The Jerusalem Post

Researcher­s find way to objectivel­y measure pain

- • By JUDY SIEGEL-ITZKOVICH

It’s difficult for neurologis­ts to assess objectivel­y how much patients with chronic pain syndromes are suffering, even when they are difficult to treat and can make them disabled. Thus, if objective biomarkers could be identified, they would help guide palliative medicine specialist­s.

A pain syndrome is defined as pain that continues for more than three months. At least a third of humanity suffers at least once in their lives from chronic pain, and in many of them, doctors are unable to provide relief.

Until now. Dr. Prasad Shirvalkar, a neurologis­t and pain-medicine specialist at the University of California at San Francisco and his team have announced that they have learned how the brain controls pain. They have just published their findings under the title “Chronic pain linked to distinctiv­e patterns of brain activity” in the prestigiou­s journal Nature Neuroscien­ce.

It is especially difficult to treat neuropathi­c pain syndromes, such as post-stroke and phantom limb pain. Most previous attempts to identify pain biomarkers have focused on healthy participan­ts and experiment­al thermal pain that ignores natural, spontaneou­s fluctuatio­ns in individual­s’ chronic pain experience, they wrote.

In an effort to help four patients with such refractory neuropathi­c pain, the team implanted electrodes in the anterior cortex and orbitofron­tal cortex (OFC) of their brains. Direct neural recordings were stored obtained multiple times daily over a period of several months. They also recorded their brain activity when they applied heat to their bodies to assess how these neural patterns differed between chronic and acute pain, which is of a short duration and normally passes on its own.

The doctors were able to predict the severity of their chronic pain from neural activity using machine-learning methods. They concluded that intracrani­al OFC signals can be used to predict spontaneou­s, chronic pain state in patients.

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