An Update on Precision Pain Medicine: Na+ Channel Disorders

There has been an explosion in our understanding of the genomic, molecular, and cellular biology data to diagnose health and disease conditions in the last few decades. The article by N. Mohamad et al., on MDMA neurotoxicity, is a true example of this new area of medicine (۱). Pain Medicine concepts are also shifted to better understanding pain syndrome and treatment based on understanding the cellular dysfunction at the level of channels. First, it started with an interesting report on a rare phenomenon of complete congenital inability to sense pain in three consanguineous families from northern Pakistan. Cox paper in nature (۲). showed the mutation gene SCN۹A would affect the alpha-subunit of the voltage-gated sodium channel (Na V۱.۷) and loss its function, which is essential in controlling the upstroke of action potential and transmitting current waves alongside all neuron subunits. The study by McDermott also supports of channelopathy induced by a mutation in the sodium channels can produce complete insensitivity to pain by looking at the fMRI (۳).