane C.S. Mapplebeck Recently, significant progress has been made in understanding the molecular and cellular mechanisms underlying nerve injury-induced pain in preclinical rodent models. In this symposium, we will discuss the latest integrative research on the peripheral and central influences on neuropathic pain. Dr. Mohammed F. Shamji will present his research on the peripheral mechanisms mediating inflammatory neuropathic pain, including the role of peripheral monocyte lineage cells. Dr. Reza Sharif-Naeini will present data on a novel central cellular mechanism for touch-evoked pain after nerve injury. Josiane C.S. Mapplebeck will address sex differences in the spinal mechanisms mediating mechanical hypersensitivity resulting from nerve injury. This symposium will highlight the disparate array of cellular and molecular mechanisms that interplay following injury to nerves and the challenge this complexity creates in therapeutic development.
Trainee Workshop: The path of least resistance in academia and beyond	2016-05-26	2016-05-26	1:30 PM	3:00 PM	2016-05-26 1:30 PM - 3:00 PM Presenter: Dr. Alexandra T. Greenhill, Dr. Loren Martin, Dr. Chrystal Palaty This workshop is geared towards the trainee members of CPS, but all members are welcome to attend. The workshop consists of a diverse panel of three speakers in different successful careers, and focuses on the paths each speaker took to their profession, as well as the pros and cons. Each speaker will give a presentation, and then there will be a 30 minute question and answer session.
Transition from Acute to Chronic Pain Surgery in Children and Adults: What We Know and Where We Need to Go	2016-05-26	2016-05-26	1:30 PM	3:00 PM	2016-05-26 1:30 PM - 3:00 PM Presenter: Jennifer Rabbitts, Jill Chorney, Brittany Rosenbloom Chronic post-surgical pain (CPSP) is a serious adverse effect of surgery defined as pain that persists for at least two months after surgery. The one-year incidence of CPSP in adults varies with procedure and is generally accepted to be moderate-to-severe in 5-10%. Less is known about pediatric CPSP; recent studies indicate it develops in 20-50% of children 12 months after major surgery. CPSP is associated with longer recovery and increased health care costs. For children it is also associated with disruptions in normal childhood development. Although we are far from being able to predict with certainty who will develop CPSP, a biopsychosocial model helps to better understand the circumstances that lead to the development of chronic pain. Intrapersonal (e.g., pre-operative pain, anxiety, and sleep patterns) and interpersonal variables (e.g., parental pain catastrophizing) play strong roles in surgical outcomes. Knowledge of the risk and protective factors that are associated with CPSP will allow for the development of interventions that target modifiable variables. Overall the aims of this symposium are to (1) examine biomedical, psychosocial, and behavioural risk factors for chronic post-surgical pain, (2) present trajectories for pain following surgery, and (3) evaluate evidence-based interventions for the prevention or management of CPSP.
Coffee/Posters/Tradeshow	2016-05-26	2016-05-26	3:00 PM	4:00 PM	2016-05-26 3:00 PM - 4:00 PM
Hot Topics Session	2016-05-26	2016-05-26	4:00 PM	5:30 PM	2016-05-26 4:00 PM - 5:30 PM Presenter: J. Mogil, M. Bichin, M.E. Hogan, J. Mapplebeck, K.S. Lichtenwalter, V. Gougeon, P. Forgeron Chair: Jeffrey S. Mogil, PhD, Alan Edwards Centre for Pain Research, McGill University Speakers: · Mark Bichin, BSc, University of British Columbia · Mary Ellen Hogan, BScPhm, PharmD, MSc, University of Toronto · Josiane Mapplebeck, BSc, Hospital for Sick Children · K.S. Lichtenwalter, PhD Candidate, McGill University · Veronique Gougeon, MSc, Sherbrooke University, école de réadaptation · Paula Forgeron, RN, MN, PhD, University of Ottawa EARLY PAIN EXPOSURE AND REGION SPECIFIC BRAIN CORTICAL THICKNESS INTERACT TO PREDICT EXECUTIVE FUNCTION AT 8YRS IN CHILDREN BORN VERY PRETERM Mark Bichin, BSc, University of British Columbia; Cecil MY Chau, Manon Ranger, Steven P Miller, Amanmeet Garg, Mirza F Beg, Kevin Fitzpatrick, Bruce Bjornson, Adele Diamond, Anne R Synnes, Ruth E Grunau PAIN-RELATED MEDICATION USE IN ADULTS 65 YEARS AND OLDER WITH CHRONIC PAIN Mary Ellen Hogan, BScPhm, PharmD, MSc, University of Toronto; Anna Taddio, Joel Katz, Vibhuti Shah, Murray Kran SEX DIFFERENCES IN THE INVOLVEMENT OF MICROGLIA AND KCC2 IN NEUROPATHIC PAIN Josiane C S Mapplebeck, BSc, Hospital for Sick Children; Orla Moriarty, Simon Beggs, YuShan Tu, Jeffrey S Mogil, Michael W Salter DECIPHERING THE ROLE OF MELANOCORTIN 1 RECEPTOR IN PAIN THROUGH SINGLE NUCLEOTIDE POLYMORPHISMS K.S. Lichtenwalter, Ph.D. Candidate, McGill University; R.N. Lichtenwalter, G.D. Slade, R. Dubner, R.B. Fillingim, J.D. Greenspan, R. Ohrbach, C. Knott, W. Maixner, L.B. Diatchenko ASSESSMENT OF CENTRAL PAIN PROCESSING AND AUTONOMIC RESPONSES IN WOMEN WITH PROVOKED VESTIBULODYNIA Véronique Gougeon, Msc, Sherbrooke University, école de réadaptation; Serge Marchand, Annie Morin , Guillaume Léonard, Isabelle Girard, Guy Waddell, Yves-André Bureau, Mélanie Morin FRIENDSHIPS OF TEENS WITH CHRONIC PAIN: HOW DO THEY COMPARE WITH FRIENDSHIPS OF HEALTHY TEENS Paula Forgeron, RN, MN, PhD, University of Ottawa; Christine Chambers, Janice Cohen, Bruce Dick, Christine Lamontagne, G. Allen Finley
