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This thesis investigates neuropathic pain prevalence, stratification, brain functional connectivity, and sensory profiles in women with endometriosis-associated pain using questionnaires, fMRI, and quantitative sensory testing.
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by qwen3.7-flash, 2026-09-09
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This doctoral thesis investigates the prevalence and characteristics of neuropathic pain within women suffering from endometriosis-associated pain using online questionnaires, functional magnetic resonance imaging, and quantitative sensory testing. The research analyzes how sensory symptom profiles correlate with psychological function, surgical history, and treatment response while examining central nervous system changes in brain connectivity. Key findings highlight distinct stratification possibilities for patients based on sensory data and demonstrate significant alterations in sensory processing mechanisms specific to this condition. This paper is centrally about endometriosis — specifically focusing on the neuropathic components of chronic pelvic pain associated with the disease.
Abstract
Chronic pelvic pain is one of the main symptoms of endometriosis which affects 1 in 10 women of reproductive age. Historically, despite the prevalence of this condition and the impact it has on those affected, endometriosis-associated pain (EAP) has been poorly understood. In this thesis I explore endometriosis-associated pain, specifically the presence of neuropathic pain (pain due to lesion/disease of the somatosensory system). To do this, I use a variety of different techniques including questionnaires, functional magnetic resonance imaging (fMRI) and quantitative sensory testing (QST). To determine the prevalence of neuropathic pain in a large population is difficult. In this thesis I use an online questionnaire on patient support websites to give an estimation of the proportions of women experiencing neuropathic pain. I investigate differences between those with and without neuropathic pain with respect to pain symptoms, psychological and cognitive function, number of surgeries to the abdomen and duration of pain. I also sub-divided women further based on their sensory symptom profiles. I replicate these findings in a novel cohort and relate them to treatment response. Central nervous system changes have been demonstrated in people with neuropathic pain. In this thesis I investigate the association between neuropathic pain features and functional connectivity of the brain in women with endometriosis-associated pain. Sensory testing is an important aspect of neuropathic pain research and in this thesis I use QST to investigate sensory perception. A range of stimuli are used to determine whether there are changes in sensory processing in women with endometriosis-associated pain. Overall, the aims of the research described in this thesis are to advance knowledge regarding the prevalence of neuropathic pain in endometriosis; how women can be stratified using questionnaires and whether that relates to treatment response; what changes associated with neuropathic pain can be seen in the activity of the brain at rest; and the sensory profiles of women with EAP. Research in the area of EAP is critical to inform clinical practice and improve treatment.
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Thesis
Neuropathic pain in endometriosis
- Abstract:
-
Chronic pelvic pain is one of the main symptoms of endometriosis which affects 1 in 10 women of reproductive age. Historically, despite the prevalence of this condition and the impact it has on those affected, endometriosis-associated pain (EAP) has been poorly understood. In this thesis I explore endometriosis-associated pain, specifically the presence of neuropathic pain (pain due to lesion/disease of the somatosensory system). To do this, I use a variety of different techniques including questionnaires, functional magnetic resonance imaging (fMRI) and quantitative sensory testing (QST).
To determine the prevalence of neuropathic pain in a large population is difficult. In this thesis I use an online questionnaire on patient support websites to give an estimation of the proportions of women experiencing neuropathic pain. I investigate differences between those with and without neuropathic pain with respect to pain symptoms, psychological and cognitive function, number of surgeries to the abdomen and duration of pain. I also sub-divided women further based on their sensory symptom profiles. I replicate these findings in a novel cohort and relate them to treatment response.
Central nervous system changes have been demonstrated in people with neuropathic pain. In this thesis I investigate the association between neuropathic pain features and functional connectivity of the brain in women with endometriosis-associated pain.
Sensory testing is an important aspect of neuropathic pain research and in this thesis I use QST to investigate sensory perception. A range of stimuli are used to determine whether there are changes in sensory processing in women with endometriosis-associated pain.
Overall, the aims of the research described in this thesis are to advance knowledge regarding the prevalence of neuropathic pain in endometriosis; how women can be stratified using questionnaires and whether that relates to treatment response; what changes associated with neuropathic pain can be seen in the activity of the brain at rest; and the sensory profiles of women with EAP. Research in the area of EAP is critical to inform clinical practice and improve treatment.
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(Preview, Dissemination version, pdf, 3.8MB, Terms of use)
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Authors
Contributors
- Division:
- MSD
- Department:
- Clinical Neurosciences
- Sub department:
- Clinical Neurosciences
- Role:
- Supervisor
- Role:
- Supervisor
- ORCID:
- 0000-0001-9249-2492
- Role:
- Examiner
- ORCID:
- 0000-0001-7759-0211
- Role:
- Examiner
- Funding agency for:
- Vincent, K
- Grant:
- Investigator initiated grant
- Programme:
- Bayer AG Investigator initiated grant for Pain Mechanisms in Endometriosis
- Funding agency for:
- Vincent, K
- Grant:
- 777500
- Programme:
- This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No [777500]. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA.
- DOI:
- Type of award:
- DPhil
- Level of award:
- Doctoral
- Awarding institution:
- University of Oxford
- Language:
-
English
- Keywords:
- Subjects:
- Pubs id:
-
1997864
- Local pid:
-
pubs:1997864
- Deposit date:
-
2021-08-12
- ARK identifier:
Terms of use
- Copyright holder:
- Coxon, L
- Copyright date:
- 2021
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