X-ray of one study participant. Implanted electrodes (red) connected to the recording implant are shown.
Prasad Silwarkar
Signs of electrical activity have been identified in the brains of people with chronic pain. Although a small study, the findings may one day lead to more effective treatments.
Chronic pain lasting longer than 3 months affects more than 30% of the world’s population and often has limited efficacy with existing treatments. To help develop new treatments, Prasad Silvalkar and his colleagues at the University of California, San Francisco, set out to better understand how the brain regulates pain.
The researchers implanted electrodes and stimulators into the brains of four people with chronic pain from strokes and amputations. These recorded brain regions are the orbitofrontal cortex (OFC) and anterior cingulate cortex (ACC), which are potentially associated with long-lasting emotional and cognitive aspects of pain, and the researchers are more likely to be involved in chronic discomfort. than some other brain regions associated with short-term pain.
Over the next three to six months, participants completed a pain severity questionnaire multiple times a day. After reporting this, pressing a button recorded his activity in the OFC and ACC for 30 seconds.
Machine learning then associated these electrical signals with participants’ self-reported pain severity. From this, the researchers identified neural patterns that indicated whether an individual was experiencing a high or low pain state, acting as a biomarker of varying levels of discomfort.
To assess how these neural patterns differed in chronic and acute pain (which usually resolves over a short period of time), the researchers next tested the same four participants on each site of the body. Brain activity was recorded during heat application.
They found that OFC was more associated with chronic pain, whereas ACC activity was associated with acute discomfort. Marco Loggia, of Harvard’s Integrative Pain Neuroimaging Center, hopes this will motivate other researchers to study OFC for chronic pain relief. Researchers may be able to test whether noninvasive stimulation of the OFC, such as transcranial direct current stimulation or transcranial magnetic stimulation, can help reduce ongoing discomfort, he says.
The results are an early step toward understanding brain patterns associated with pain and may help develop more effective treatments, the researchers say.
People with particularly severe chronic pain could have electrodes and stimulators implanted in their brains to show how their unique neural signatures relate to discomfort. “By understanding this better, we hope to be able to actually use this information to develop personalized brain stimulation therapies for the most severe pain,” Silvalker said. To tell.
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