Legal issues and neuroethics of brain-imaging based "pain-o-meters": friend or foe?	2016-05-26	2016-05-26	4:00 PM	5:30 PM	2016-05-26 4:00 PM - 5:30 PM Presenter: Karen D. Davis, Tor Wager, Amanda Pustilnik The inherent subjective nature of pain can be a roadblock to confirming its existence. This clinical challenge imposes a hardship for patients to "prove" they have chronic pain without an objective measure acceptable by insurance providers and the courts. Thus, "pain-o-meter" objective tests of pain based on brain imaging has thus become sought after. This workshop will present 1) an overview of the capabilities and limitations of fMRI for this purpose, individual differences, new pain theories for consideration for test development ("dynamic pain connectome" and a brain "pain switch"), and ethical issues pertaining to false negative findings, and the impact on free will and privacy, 2) more advanced technological approaches (e.g., using machine learning and multivoxel pattern theory) that could hold promise for developing pain-o-meter tests, and 3) insight into how the legal system and courts view pain, the brain, admissible evidence, and the impact of pain-o-meter tests on policy.
Spinal Cord Stimulation for the treatment of neuropathic pain	2016-05-26	2016-05-26	4:00 PM	5:30 PM	2016-05-26 4:00 PM - 5:30 PM Presenter: Mohammed F. Shamji, Cecile C. de Vos, Rui V. Duarte Spinal cord stimulation (SCS) for the treatment of neuropathic pain has been available for over forty years and its efficacy has been demonstrated for chronic intractable pain of various aetiologies. However, technological development of SCS therapy has been relatively slow and only recently several new stimulation paradigms and targets have become available, that might allow for broader application of the technology. In this symposium we will give an overview of the current evidence for SCS therapy, the first results of several new forms of SCS and how these new stimulation approaches can be used to target specific patient populations and further personalise pain treatment.
Taking the pain out of studying pain expression: toward abbreviated measurement systems	2016-05-26	2016-05-26	4:00 PM	5:30 PM	2016-05-26 4:00 PM - 5:30 PM Presenter: Kenneth M. Prkachin, Joshua A. Rash, Ahmed Ashraf Several decades of research have established the value of measures of facial expression in the assessment of pain. Studies of humans across the lifespan and in experimental and clinical settings have identified facial actions that covary with and appear to carry specific information about the intensive aspects of pain. Animal studies suggest the presence of homologous expressions in other species. Despite considerable evidence supporting the value of pain assessment via facial expression, applications of facial measurement have been limited in both research and clinical settings primarily because obtaining them is resource-intensive. Highly-trained human observers are still required. Assessment protocols typically involve offline assessment using video recordings played in stop action or frame-by-frame modes, dramatically increasing the amount of time required to quantify outcomes. This symposium focuses on two abbreviated measurement systems, the Index of Facial Pain Expression, an observational system requiring human observers and automated facial analysis, a computer-based approach arising from the field of affective computing. The Index of Facial Pain Expression (IFPE) is a new technique that has been designed to accelerate assessment of human pain expression. It is an observational procedure based on the literature that has characterized pain expression. Following a manual, trainees first learn the characteristic changes produced by four pain-related facial actions. Trainees practice against a set of criterion video recordings and receive feedback about their performance. A final test establishes their reliability against criterion scoring, using several conventional reliability metrics. Researchers and clinicians interested in assessing pain expression have long held out the hope that computer-assisted automated systems could supplement or replace human observers. Applications of advances in computer-vision from the field of affective computing have now shown that the dream of automated computer analysis of facial expression is now feasible. Recent advances toward the development of automated analysis of pain expression will also be presented.
