Starts:

Thursday, September 22nd
10:45am-12:15pm EDT

Category:

Topical Workshop

Tracks:

Treatment/Management

Room

701 A

Mechanistic Brain-based Treatments for Chronic Pain

There is ample evidence that brain mechanisms contribute to the development and maintenance of chronic pain. Such mechanisms involve sensitization with changes in primary somatosensory cortex and insula, a shift from nociceptive to emotional brain networks, alterations in somatosensory and motor processing, dysfunctional reward processing involving prefrontal and striatal networks or deficient processing of and learning about appetitive events with changes in striatal and orbitofrontal regions. We discuss novel interventions that target these mechanisms involving brain stimulation, virtual and augmented reality applications, neurofeedback, training with brain computer interfaces, pharmacologically aided pain extinction retraining as well as novel behavioral, physical and pharmacological interventions and their combination that target these brain circuits. We also show that matching of patients to their best fitting treatment greatly enhances the efficacy of these interventions and discuss behavioral, physical and neural biomarkers of patient to treatment matching and treatment outcome.

Presentations

Time
10:45am EDT12:15pm EDT
10:45am EDT12:15pm EDT

Brain-based Treatments Targeting Aberrant Sensorimotor Cortex Excitability in the Transition to Chronic Pain

Tracks: Treatment/Management
Categories: Topical Workshop

This presentation will explore novel brain-based treatments designed to target aberrant sensorimotor cortex excitability in the transition from acute to chronic pain. An increasing body of research suggests low sensorimotor cortex excitability in the acute stage of musculoskeletal pain could be a risk factor for the development of chronic pain. Treatments designed to raise sensorimotor cortex excitability when pain is acute could therefore provide an avenue for early intervention, potentially halting the transition to chronic pain. Non-invasive brain stimulation is one technique that can modulate sensorimotor cortex excitability and influence broader cortical processing through widespread network effects. This presentation will examine non-invasive brain stimulation (transcranial direct current stimulation, repetitive transcranial magnetic stimulation) as a potential treatment in individuals with musculoskeletal pain, focusing on the cortical mechanisms of action. In addition, new data investigating the effect of nicotine on sensorimotor cortex excitability in pain will be presented.

10:45am EDT12:15pm EDT

Neurofeedback Treatment to Modulate Sensorimotor Cortical Representation of Phantom Limb Pain

Tracks: Treatment/Management
Categories: Topical Workshop

Abnormal cortical activities relating to the chronic pain is a therapeutic target of neurofeedback and neuromodulation. Phantom limb pain has been attributed to the abnormal cortical reorganization of the sensorimotor cortex after the amputation of a limb and partial or complete deafferentation. We have developed a Brain-Computer Interface (BCI) based on magnetoencephalography (MEG) signals to control a robotic hand or virtual hand so that the cortical representation of the phantom hand is modulated to relieve the pain. A ten-minutes training to use the BCI changed the cortical representation of phantom hand movements and the pain significantly. Moreover, an intensive training for 3 days reduced the pain significantly for 5 days compared to the sham training in a randomized cross-over trial. The neurofeedback training to modulate the abnormal cortical representation that causes the pain will be the mechanisms-based treatment for the chronic pain.

Presenters

Professor Takufumi Yanagisawa

Professor
Osaka University Graduate School of Medicine, Osaka University Institute for Advanced Co-Creation Studies

Professor Herta Flor

Scentific Director
CIMH/Heidelberg University

Professor Siobhan Schabrun

William & Lynne Gray Endowed Research Chair in Mobility and Activity
University of Western Ontario