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ICT & health shed new light on chronic pain management

Data was collected over several months while patients were at home and analyzed using machine learning tools. In this way, the researchers identified a brain region associated with chronic pain and objective biomarkers of chronic pain in individual patients.

These findings represent a first step in development new method to track and treat chronic pain is published in Nature Neuroscience and funded by the National Institutes of Health’s Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative and the Helping to End Addiction Long-term Initiative (NIH HEAL Initiative) (NIH).

Chronic pain

“Walter Koroshetz, MD, director of the National Institute of Neurological Disorders and Stroke, part of the NIH, says that this is an excellent example of how the brain activity measurement tool created by the BRAIN Initiative has been successfully applied to problems urgent public health in. relieve persistent, severe pain. It indicates that the hope is that further development based on these preliminary results may lead to effective, non-addictive treatments for pain.

Chronic pain is one of the leading causes of disability worldwide. Neuropathic pain is caused by damage to the nervous system itself. It usually happens as a result of injuries to the nerves in our body, but the people in this study think they have pain from the brain itself. This type of pain does not respond well to current treatments and can be disabling for those living with it.

“When you think about it, pain is one of the experiences the most basic an organism can have,” says Prasad Shirvalkar, MD, Ph. author of this study paper. “nonetheless, we still don’t know much about how pain works. By developing better tools to study and possibly influence the brain’s pain response, we hope to provide options for people living with chronic pain.

New approach

Instead of traditionally relying on self-reports from people living with chronic pain, researchers in this study took a new approach. In addition to collecting data through questionnaires on pain intensity and emotional impact, they also looked directly at changes in brain activity in two specific areas associated with pain response: the anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC). These observations were made while the participants reported their current level of chronic pain.

Acute and chronic pain

Dr. Shirvalkar: “Functional MRI studies show that the ACC and OFC regions of the brain become active during acute pain experiences. Our interest was in investigating whether these regions are also involved in the process of chronic pain in the brain. In particular, we were wants to understand how pain changes over time and what brain signals might correspond to, or be predictive of, high levels of chronic pain.”

Four participants, three with post-stroke pain and one with phantom limb pain, underwent a surgical procedure that implanted electrodes targeting the ACC and OFC. Several times a day, participants were asked to answer questions about how they would rate their pain, including its intensity, type of pain, and emotional impact. Then a brain recording was initiated by clicking on a remote control device, giving a snapshot of the activity of the ACC and OFC at that specific time. Using machine learning analysis, the research team was able to use activity in the OFC to predict participants’ chronic pain status.

New therapies

This study marks an important first step in understanding the patterns of brain activity that underlie our perception of pain. By identifying such a pain signature, new therapies can be developed. Many people will help. In the Netherlands, more than 2.2 million people suffer from chronic pain, with a significant impact on the patients’ daily functioning (not only on a physical level, but also on social-emotional well-being.

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