Pain Research

Publication Analysis 1998-2009
by Ralf Neumann, Labtimes 04/2011

Europe... ... and the World Most Cited Authors... ... and Papers

Most Cited Authors - Pictures

England and Germany dominate European pain research almost head to head. Danish articles achieved the highest average citation rate. “Hottest” topics are molecular pain control, migraine and the neuropsychology of pain.

Pain can be a big problem for the individual. The same, however, has obviously been true for biomedical research up until recently. At least, when flicking through current reviews about the mechanisms of pain sensation or visiting websites on pain research groups and institutes you almost always come across sentences like:

  • “Pain is a familiar yet relatively little-understood element of our physiology. Its study can offer insights into our nervous system and treatments for the largely neglected area of chronic pain.” (The London Pain Consortium);
  • “Like neuropathic pain, the cause of chronic pain in these common conditions is poorly understood, often leading to suboptimal treatment.” (Brain Research Centre, Vancouver);
  • “Adolescent low back pain (ALBP) is a common form of adolescent morbidity which remains poorly understood.” (Journal of Pain Research, 2010, vol. 3:57).

More complex than previously realised

You can easily find many more similar quotes basically agreeing to the conclusion that, on the one hand, research and knowledge about pain have clearly increased in recent years – but on the other hand, the “pain problem” has turned out to be far more complex than previously realised. Or, as the Pain Research Center at the University of Utah explains in more detail:

“Although the mechanisms of pain and pain pathways are becoming better understood, it should be emphasized that an individual’s perception of pain and appreciation of its meaning are complex phenomena that involve psychological and emotional processes in addition to activation of nociceptive pathways. Pain intensity is not proportional to the type or extent of tissue damage but may be influenced at many sites within the nervous system.”

Given this complexity, it becomes clear that pain research is fuelled from quite a number of “classical” disciplines. And those are not only the “obvious” ones, like anaesthesiology, neurology, physiology and pharmacology, but also include certain groups from molecular biology and biochemistry as well as from experimental psychology, social medicine and epidemiology. The consequence being that, when comparing in this publication analysis, for example, molecular pain researchers with “pain and public health” experts, we might well face the same “apples-and-oranges” problem as in many other biomedical fields.

European ups and downs

However, this is not the only issue where caution must be exercised when performing a comparative publication analysis of European pain research. In addition, there is also a technical problem. While it is easy to assemble a list of expert journals specialising in pain or anaesthesiology research, a far bigger task lies in sniffing out every “pain-relevant” article, which appeared in multidisciplinary journals like Nature, Science, New England Journal of Medicine or The Lancet. And since Thomson Reuter’s database Web of Science, which was used for this analysis, doesn’t provide any reliable tools to automatically extract “pain articles” from those multidisciplinary journals, we therefore had to omit them, at least in the part of the analysis comparing the publication output of the individual countries (see tables on this page). This way, some of the most prominent papers in the field are certainly not included. However, despite this limitation, we nevertheless believe that a survey, restricted to the specialist journals only, still provides sufficiently valid indicators for the countries’ overall productivity in pain research. On the contrary, rankings of the most-cited researchers and papers (see tables, p. 38) could be analysed from publications in all journals.

Given this directive, let’s see how the publication performance in pain research during the period 1998-2009 is distributed among the individual European countries. In terms of both, total numbers of papers and overall citations, England climbed to the top position only slightly ahead of Germany. At the same time, however, each of the two more than doubled the result of France in third place. Strong performers, when compared to earlier analyses of other biomedical fields, were Netherlands (4th) and Denmark (5th), whereas Spain (14th) ranked considerably lower than usual.

When comparatively small countries achieve high total citation numbers, the underlying reason is usually a high average rate of citations per article. Accordingly, Denmark with its 16.4 citations per article is Europe’s leader of pain research in this respect, followed by the Netherlands and Norway (both 12.9).

Part-time versus full-time pain researchers

When totalling all articles in pain research journals, which appeared between 1998 and 2009 with at least one author from an European institution, “Europe” outperforms its eternal scientific rival, the USA, more clearly than in many other biomedical fields. Despite a higher average citation rate of US articles in the pain research journals (9.7 vs. 7.9), Europe nevertheless topped their US colleagues by a 30% higher number of total citations due to producing almost 60% more articles (43,400 vs. 27,200).

The five most-cited European “pain articles” from the period 1998-2009 reveal an unexpected picture: rankings 1 and 3, which deal with the molecular players of pain initiation and control, are flanked by three papers on neuropsychological aspects of pain sensation.

Accordingly, these two groups are also represented in the list of the thirty most-cited European pain researchers: three neuro­psychologists, for example, Johan Vlaeyen (13th) and seven molecular pain researchers headed by Vincenzo di Marzo, who by far collected the most citations of all European pain researchers.

Di Marzo, however, can only be regarded as a “part-time” pain researcher. Being interested in endocannabinoids, he hasn’t restricted his research only to their role in molecular pain control but has also published numerous papers on other actions of those promiscuous neuromodulary lipids – as, for example, in tumour suppression, memory, inflammation, neuroprotection, energy balance and gastrointestinal function.

Hans-Christof Diener, director of the Neurological Clinic of the University Duisburg-Essen, in second place is a similar case as part-time pain researcher. Heading the group of the seven migraine specialists in the list, he also published quite a number of papers on other neurological conditions, such as stroke.

