A new biomarker utilizing sensorimotor peak alpha frequency (PAF) and corticomotor excitability (CME) has successfully predicted pain sensitivity in patients following an injection-induced pain episode. The study, conducted at the University of Western Ontario, found that individuals with slower PAF and CME depression experienced higher pain levels. This discovery potentially paves the way for new treatments and preventative measures for chronic pain.
Investigators utilized the biomarker, which consisted of two measures — sensorimotor peak alpha frequency and corticomotor excitability — to predict pain response in patients who received an injection that induced prolonged temporomandibular pain.
They used machine learning models to see if PAF and CME could predict pain sensitivity in a training set and then compared the predicted and the actual pain reported by patients. The PAF/CME biomarker successfully categorized participants with “high” and “low” pain sensitivity, with an area under the curve of 1.00. Results were reproduced across a variety of methodological parameters. “Using the PAF/CME biomarker signature, we were able to accurately and reliability predict who would develop high vs low pain with excellent accuracy,” study investigator Siobhan Schabrun, PhD, professor and research chair in mobility and activity, University of Western Ontario, London, Ontario, Canada, told“This is important because individuals who experience higher pain soon after injury are more likely to develop chronic pain.” The findings “pave the way for new treatments and preventatives for chronic pain,” she stated.“Musculoskeletal pain is a leading cause of disability worldwide, and once pain becomes chronic — defined as pain lasting more than 6 months — there are few effective treatments,” Schabrun said. “Understanding who is at risk of developing chronic pain at the time of injury would help in the diagnosis, prevention, and treatment of chronic pain, reducing the prevalence of a major global health problem,” she added. Two features of cortical activity are important in shaping the subjective experience of pain. These are neural oscillatory rhythms involved in processing nociceptive input and corticospinal signaling involved in subsequent motor response. Studying these features of cortical activity has led to the identification of a “promising” sensorimotor cortical biomarker signature, consisting of two metrics: PAF and CME. “Given that individuals who experience higher pain in the early stages of a prolonged pain episode are more likely to develop chronic pain in the future, slow PAF before an anticipated prolonged pain episode and/or CME depression during the acute stages of pain could be predictors for the transition to chronic pain,” the researchers wrote. Previous research has suggested that slower PAF prior to pain onset and CME depression during prolonged pain were linked with more pain. So in the current study, the researchers “undertook analytical validation” of this new brain-based biomarker signature for musculoskeletal pain, Schabrun said. “The biomarker consisted of measures of corticomotor excitability — the excitability of the pathway between the brain and muscle — made using transcranial magnetic stimulation and peak alpha frequency made using electroencephalography,” she added. To find whether individuals can accurately be classified as having “high” or “low” pain sensitivity, based on these two metrics, the investigators used a model of prolonged myofascial temporomandibular pain — masseter intramuscular injection of nerve growth factor — to produce progressively developing pain lasting up to 4 weeks. They collected outcomes over a over a 30-day period. Participants visited the laboratory on days 0, 2, and 5 when pressure pain thresholds, PAF, and CME were measured. Of the total group, 100 participants were included in the training set and 50 in the test set. All were healthy adults with no history of chronic pain and no neurologic or psychiatric conditions. On day 0, following two laboratory sessions, NGF was injected into the right masseter muscle. The participants submitted electronic pain diaries twice daily, where they rated their pain during various activities, with chewing and yawning used as primary pain outcomes. The researchers employed five machine learning models on the label training set, with pain sensitivity as the dependent variable and sensorimotor PAF and change in CME as independent variables. Fivefold cross-validation was used to identify “optimized parameters” in the training set, and these were then used to predict labels in the validation set to validate model selection. The model with the best performance on the validation set was then locked in.Logistic regression emerged as the “winning classifier.” The authors described its AUC as “outstanding,” at 1.00 when applied to the validation set. Slower PAC and CME depression predicted higher pain. The locked model assessed on the test set also had “excellent performance” . Results were reproducible across a wide range of methodological parameters. Inclusion of sex and pain catastrophizing as covariates didn’t improve the model, “suggesting the model including biomarkers only was more robust.” PAF and CME biomarkers