Chronic pain is a significant clinical and societal issue, with current management strategies remaining inadequate. One treatment option that has been shown to be effective in some individuals is spinal cord stimulation (SCS). Whilst SCS is effective at reducing pain in over 50 per cent of individuals with chronic pain, the mechanism via which SCS relieves pain and why some individuals respond and others do not remains unknown.
This study aims to establish the underlying cortical, subcortical and brainstem changes associated with the analgesic effects of spinal cord stimulation (SCS). Functional magnetic resonance imaging (fMRI), arterial spinal labelling and anatomical MRI will be used to determine brain activity patterns associated with pain relief during SCS, with particular focus on the brainstem. In addition, the investigators will use fMRI and arterial spin labelling (ASL) to determine if the state of the brain can predict treatment efficacy.
The goal is to understand how SCS reduces pain and also to establish a biomarker that can predict who will respond to SCS. If we can determine a treatment efficacy biomarker, we may be able to determine whether implanting a SCS is going to be of benefit in an individual subject.
Dr Alister Ramachandran, Westmead Pain Management Centre NSW, Professor Luke Henderson, University of Sydney, Professor Chris Peck, Westmead Hospital, University of Sydney.
The project was awarded $A66,000 through the ANZCA research grants program for 2022.