CPS Awards Reception & Gala	2016-05-26	2016-05-26	6:30 PM	11:00 PM	2016-05-26 6:30 PM - 11:00 PM Purchase your ticket and join us as we honour this year's CPS award recipients: Distinguished Career Award - Dr. Alexander John Clark (Capital Health Early Career Award - Dr. Hance Clarke (Toronto General Hospital) Outstanding Pain Mentorship Award - Dr. Joel Katz (York University) Pain Awareness Award - Dr. Christine Chambers (Dalhousie University and IWK Health Centre)

May 27, 2016

	Start Date	End Date	Start Time	End Time
SPOR Chronic Pain Network Information Meeting	2016-05-27	2016-05-27	7:15 AM	8:45 AM	2016-05-27 7:15 AM - 8:45 AM Presenter: Dr. Norm Buckley
Breakfast	2016-05-27	2016-05-27	7:30 AM	8:45 AM	2016-05-27 7:30 AM - 8:45 AM
Opening Remarks	2016-05-27	2016-05-27	8:45 AM	9:00 AM	2016-05-27 8:45 AM - 9:00 AM
Plenary Speaker: Ethical Implications of Innovations in Clinical Trial Design and Conduct	2016-05-27	2016-05-27	9:00 AM	9:45 AM	2016-05-27 9:00 AM - 9:45 AM Presenter: Dr. Michael Rowbotham In the past decade, a variety of novel clinical trial designs have entered widespread use, such as the EERW (Enriched Enrollment Randomized Withdrawal) design and adaptive trial designs. All share goals of reducing the placebo effect, reducing sample size requirements, and shortening the time from ‘first-in-man’ study to final registration trial. Most large registration trials are international efforts, and narrow subject enrollment time windows puts pressure on sites to rapidly screen and enroll subjects. The magnitude of fraudulent enrollment, either through intentional misrepresentation by subjects or study site personnel, remains unknown but puts trial validity and subject safety at risk. Finally, success in finding and validating objective biomarkers that can be used to more precisely target patients most likely to benefit lags far behind cancer therapy, where it is the norm. Practical and ethical aspects of all three themes will be reviewed.
Plenary Speaker: “Listening” & “Talking” to Neurons: Clinical implications of glial dysregulation of pain, opioid actions & drugs of abuse	2016-05-27	2016-05-27	9:45 AM	10:30 AM	2016-05-27 9:45 AM - 10:30 AM Presenter: Dr. Linda Watkins “Listening” & “Talking” to Neurons: Clinical implications of glial dysregulation of pain, opioid actions & drugs of abuse - Moving from Concept to Clinical Trials! Work over the past 25 years has challenged classical views of pain and opioid actions as being mediated solely by neurons. Glia are key players in chronic pain, compromising the opioid efficacy for pain control, enhancing tolerance and dependence/withdrawal, and contributing to drug reward from opioids and other abused drugs. Further, glia can be “primed” so to contribute to pain chronification. Intriguingly, the glial activation receptor creating neuroinflammation under conditions of chronic pain is the same receptor that is activated by opioids and other abused drugs, unique from the neuronal opioid receptor. Indeed, clinically-relevant therapeutics targeting this glial activation receptor in particular or glially-drive neuroinflammation more generally have shown remarkable efficacy as stand alone treatments for neuropathic pain, improving the clinical utility of opioids and suppressing drug abuse. As such therapeutics are rapidly moving toward clinical trials, translation to humans of data from rodents, horses, and pet dogs is approaching.
