A new brain stimulation technique pioneered by researchers from Neuroscience Research Australia (NeuRA) and UNSW could prevent the development of chronic pain, a debilitating condition that affects nearly 20% of the world's population.
A five-day course of repetitive transcranial magnetic stimulation (rTMS) before pain onset was found to significantly reduce future pain intensity and improve brain activity associated with pain resilience.
Chronic pain affects more than 1.5 billion people globally, costing the Australian economy alone an estimated $138 billion per year in lost productivity and healthcare expenses.
Taking action before pain takes hold
“Our research showed that repetitive transcranial magnetic stimulation, or rTMS, which is a non-invasive brain stimulation, could be delivered in a preventative way before pain takes hold,” NeuRA research fellow and head of Neurostimulation at the NeuroRescovery Research Hub at UNSW Dr Nahian Chowdhury said.
“Chronic pain is a global health issue, impacting patient quality of life and healthcare systems.
“We looked at how we can support the body before a pain event, and before pain is chronic, by targeting the features of cortical activity associated with chronic pain susceptibility.
“We found that a five-day course of rTMS before pain onset has the potential to interrupt the transition to chronic pain.”
The technique was tested on 41 healthy patients in a blinded, randomised, sham-controlled trial over 26 days.
Patients received active or sham rTMS over five sessions with key brain activity measures such as Peak Alpha Frequency (PAF) and corticomotor excitability (CME) assessed on days zero and four.
At the end of day four, participants received an injection into their cheeks to induce prolonged pain.
For days 5-25, the trial participants completed twice-daily electronic diaries measuring pain and function.
“Those people who had received active rTMS experienced lower pain on chewing and yawning than those who received the sham,” Dr Chowdhury said.
The findings point to a promising new path to potentially preventing chronic pain altogether, especially in instances where future chronic pain is a known risk factor.
“More research is required, but this research shows in some situations – such as for people undergoing a surgery known to be painful or often leading to chronic pain – there is promise from preventative treatments that may be able to stop chronic pain before it begins,” Dr Chowdhury explained.
Dr Chowdhury’s research was published in PAIN, which can be accessed online.