Doctors Use Brainwaves to Objectively Measure Chronic Pain

Chronic pain can be objectively measured from brain signals recorded in daily life, scientists demonstrated for the first time in a study published in Nature Neuroscience in May 2023.

A team led by Prasad Shirvalkar, a neurologist and pain medicine specialist at UCSF, used deep brain stimulation implants to monitor four patients with uncontrollable chronic pain, three recovering from strokes and one with phantom limb syndrome, over three to six months.

Electrodes tracked activity in the anterior cingulate cortex and orbitofrontal cortex while participants completed pain severity surveys and captured snapshots of their brain activity with a remote.

The orbitofrontal cortex showed the strongest association with chronic pain, allowing researchers to reliably predict each patient's reported pain intensity from brainwaves alone.

The findings indicate chronic pain is not simply a more enduring version of acute pain but is fundamentally different in the brain, activating distinct neural circuits that cannot be treated identically.

The work supports developing personalized brain stimulation therapies for the estimated 51.6 million Americans living with chronic pain, with future trials planning to enroll six patients and then 20 to 30 in a second phase.

Researchers caution that the small sample size and the serious risks of brain surgery mean the approach needs broader validation.