Norman Prince Neurosciences Institute

Brain Sensor Holds Promise of Objective Pain Assessment

Anyone who has been treated for pain is familiar with the 0-to-10 scale that clinicians have used for decades to assess and treat pain. While the scale can be helpful, it is open to interpretation by patients and clinicians, and is no help when treating non-verbal patients, toddlers or animals.

Carl Saab, PhD, is a researcher in neurosurgery at Rhode Island Hospital and associate professor of neuroscience at The Warren Alpert Medical School of Brown University. After 20 years of researching pain at the molecular level, Dr. Saab is on the verge of introducing a dramatically different diagnostic model for use in quantifying levels of pain.

Dr. Saab has developed and successfully tested an objective pain measurement method that will give clinicians more information and provide a visual representation of the impact and intensity of the pain registered by the patient’s brain.

Historically, pain has been addressed as a symptom of another problem or disease. The common treatment has been to prescribe pain medication, which is a temporary measure at best, and may result in adverse side effects and addiction. The current opiate addiction crisis is a clear indication that traditional diagnosis of, and treatment for, chronic pain is insufficient.

Chronic Pain as Its Own Disease

“There is now a paradigm shift to recognize chronic pain as a separate disease, as its own entity,” said Dr. Saab, who within the past year has authored six papers (including for the journal Scientific Reports) and a book chapter on chronic pain. He notes that conditions like phantom limb pain, diabetic neuropathy, fibromyalgia, migraines and other maladies reveal the need for greater insight into the science of pain, leading to better treatment options.

Rather than developing another opiate derivative or pain pill, Dr. Saab’s research focuses on finding a “neurophysiological biomarker” to improve diagnosis and achieve a better treatment. “We can’t open the brain to see what’s happening, but we can use a wearable device to record brain activity.

“We know that pain manifests as a pattern of neuronal activity or ‘firing’ in the brain,” he said. “Using a wearable sensory device (similar to a portable EEG), we can detect these firings, assess pain, and give it a score. We’ll be able to pinpoint the area of the brain involved and identify patterns of brain activity for different pain states.”

This could be a game changer for chronic pain patients who struggle for years, searching for accurate diagnosis and relief from what can become a debilitating condition, and for clinicians who have no objective measurement tools and little to offer patients whose pain persists despite all efforts to manage it.

Looking for Ways to Measure Pain

Dr. Saab is collaborating with a major device manufacturer to produce a customized headset that will hold the electrodes used to record the data on a smartphone or computer, which then will transmit it for analysis. He and his team have created an algorithm to interpret the data and color-code it by intensity, like the bands of color that indicate the temperature on a weather map.

Developing the algorithm was the most intricate, time-consuming part of the project. The team has created a prototype of its headset and is working on contracts with industry partners.

“We are poised to move this project from the lab setting to the real-world setting. We have validated it in mice and rat models, and have now moved to testing in healthy humans, using hand-in-ice-cold-water tests, as well as pain patients,” Dr. Saab said. “With support and encouragement from the Lifespan health system and Rhode Island Hospital, we have launched a new company to advance this technology.”

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