And the remaining 17 in the top 30? Two can be attributed to the field of chronic pain epidemiology, whereas most of the rest – thus, half of the list – are mainly devoted to more clinical questions like pain assessment, pain treatment and anaesthesia.


Articles appearing between 1998 and 2009 in ‘Pain’ or ‘Anaesthesiology’ journals as listed by Thomson Reuter’s Web of Science. The citation numbers are accurate as of March 2011. A country’s figures are derived from articles where at least one author working in the respective European nation is included in the authors’ list. Israel is included because it is a member of many European research organisations and programmes (EMBO, FP7 of the EU...).

Citations of articles published between 1998 and 2009 were recorded up until May 2011 using the Web of Science database from Thomson Reuters. The “most-cited papers” had correspondence addresses in Europe or Israel.


Country Citations Articles Cit./Art.

... and the World

Citations Articles Cit./Art.
New Zealand4.6295318,7

Most Cited Authors...

Citations Articles
1.Vincenzio di Marzo, Endocannabinoid Res. Grp. CNR Pozzuoli19.354312
2.Hans-C. Diener, Neurol. Univ. Duisburg-Essen11.940499
3.Peter J. Goadsby, Headache Grp. Neurol. Univ. Coll. London (s. 08 USA)10.760264
4.Lars Arendt-Nielsen, Ctr. Sens.-Motor Interact. (SMI) Aalborg Univ.9.072473
5.Henrik Kehlet, Surg. Pathophysiol. Rigshosp. Copenhagen Univ.8.905226
6.Stephen B. McMahon, Wolfson Ctr. Age-Rel. Dis. King’s Coll. London7.891108
7.Troels S. Jensen, Danish Pain Res. Ctr. Aarhus Univ. Hosp.7.064200
8.Michel D. Ferrari, Neurol. Leiden Univ. Med. Ctr.6.376157
9.Stein Kaasa, Pain & Palliat. Res. Grp. Norw. Univ. Sci. & Tech. Trondheim6.367150
10.Jes Olesen, Neurol. Glostrup Univ. Hosp. Copenhagen5.539174
11.John B. Davis, Neurology GlaxoSmithKline R&D LtdHarlowUK5.33052
12.Gerd Geisslinger, Clin. Pharmacol. Univ. Hosp. Frankfurt5.148199
13.Johan W.S. Vlaeyen, Clin. Psychol. Sci. Univ. Maastricht5.060125
14.Herta Flor, Clin. & Cogn. Neurosci. Ctr. Inst. Mental Hlth. Univ. Heidelberg5.022132
15.Bart W. Koes, Gen. Practice Erasmus MC Univ. Med. Ctr. Rotterdam4.729187
16.Gary Macfarlane, Epidemiol. Pain Res. Collab. Univ. Aberdeen4.516145
17.Henry J. McQuay, Clin. Anaesth. Univ. Oxford4.496109
18.Martin Schmelz, Anesthesiol. Med. Fac. Mannheim Heidelberg Univ.4.394156
19.Maurits van Tulder, Health Sci. VU Univ. Amsterdam4.327133
20.Rolf-D. Treede, Neurophysiol.Med. Fac. Mannheim Heidelberg Univ.4.286111
21.Geert Crombez, Exp.-Clin. and Health Psychol. Ghent University4.159136
22.Jean Schoenen, Headache Res. Unit Neurol. Univ. Liège4.069138
23.Volker Höllt, Pharmacol. Univ. Magdeburg4.032116
24.Arne May, Syst. Neurosci. Univ. Hosp. Eppendorf Hamburg3.989151
25.John N. Wood, Wolfson Inst. Biomed. Res. Univ. Coll. London3.98866
26.Martin Koltzenburg, MRC Ctr. Inst. Neurol. Univ. Coll. London3.97765
27.Anthony H. Dickenson, Neuropharmacol. Univ. Coll. London3.905118
28.Giuseppe Nappi, Headache Sci. Ctr. Univ. Pavia3.895244
29.Martin Tramèr, Anaesthesiol. Univ. Hosp. Geneva3.82480
30.R. Andrew Moore, Pain Res. & Clin. Neurosci. Univ. Oxford3.769112

... and Papers

1.Davis, JB; Gray, J; Gunthorpe, MJ; [...]; Bingham, S; Randall, A; Sheardown, SA
Vanilloid receptor-1 is essential for inflammatory thermal hyperalgesia.
NATURE, 405 (6783): 183-187 MAY 11 2000
2.Singer, T; Seymour, B; O’Doherty, J; Kaube, H; Dolan, RJ; Frith, CD
Empathy for pain involves the affective but not sensory components of pain.
SCIENCE, 303 (5661): 1157-1162 FEB 20 2004
3.Calignano, A; La Rana, G; Giuffrida, A; Piomelli
Control of pain initiation by endogenous cannabinoids.
NATURE, 394 (6690): 277-281 JUL 16 1998
4.Ploghaus, A; Tracey, I; Gati, JS; Clare, S; Menon, RS; Matthews, PM; Rawlins, JNP
Dissociating pain from its anticipation in the human brain.
SCIENCE, 284 (5422): 1979-1981 JUN 18 1999
5.Crombez, G; Vlaeyen, JWS; Heuts, PHTG; Lysens, R
Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.
PAIN, 80 (1-2): 329-339 MAR 1999

Last Changed: 31.03.2012