Scientists discover how to monitor and predict chronic pain: hope for new treatments

a group of scientists discovered brain signals that reveal how much pain a person is in; They say this startling discovery is a step toward radical new treatments for people living with debilitating chronic pain.

AND the first time it was possible to decode brain activity underlying chronic pain, fueling hope that brain-stimulating therapies already in use for Parkinson’s and depression could help those left with no other options.

“What we have learned is this chronic pain can be monitored and predicted successfully in the real world, while patients are walking their dog, or at home, when they get up in the morning and move on with their lives,” explained Prasad Shirvalkar, neurologist and principal investigator of the project at the University of California , San Francisco.

A “silent epidemic” of chronic pain affects millions of adults worldwide who have been in pain for at least three months despite medication or treatment. The causes are many and range from arthritis, cancer and back problems to diabetes, stroke and endometriosis.

But while chronic pain is causing an increase in strong opioid prescriptions, no medical treatment works well for the conditionprompting experts to call for a complete rethink of the way health services manage patients with long-lasting pain.

For this study, published in Nature Neuroscience, Shirvalkar and colleagues surgically implanted electrodes in four patients with chronic intractable pain after stroke or loss of a limb.

The devices enabled patients, at the push of a button on a remote phone. record activity in two regions of the brain: the anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC).

Several times a day the volunteers were asked to complete short strength surveys andthe kind of pain they experiencedand then recorded snapshots of their brain activity.

Armed with survey responses and brain recordings, the scientists figured it out could train an algorithm to predict pain of a person based on electrical signals in their OFC.

“We have developed a biomarker target for that kind of pain,” Shirvalkar said.

A separate document from the team found this out very different brain activity accompanied the sharp pain or short-lived, such as that produced by a hot object touching the skin.

The discovery may explain, at least in part, because routine painkillers are less effective for the chronic pain of the brief twinge of a bruised finger.

“chronic pain It’s not just a more long-lasting version of acute painit’s fundamentally different in the brain,” Shirvalkar said, adding, “The hope is that by better understanding this, we can use the information to develop personalized brain stimulation therapies for more severe forms of pain.”

The findings could have an immediate impact on clinical trials investigating a procedure called deep brain stimulation to control chronic pain.

Deep brain stimulation sends electrical impulses to the brain to disrupt problematic signals. Because it involves brain surgery, this is a treatment of last resort, but is already used for Parkinson’s disease and major depressive disorder. To be effective, clinicians need to know precisely which signals to target.

Professor Blair Smith, a chronic pain expert at the University of Dundee who was not involved in the research, explained Keeper than the lack of objective measures for pain it makes it difficult for doctors to assess whether treatments are effective.

“If this research is successfully extended, it offers an opportunity not only to develop an objective measure of some types of pain, but also to improve our understanding of biological mechanismsSmith argued.

“But pain is a complex phenomenonWith psychological, social and cultural factors, previous experiences of pain and expectations that are fueled”, closed.

Source: The Guardian