Coffee	2016-05-27	2016-05-27	10:30 AM	11:00 AM	2016-05-27 10:30 AM - 11:00 AM
Addressing the rising epidemic of maternal prescription opioid use and associated neonatal consequences	2016-05-27	2016-05-27	11:00 AM	12:30 PM	2016-05-27 11:00 AM - 12:30 PM Presenter: Tim F. Oberlander, Marsha Campbell-Yeo, Lenora Marcellus There is a rising epidemic in the numbers of child bearing women taking prescription opioids, currently more than one-third compared to previous studies reporting only 6-7% of pregnant women. Major risks of prenatal opioid exposure include birth defects, altered brain development, and neonatal abstinence syndrome (NAS). Neonatal Abstinence Syndrome (NAS) has become one of the fastest growing reasons for neonatal hospital admissions. Over the past ten years (2004-2013), NAS incidence has increased 4-fold and the median length of stay for NAS increased from 13 to 19 days, thus leading to 7-fold increases in NICU-days attributed to NAS. Initial data suggest that recent increases in NAS may have resulted from increased use of prescription opioids rather then illicit drugs. There is a need for all care providers across a diverse care spectrum including general care and specialties encompassing pain management, obstetrics, and pediatrics to be aware of the consequences of prenatal opioid exposures, appropriate treatment of mothers and their newborns as well as the often complex medical and social issues associated with these families. The overall aim of this session will be to identify challenges and potential solutions to better manage opioid using women and their exposed newborns during pregnancy and following birth.
From Past to Future: QST to Jedi Mind Tricks	2016-05-27	2016-05-27	11:00 AM	12:30 PM	2016-05-27 11:00 AM - 12:30 PM Presenter: Serge Marchand, Pam Squire, Owen Williamson Chronic pain is a complex phenomenon and two patients with an apparent similar clinical tableau could in fact results from totally different mechanisms that will not respond to the same treatment. The most important challenge is to find a way to better target patients who will respond to a specific treatment. Being able to phenotype chronic pain patients based on the mechanisms involved in their pathology seems to be the best way to reduce the trial-error process of current pain treatment algorithms. Too often published papers describe the common symptoms of patients with these mechanisms and outline the pathophysiology but fail to describe how to perform an examination that would document the presence or absence of these mechanisms. Recent studies have highlighted the fact that relatively simple quantitative sensory tests (QST) are able to identify/distinguish between central excitatory (temporal summation) or inhibitory (Conditioned Pain Modulation) deficits in patients suffering from chronic pain. Other examination techniques can demonstrate body perception disturbance. This workshop will demonstrate how to use standardized tools to demonstrate these physical examination techniques.
New insights into neuropathic pain in breast cancer	2016-05-27	2016-05-27	11:00 AM	12:30 PM	2016-05-27 11:00 AM - 12:30 PM Presenter: Faraj Abdallah, Lynn R Gauthier, Patricia Poulin Breast cancer is the most commonly diagnosed cancer among Canadian women. With increased focus on screening and advances in treatments, survival rates have improved dramatically. Unfortunately, many breast cancer survivors may be left with lasting treatment-related pain long after their cancer has been resected. Neuropathic pain may be especially common and it is associated with substantial disability and distress. It may also be particularly refractory to pharmacologic management. There remain many gaps in our knowledge about its development and which measurement tools should be used to assess neuropathic pain in this population. Thus, a better understanding of neuropathic pain in breast cancer, including novel prevention and inter-disciplinary management strategies, is critical. The overall aim of this symposium is to present new research into the prevention, development, and management of neuropathic pain in breast cancer.
Virtual Reality and Pain: A New Frontier or Smoke and Mirrors?	2016-05-27	2016-05-27	11:00 AM	12:30 AM	2016-05-27 11:00 AM - 12:30 AM Presenter: Bernie Garrett, Diane Gromala, Jeffrey I. Gold Virtual Reality (VR) involves an artificial three-dimensional (3D) environment that is experienced by a person through sensory stimuli (usually visual, aural and often touch) delivered by a computer and in which one's actions partially determine what happens in the environment. The sense of immersion in an VR environment is achieved through visual and auditory stimuli that simulate 3D visual and auditory cues available in the real world. VR environments are hypothesized to reduce pain via non-pharmacologic attentional and distractive mechanisms, although the exact mechanisms remain unclear. The neuromatrix theory suggests that pain is a multidimensional experience produced by "neurosignature" patterns of impulses generated by a widely distributed neural network termed the "body-self neuromatrix" in the brain. VR therapy may work by dampening the acuity of the pain modulation system by acting on the signaling pathways of the neuromatrix, producing analgesia. The use of VR for pain management is in its infancy. This symposium will provide a review of the evidence for and against VR as an adjunctive therapy for acute and chronic pain in adults and children.
Annual Family Physician Lunch Meeting	2016-05-27	2016-05-27	2:00 PM	7:00 PM	2016-05-27 2:00 PM - 7:00 PM Presenter: Maureen Desmarais & Dr. Victor Ng

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