Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News
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A new study is shedding light on chronic pain and how researchers are using brain implants to objectively measure pain intensity in patients. The research, which was published this week in Nature Neuroscience, identified biomarkers specific to chronic pain.
THE STUDY
The team of scientists implanted electrodes in the anterior cingulate cortex and orbitofrontal cortex (OFC) part of the brain in four patients with post-stroke pain and phantom limb pain. This part of the brain is responsible for planning, expectation, and emotions.
The researchers asked patients about their pain levels multiple times a day for six months. They then built machine-learning models to match and predict the patients reported pain metrics. The team found that low frequencies in the orbitofrontal cortex matched with the patients’ subjective pain reports. The greater the shift in low-frequency activity that was measured by the team, the more likely it was that the patient was experiencing intense pain.
WHAT IT MEANS
This helped researchers to be able to objectively measure chronic pain. The team also were able to measure differences between acute pain and chronic pain by applying heat to the patients bodies, causing short-term, but intense pain. In two of the patients, brain recordings showed that the anterior cingulate cortex was more involved in processing acute pain.
Dr. Prasad Shirvalkar, lead author of the study and assistant professor of Anesthesiology at UC San Francisco explained that “When we find those new targets, the next goal is identifying brain biomarkers of chronic pain for each patient.” The team was able to directly record results from the patients’ brains while they were experiencing pain. Shirvalkar added that “By combining their neural signals with their pain reports, we’re trying to build a model of how their brain represents pain.”
HOW IT IS USEFUL
Researchers are hopeful that this will serve as an objective measurement of chronic pain and a better understanding of how to measure and treat chronic pain conditions with DBS. Further research is needed to explore if other areas of the brain contribute to pain signals in many different conditions. However, these neural biomarkers will lead the way in developing personalized brain stimulation to treat chronic pain, researchers compared the technology to using a thermostat.
The study was part of a larger clinical trial focused on deep brain stimulation (DBS) as an option for treatment-resistant chronic pain. This trial has a total of ten participants with post-stroke pain, phantom limb syndrome, and spinal cord injury pain and will evaluate if DBS could be a safe and effective treatment for chronic pain. DBS is currently used to treat disorders like Parkinson’s disease, dystonia, and essential tremors.
Although everyone experiences pain, each person feels pain differently. Healthcare providers often use a pain scale as a subjective measurement of pain to track and manage pain levels. Pain is usually measured on a scale of 0 to 10, with zero being no pain and 10 being the worst pain possible.
According to the National Institute of Neurological Disorders and Stroke (NINDS), chronic pain is a disorder that can be made worse by environmental and psychological factors, persists over a long period, and can be challenging to manage. People with chronic pain are at risk for developing problems with physical functioning, cognition, and emotions.
Data from a 2019 National Health Interview Survey found that 20.4% of adults had chronic pain and 7.4% of adults had chronic pain that interfered with work or daily life and was found to increase with age and was highest in those aged 65 and older.
Chronic pain has been linked to poor quality of life, opioid dependence, depression, suicide, as well as Alzheimer’s disease, and related dementias.