Research: Pain in the brain can be relieved by focused ultrasound

With focused ultrasound, a tiny spot is exposed to a narrow band of sound waves using the same technique used to observe an embryo in the womb.

You take acetaminophen or ibuprofen when you feel pain. You may be administered an opioid painkiller, which can be addictive in certain situations if the pain is severe or persistent.

The concept is suggested by recent research conducted by Wynn Legon, an assistant professor at the Fralin Biomedical Research Institute at VTC, and his colleagues. The study, which was published in the journal PAIN, discovered that low-intensity focused ultrasound soundwaves directed at the insula, a region deep inside the brain, can lessen the experience of pain as well as its associated side effects, such as variations in heart rate.

This is a proof-of-principle study. Can we get the focused ultrasound energy to that part of the brain and does it do anything? Does it change the body’s reaction to a painful stimulus to reduce your perception of pain?

Wynn Legon

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With focused ultrasound, a tiny spot is exposed to a narrow band of sound waves using the same technique used to observe an embryo in the womb. High-intensity ultrasound can cause tissue ablation. It can have milder, more fleeting biological effects at low intensity, such as changing the electrical activity of nerve cells.

For a considerable amount of time, neuroscientists have investigated potential nonsurgical treatments for depression and other conditions, such as transcranial magnetic stimulation. But Legon’s work is the first to focus on the insula and demonstrate that targeted ultrasound may reduce pain by penetrating deep into the brain.

23 human subjects in good health participated in the study. They put heat on the backs of their hands to make them hurt. They also donned a gadget that used magnetic resonance imaging (MRI) guidance to deliver concentrated ultrasonic pulses to a specific location in their brains.

In each application, participants scored their level of discomfort on a zero–9 scale. Researchers also tracked each subject’s heart rate and heart rate variability, or the variation in the intervals between heartbeats, to see how the body’s response to an unpleasant stimulus is influenced by ultrasonic waves sent to the brain.

On average, participants reported a three-fourths of a point decrease in discomfort.

That might seem like a small amount, but once you get to a full point, it verges on being clinically meaningful. It could make a significant difference in quality of life, or being able to manage chronic pain with over-the-counter medicines instead of prescription opioids.

Wynn Legon

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The use of ultrasound technology was also found to lessen heart rate variability and heart rate, two bodily reactions to pain stress that are linked to improved general health.

Your heart is not a metronome. The time between your heart beats is irregular, and that’s a good thing.

Increasing the body’s ability to deal with and respond to pain may be an important means of reducing disease burden.

Wynn Legon

Focused ultrasound’s effect on those variables points to a potential future avenue for the Legon lab’s research: investigating the heart-brain axis, or the relationship between the heart and brain, and if the pain may be lessened by lessening the consequences of cardiovascular stress.

Source: Virginia Tech News

Journal Reference: Legon, Wynna,b,c,d,*; Strohman, Andrewe,f; In, Alexandere; Payne, Brightona,d. Noninvasive neuromodulation of subregions of the human insula differentially affect pain processing and heart-rate variability: a within-subjects pseudo-randomized trial. PAIN ():10.1097/j.pain.0000000000003171, February 1, 2024. | DOI: 10.1097/j.pain.0000000000003171

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