Brain processes are increasingly considered to be an important contributor to chronic pain, psychological distress and disability. While our understanding of the mechanistic pathways involved is in its infancy, technologies are being developed to influence brain processes that may contribute to chronic pain.
I am working with colleagues at the University of Manchester towards a vision of an integrated EEG and brain stimulation platform to detect, diagnose, monitor and treat brain mechanisms contributing to chronic pain and psychological distress. Currently, such mechanisms are under-detected and often treatment options are limited or associated with significant unwanted side effects (e.g. pharmaceuticals). We are in the process of developing and testing technologies that will measure and modify brain mechanisms that directly link to many aspects of chronic pain pathophysiology and associated mental health problems.
Neurostimulation, i.e. applying visual, sound, tactile or electrical stimulation to the brain, can have the effect of reducing acute pain. This provides an alternative therapeutic approach that is currently in need of engineering development and clinical validation for use in treating chronic pain. Neurostimulation may be able to dampen cortical excitability, i.e. the enhanced pain processing (nociception) due to central nervous system sensitisation that contributes to pain-related distress and interrupts sleep. We may also be able to modify longer-term neuroplastic mechanisms contributing to chronic pain.
This project is working to identify a brain signature of resilience to pain in elderly patients with arthritis using recordings from the brain surface using electroencephalography (EEG). We will use this signature to train elderly patients to increase their resilience to pain by giving them immediate feedback on how their brains are responding (EEG-neurofeedback). This has the potential to provide a potentially safe and low-cost therapy for chronic pain in the medium term that could in the longer term be adapted for home use.