New approach offers hope to chronic pain patients

Deep-brain stimulation may offer an alternative to existing chronic pain treatments, according to UVA researchers who are embarking on a clinical trial.

 Back pain (photo credit: INGIMAGE)
Back pain
(photo credit: INGIMAGE)

Researchers at the University of Virginia are combating chronic pain with the help of a $5 million grant from the National Institutes of Health to fund a clinical trial. 

A device will be inserted into the body to stimulate sections of the insula, the part of the brain responsible for pain. It is intended to raise pain tolerance and offer an alternative to medication for chronic nerve pain management. 

Dr. Jeff Elias of the UVA School of Medicine’s Department of Neurological Surgery and the UVA Brain Institute said that if it's successful, the approach could shed light on the fundamental nature of pain itself. 

“Our team combines depth of knowledge in the mechanisms and measurement of pain along with expertise in brain surgery and brain mapping."

Mark Quigg

“For the first time, we will be able to monitor the brain’s signals and distinguish how they look when the patient is having pain versus when they are not in pain,” Elias said. “Understanding the fundamental changes that occur to our brains when we develop a pain condition is critical if we are going to design ways to manipulate and alter these pain signals.”

The pain crisis and opioid epidemic

Chronic nerve pain develops when some part of the nervous system is injured. Some patients with neuropathic pain do not experience relief with existing treatments.

The steep rise in opioid use here is a real danger to public health (credit: INGIMAGE)The steep rise in opioid use here is a real danger to public health (credit: INGIMAGE)

Pharmaceuticals such as opioids often do not help pain management and commonly cause harmful side effects. Opioids also carry a serious risk of addiction, as seen in communities across the nation. Neuropathic pain is recognized as one of the more challenging pain conditions to treat.

Treatment in the trial

Deep-brain stimulation, or DBS, may offer an alternative to existing treatments, according to the UVA team. It is already used to treat epilepsy and movement disorders, and there is emerging evidence that it may be effective for chronic pain.

To test this, UVA will launch a clinical trial in 12 patient volunteers with refractory, or treatment-resistant, neuropathic pain. A newly assembled UVA pain research team will map the volunteers’ brains and stimulate sections of the insula, to see if this provides pain relief.

“Our team combines depth of knowledge in the mechanisms and measurement of pain along with expertise in brain surgery and brain mapping,” according to Dr. Mark Quigg, a member of the team. “UVA – with critical help from the Brain Institute – has a unique opportunity to advance treatment in the widespread and difficult problem of chronic pain.”

To join the clinical trial, contact Judy Beenhakker at [email protected]