Figure 2.

Top: Concept of Centers of Excellence. Piecemeal science suffers from the inability to tackle large problems. Integrated approaches offer a focus on the problem at hand and bring together patients, scientists, and clinicians. The figure depicts the pain patient population as the focus of such a center. Interactions across scientific and clinical disciplines would occur through the center. Multiple processes converge, from clinical and brain imaging phenotype together with genomic information, to evaluation of responders and nonresponders, to current or new treatments.

Bottom: Focus on Targeting Major Chronic Pain Conditions. The figure captures a few salient points: (1) Chronic pain conditions vary in terms of incidence and prevalence. Some conditions are highly prevalent (e.g. osteoarthritis), while others are rare but represent specific gene-based diseases (e.g. hemiplegic migraine). (2) A vision for the development of centers of excellence that focus on a specific chronic pain subtype. These may be constituted through single-site or consortia arrangements; the latter may include academia, government, and industry.