showed good to “excellent” test-retest reliability. The researchers noted that the use of a cohort of exclusively healthy participants and an experimental pain model limits the generalizability to clinical populations. “We are currently undertaking studies to show the accuracy and reliability of using the biomarker in clinical populations to predict who will transition from acute to chronic pain,” Schabrun reported. “If accuracy and reliability remain high, the biomarker could be used clinically to identify those at risk of developing chronic pain and to target early interventions toward this group, interfering with the development of chronic pain. In the future, these findings could also be used to develop novel brain-based treatments and preventatives that reduce the prevalence of chronic pain,” she added., Prasad Shirvalkar, MD, PhD, of the University of California San Francisco, and Christopher Rozell, PhD, of the School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, described the quest to identify objective biomarkers that track individual pain severity as the “holy grail” of pain neuroscience.However, they warned, “While progress in quantifying subjective percepts is exciting…we must take care to ensure that quantitative measures do not supplant lived experience reports, introduce distrust in the physician-patient relationship, set unrealistic patient expectations, or exacerbate existing inequalities in pain treatment across this vulnerable population.” This project was funded by the National Institutes of Health. Andrew J. Furman, PhD, and David A. Seminowicz, PhD, reported having a patent issued for PAF through the University of Maryland, Baltimore. The other study authors disclosed no relevant financial relationships. Shirvalkar reported receiving grants from the National Institutes of Health, nonfinancial support from Medtronic and QuantalX and having had a patent pending for closed-loop deep brain stimulation for chronic pain. Rozell reported receiving personal fees from Motif Neurotech and having had a patent pending for a system to identify transitions in brain states from electrophysiological markers in DBS for depression. Batya Swift Yasgur, MA, LSW, is a freelance writer with a counseling practice in Teaneck, New Jersey. She is a regular contributor to numerous medical publications, including Medscape Medical News and WebMD, and is the author of several consumer-oriented health books as well as Pain Management in Dentistry Skill Checkup: A 48-Year-Old Man With Persistent Fatigue, Sleep Issues, Body Pain, and Inability to ConcentrateAll material on this website is protected by copyright, Copyright © 1994-2025 by WebMD LLC. This website also contains material copyrighted by 3rd parties.
CHRONIC PAIN BIOMARKER PAIN SENSITIVITY MUSCULOSKELETAL PAIN NEUROSCIENCE
United States Latest News, United States Headlines
Similar News:You can also read news stories similar to this one that we have collected from other news sources.
TRISH Seeks Research Proposals for Remote Biomarker Analysis in Space ExplorationThe TRISH institute is accepting research proposals to develop new technologies for analyzing biomarkers in microphysiological systems (tissue chips) during space exploration. This initiative aims to enable in-situ measurement of astronaut health data without relying on sample return to Earth, which may be impractical for deep space missions.
Read more »
CME Launches One-Ounce Gold Contract, But 100-Ounce RemainsThe CME Group finally launched a one-ounce gold futures contract, addressing concerns about excessive volatility driven by margin-oriented trading. While this is a positive development for smaller investors, the CME continues to offer the 100-ounce contract, potentially dampening the impact. The author analyzes gold's technical outlook and discusses the long-term bullish factors driving gold prices.
Read more »
Bacteria Found Thriving in Fish Brains, Raising Questions About Human MicrobiomeRecent research has provided compelling evidence that bacteria can exist in the brains of healthy vertebrates, specifically fish. This challenges the long-held belief that the brain is protected from outside microbial invasion by the blood-brain barrier. The study, published in Science Advances, found diverse communities of bacteria in the brains of salmon and trout, with some species showing adaptations to survive in brain tissue and cross the blood-brain barrier. While fish physiology differs from humans, this discovery raises intriguing possibilities about the existence of a human brain microbiome and its potential impact on neurobiology.
Read more »
Oral Microbiome Dysbiosis: Biomarker for Upper GI Disorders?Changes in oral microbiota were associated with precancerous lesions and disorders of the upper gastrointestinal tract in a population-based study.
Read more »
CME Options Flash Strongest Bullish Signal Since Trump's ElectionTraders are betting big on Bitcoin's continued rally, with CME options showcasing the strongest bullish sentiment since the 2020 presidential election. Call option buying and sustained ETF inflows fuel optimism.
Read more »
Breaking: CME to Launch XRP and SOL Futures ContractsXRP and SOL are expected to get futures contracts on CME
Read more »