Chronic Pain Research

A staggering 1 in 5 people experience chronic pain: an ongoing and often debilitating condition that can last from months to years. This persistent pain can impact many parts of a person’s life, with almost half of people with chronic pain also experiencing major anxiety and depression disorders and an alarming 20 per cent of people with chronic pain have considered suicide. Chronic Pain remains minimally responsive to existing pharmacologic and non-pharmacologic treatment, highlighting an urgent need to develop new interventions.


Our research group has discovered for the first time that ongoing pain decreases the content of the brain’s neurotransmitters Glutamate and GABA in the area of the brain responsible for processing emotion. This means the brain cells do not properly communicate to each other, jeopardising their ability to process and regulate emotion.

We are currently recruiting participants for some of our current trials.

Emotional Recovery Program

We have developed an online emotional recovery program (iDBT-Pain; Internet-delivered Dialectical Behavioural Therapy  - Pain) to teach chronic pain sufferers skills to self-regulate their negative emotions in a way which decreases both their emotional suffering and pain. The program helps normalise the abnormal brain function and neurochemistry observed in people with chronic pain. Maybe more important, our online program offers hope to people living with disabilities or those in rural and remote communities who often struggle to access pain management services, and can easily be deployed when social and physical interactions are limited. The Emotional Recovery Program is a blended treatment that includes six online emotion recovery skills training sessions delivered via Zoom and a web app via interactive modules and video tutorials.

Early results of the emotional recovery program are very promising and have been published in the Journal of Pain. We are now undertaking research to investigate the program in a larger trial. If you are interested in participating please contact us.

Neuroimaging, Neurobiology and Mental Health Research Program

Beyond the debilitating physical experience of chronic pain, mental health disorders are a common occurrence. Clinical depression is reported in around 54% of people with chronic pain, 35% experience anxiety, around 20% fulfil the criteria for posttraumatic stress disorder (PTSD), bipolar disorder cooccurs in around 25% of cases of chronic pain, and around 20% of people have a diagnosis of psychosis (e.g. schizophrenia, schizoaffective disorder), and/or experiencing psychotic symptoms (e.g. hallucinations, or anhedonia, the inability to experience pleasure from positive stimuli).


Our research group is dedicated to unravelling the neurobiological underpinnings of pain and related mental health issues. Using cutting-edge neuroimaging and neurobiological techniques, the program aims to identify biomarkers for pain, and associated mental health problems, such as anxiety or depression. In particular, sustained exposure to chronic stress, such as chronic pain, can trigger a cascade of neurobiological changes, including increased inflammation and oxidative stress that are deleterious for the brain.

The mission of the Neuroimaging, Neurobiology and Mental Health research program is three-fold:

1.  Identify the early neurobiological changes occurring in the aftermath of pain sensation. This approach will identify important targets for early, individualised intervention and prevention of chronic pain.
2.  Clarify if pain triggers the development of mental health problems and/or if subclinical underlying risk factors for mental health problems could be responsible for the chronification of pain. Among the various mental health issues reported by people suffering from chronic pain, anxiety, depression and posttraumatic stress disorder are the most prevalent. Identifying, targeting and treating these comorbid conditions can enhance the success of treatments for chronic pain.
3.  Developing and applying individualised interventions for chronic pain and associated mental health problems. These interventions include neurofeedback brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS).

Nerve Pain Recovery Program

One of the most common and most difficult chronic pain conditions to treat is chronic nerve pain. Patients describe nerve pain as severe burning that is unbearable and terrifying. As noted earlier, pain is often accompanied with major depression and anxiety. There are currently no effective treatments for this condition, indicating the urgent need to develop and test novel interventions.


Previous theories about the causes of chronic neuropathic pain focus on the periphery (e.g., damage in a body part). However, consistent and compelling evidence indicates that treatments based on these theories are not effective at reducing nerve pain. Instead, brain processes are recognised to be key in the development of chronic nerve pain.

 

The StoPain Trial

Chronic neuropathic pain can be a debilitating secondary condition for persons with spinal cord injury and effective pharmacological and non-pharmacological treatments remain elusive. Drawing on our discoveries that identified the key role of electrical brain activity in the development of neuropathic pain after spinal cord injury, we have developed a novel brain-machine interface treatment that targets the abnormal brain activity associated with neuropathic pain after spinal cord injury. This new treatment targets disruption in brain activity via EEG neurofeedback. Specifically, the electrical brain activity is monitored, processed, and provided back to participants in real-time via visual feedback in a gaming environment. Using this feedback, individuals can learn to regulate their brain activity in a way that reduces their pain.

Each trial participant will receive 30-minute daily sessions of the electrical brain intervention for 20 days over a 4-week period. The electrical brain activity treatment incorporates an interactive gaming interface (i.e. “NeuroGame”), and a neuromodulation protocol that teaches individuals to learn how to regulate their brain activity in a way that reduces their nerve pain.


This program has received funding from the National Health and Medical Research Council (NHMRC) and the Australian Medical Research Future Fund (MRFF) to conduct a clinical trial with adults suffering from chronic nerve pain. If you are interested in participating or would like to find out more, please contact us.