Using mathematical models to identify brain changes in people with chronic pain

Disease - Osteoarthritis, fibromyalgia, knee pain

Lead applicant - Dr Christopher Brown

Organisation - University of Liverpool

Type of grant - Research Award

Status of grant - Active

Amount of the original award - £199,572

Start date - 1 March 2018

Reference - 21525

Public Summary

What are the aims of this research?

When pain is felt, it goes through a number of processing stages before it reaches the part of the brain that brings it into our consciousness. At each of these stages the signal is ‘filtered’, either increasing or decreasing the pain sensation. It has been found in people with chronic pain that there are differences in the structure and activity of brain regions where this filtering occurs, and this activity is related to the pain symptoms.

The researchers aim to find new ways of measuring how these brain changes occur, particularly as they may cause resistance to treatment. They aim to use mathematical models to do this, which could act as a good starting point for the development of new diagnostic tools and treatment options.

Why is this research important?

Theories of how the brain learns and changes in response to painful experiences offers a way of investigating how the brain changes in people experiencing chronic pain. These theories are based on the idea that the brain is continually learning to better predict pain, and these predictions influence our perception.

It is known that our perception of body sensations, such as pain, is dependent on our previous experiences. For example, if we expect something to hurt we are more likely to experience a stronger pain sensation. In people with osteoarthritis and fibromyalgia, the severity of the pain symptoms is linked to an increase in activity in the areas of the brain that control this effect of expectancy. This could help to explain why different people with osteoarthritis and fibromyalgia experience different pain levels and treatment outcomes.

The researchers will use people with osteoarthritis, fibromyalgia or healthy controls, to test current mathematical models and see if they can successfully detect changes in brain structure and function that are because of pain stimuli only. This will help to identify how the brain learns and adapts to the sensation of pain. The researchers will test if these models can be applied in the clinic and group patients based on how they process pain. This will help to identify how successful a course of treatment would be for each patient.

How will the findings benefit patients?

If mathematical models can be successfully used to test for brain changes in people with chronic pain then this will mean that potential treatment resistance can be identified before treatment is started. Instead, patients could be matched to the best treatment option for them. Furthermore, the models could identify brain processes that cause chronic pain and these could act as targets for new treatments.