Chronic pain, defined as persistent pain lasting more than three months is a significant healthcare burden that is difficult and costly to treat.
The central pain treatment option is primary drug based that include the use of opioids, anticonvulsants, and anti-inflammatory agents, which are costly with relatively low success rates. More importantly, these options share the shortcomings of potentially serious adverse side effects, complications and cause dependency in the users.
Research has shown that chronic pain not only affects the central nervous system (CNS) but also arise from CNS dysfunction. It has been hypothesised that directly manipulating brain regions could improve pain modulatory systems and thereby reverse the abnormalities in the CNS.
As a whole, the two most prominent problems facing existing management of chronic pain is the lack of an objective way to detect pain and the lack of a non-invasive and affordable method to treat the CNS in the handling of pain.
TTSH & I2R have jointly conducted a public funded feasibility study of using Brain Computer Interface (BCI) based chronic pain management system (https://clinicaltrials.gov/ct2/show/NCT03032497).
In this study, we developed a pain neuromatrix modelling and decoding system to identify pain signature through correlating the electroencephalogram (EEG) signal to pain episodes. Thereafter, we proceed to develop a closed-loop sensing and neural feedback mechanism using joint attention and pain neuromatrix activity monitoring and stimulation to help chronic pain patients.
We are looking for potential commercial partner to productize this medical technology and obtain relevant regulatory approval.
TECHNOLOGY FEATURES & SPECIFICATIONS
This is a BCI-controlled pain management system that is capable of performing the following functions:
Detect specific EEG’s pain signature relevant to pain episodes from participant.
Employ joint attention and pain neuromatrix activity monitoring as neuro-feedback and use gamification to alleviate perceived fear-related pains.
During intervention, the participant will undergo a novel BCI based pain neuromodulatory therapy using gamification, incorporating a pain neuromatrix activity detection and attention detection algorithm that enabled patients to practise an individualized pain management strategy. The participant will be instructed to focus and sustain their concentration to improve the attention score.
When the participant experiences a pain episode, the pain neuromatrix will be activated and the wellness score will go down.
The participant is advised to practice pain-management strategies taught by their clinician or therapist to improve the wellness score. These strategies may include cognitive behaviour therapy, breathing techniques, and other tailored management strategies.
This visual neuro-feedback mechanism provides the subject with a more direct and informative response. One that informs them whether such pain-management strategies work and thereafter allowing them to translate or use these strategies more effectively in their day-to-day activities.
Refer to the link below to see a demo video of the technology:
Unlike existing drug based or non-drug pain treatment approaches for chronic pain that concentrate more on peripheral pain pathways and mechanisms, our approach focus on the CNS by directly manipulating brain regions which improve the pain modulatory systems which may eventually reverse the abnormalities in the CNS.
Our BCI neuromatrix feedbacks will inform the user about the current pain activation and attention level, and guide the user in learning to modulate the EEG characteristics and develop skills to manage attention to alleviate perceived fear-related pains.
The BCI system captures EEG signals and decodes the underlying brain states in relation to cognition and fear-related pain perception. Such decoded brain states are then presented to the participant in visual or other form to guide the participant to learn to regulate the brain states towards better pain management.
For example, the participant may over a few sessions learn to focus on the visual feedback while inhibiting the brain function activity in relation to fear-related pain perception. With practice, the user is encouraged to achieve brain activity modulation without external feedback so fear-related pain can be reduced in realistic situations.
In short, our BCI pain management system can potentially be use as:
an objective and repeatable measurement of pain.
a novel pain treatment approach using attention and pain neuromatrix as neuro-feedback to guide chronic pain sufferer to adopt pain management strategy more effectively.
The World Health Organization (WHO) estimates that about 22 per cent of the world's population live with chronic pain. GSK Global Pain Index 2017 reported that on top of workplace productivity, pain also hits quality of life and cost the global economy more than $245 billion dollars USD annually. In fact, chronic pain continue to be a common problem that affect 1 in every 10 person locally.
A 2016 Singapore study led by IMH, the Well-being of the Singapore Elderly (WiSE) found that about one in five patients aged 60 years and above will experience chronic pain. Acute hospital, community hospital, clinics and other care facilities in Singapore has seen a steady increase in patients seek treatment in their pain management centre.
Chronic pain is one of the top causes of disability and if left untreated can lead to many undesirable personal and sociological outcomes such as depression, impaired cognitive function and impact the quality-of-life of sufferers and their families and care givers.
Our BCI pain management system is likely to benefit these chronic pain sufferers; improve their quality-of-life; improve work productivity and reduce the overall healthcare burden on chronic pain management.