Brain implants reveal chronic pain signals

Scientists have a new and clearer view of chronic pain in the brain.
Over several months, electrodes implanted in the four people’s brains picked up specific signs of their persistent pain. This detailed look at chronic pain, published May 22 in Nature Neuroscience, suggests new ways to reduce intolerable symptoms.
Catherine Martucci, a neuroscientist who studies chronic pain at Duke University School of Medicine, said the approach “gives the brain a way to track pain,” Science News reported.
Chronic pain is very common. From 2019 to 2020, more American adults were diagnosed with chronic pain than with diabetes, depression and hypertension, researchers reported at the JAMA Network Open May 16.
Pain is also incredibly complex, complex, influenced by the body, brain, situations, emotions and expectations, says Martucci.
This complexity makes chronic pain invisible to outsiders and very difficult to treat.
One treatment is electrical stimulation of the brain. As part of a clinical trial, researchers at the University of California, San Francisco implanted four electrode wires into the brains of four volunteers with chronic pain. These electrodes can monitor and stimulate neurons in her two brain regions, the orbitofrontal cortex (OFC) and the anterior cingulate cortex (ACC).
Although the OFC is not known to have a significant impact on pain in the brain, this region contains nerves that connect with pain-related areas, such as the ACC, which is thought to play a role in how people experience pain. There are many connections.
But before researchers could stimulate the brain, they needed to know how chronic pain affected it. For about three to six months, implanted electrodes monitored brain signals throughout life in these people. During that time, the participant rated his pain on a standard scale two to eight times his day.
The researchers used sophisticated machine learning approaches to relate each person’s pain ratings to patterns of brain activity, ultimately characterizing each person’s chronic pain.
In many ways, the patterns were unique to each person, but they also overlapped. Brain activity in the OFC (the area at the front of the brain just behind the eyes) was tracked along with people’s chronic pain levels. I also encountered some unexpected pain patterns along the way. For example, two volunteers’ pain varied over a period of approximately 3 days.
Neuroscientist Chelsea Kaplan of the University of Michigan Center for Chronic Pain and Fatigue Research said, “Brain activity in the OFC could be a robust biomarker of chronic pain, helping physicians track treatment response, and “It’s a signal that could serve as a new target for therapy.” in Ann Arbor.
The study involved only four people, three of whom suffered from stroke pain and one who suffered from phantom limb pain after amputation.
“We need to know if these findings can be generalized to other patients and pain conditions,” Kaplan said.
If brain activity patterns become common in people with chronic pain, Martucci said, they could one day be used to measure pain in people who cannot communicate.
This includes people with unresponsive conditions such as locked-in syndrome.
But the purpose of identifying reliable markers of chronic pain isn’t necessarily to prove whether a person is in pain or to serve as a yes/no diagnostic test, says study co-author and UCSF neurologist. Physician Prasad Silvalkar said at a press conference on May 18. Instead, it is meant to guide therapy. Silvalker and his colleagues are now conducting clinical trials to stimulate people’s brains to treat chronic pain.

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