Researchers at UVA Health are pioneering brain stimulation to treat chronic pain that doesn’t respond to medication.
The National Institutes of Health will provide funding for a clinical trial to support their innovative plan.
The new approach was developed by a UVA pain research team. It aims to control pain signals from deep within the brain. Early evidence suggests that the Insula, a brain region responsible for pain perception, is essential. The team plans to optimize deep brain stimulation, an established neuromodulation technique, for use in the Insula to provide much-needed pain relief.
Researchers say the approach could shed light on pain’s fundamental nature if the system is successful.
“For the first time, we will now be able to monitor the brain’s signal and distinguish when patients are in pain from when they’re not,” Dr. Jeff Elias of UVA School of Medicine’s Department of Neurological Surgery. Understanding the fundamental changes in our brains when we experience pain is excruciating if we want to create ways to alter and manipulate these pain signals.
New Pain Research Team
UVA Health has assembled a team of experts to tackle the opioid crisis and pain epidemic. Chang-Chia Jeff Liu, a strategic recruit to the Department of Neurological Surgery, was supported by the UVA Brain Institute and will work with Elias to develop new pain treatments. Liu is an electrophysiologist who studies the nervous system’s transmission of pain signals and how the brain perceives them. The Director of UVA’s Electroencephalogram & Evoked Potential Lab, Dr. Mark Quigg, is also a doctor. He is an expert in clinical trials and brain rhythms. The Department of Anesthesiology has recently hired Patrick Finan, a clinical psychologist who specializes in measuring pain in clinical settings and its effects on cognition, emotions, and daily function.
Multidisciplinary teams are uniquely equipped to examine the complex problem of chronic pain.
Quigg stated, “our team combines depth in knowledge in the mechanisms, measurement, and treatment of pain with expertise in brain surgery or brain mapping.” With critical support from the Brain Institute, UVA has the unique opportunity to improve treatment for chronic pain.
UVA Health will use this vast expertise to help patients suffering from chronic neuropathic pain (nerve) and to offer relief.
Chronic nerve pain occurs when a part of the nervous system is damaged. Many patients suffering from neuropathic pain don’t feel relief despite current treatment options. Opioids, such as opioids, are not always effective in pain management. They can also have side effects that can be dangerous. There is also a risk of addiction to opioids, as can be seen in many communities across the country. Neuropathic pain is one of the most challenging pain conditions to treat.
Deep-brain stimulation (or DBS) may be an alternative to current treatments. It has been used in the treatment of epilepsy and movement disorders. There is also emerging evidence that DBS may be valid for chronic pain. UVA will conduct a clinical trial with 12 patients suffering from neuropathic pain refractory or resistant to treatment. To determine if stimulation can provide pain relief, UVA experts will map volunteers’ brains.
Participants deemed to be a benefit will then be enrolled in a randomized, double-blinded trial. To test if DBS can offer ongoing relief, electrodes will be placed along the Insula.
Researchers will also study volunteers’ brain activity to find biological indicators of pain. These “biomarkers” could help doctors assess and treat patients’ pain better and could be used to create a new DBS system for pain management.
Researchers hope the project will reveal important information about the nature of pain. Liu stated that pain is a subjective experience. “We don’t take pain-related brain activity seriously if we don’t study it in patients,” Liu said.