Neurotechnology for Chronic Pain

神经技术治疗慢性疼痛

• 批准号: EP/W03509X/1
• 负责人: Ben Seymour
• 金额: $ 120.36万
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FW03509X%2F1
• 关键词: Neurotechnology; Chronic; Pain

At least 20% of the UK population suffer from clinically significant chronic pain, making chronic pain almost unparalleled in its clinical and socioeconomic impact. The problem is amplified by the paucity of currently available pharmacological and non-pharmacological solutions. However recent advances in our understanding of the neurobiological mechanisms of chronic pain have created an enormous but untapped opportunity for neurotechnology, with the capacity to completely transform the clinical landscape of chronic pain. Realising this capacity depends critically on creating a technological and clinical infrastructure that brings together interdisciplinary expertise (researchers, clinicians, patients), different chronic pain conditions (nociceptive, neuropathic, nociplastic), and different technological tools. From a neuroengineering perspective, this will allow technological integration with a focus on key strategic targets informed by neurobiological mechanisms. This has the power to drive neural changes associated with chronic pain - as well as its associated fatigue, depression and anxiety, towards recovering a normal state of health, and deliver major impact across multiple medical conditions and chronic illnesses, many of which have chronic pain as their single most problematic facet. Our central objective is to create a comprehensive network dedicated to discovery and enhancing capability of chronic pain neurotechnology, to bring about a step-change in current available therapeutics. We will engage fully across the spectrum of researchers, clinicians, patients, and other stakeholders to i) define the current landscape and identify key opportunities and challenges; ii) engage in an innovative discovery research focused on technology development chronic pain, and iii) create a sustainable infrastructure for pain neurotechnology by supporting ECRs, education and training, and seeding new UK and international collaborations. Our scientific and technical focus is based on building integrated systems that combine core technologies, typically as closed-loop systems: for example closed-loop neurostimulation using peripheral sensor detection of nociceptive reflexes, cognitive VR with neurostimulation, EEG neurofeedback within cognitive and behavioural digital therapy, and others. The aim is to build the capability to combine individual technologies in a way that is target-focused, therapeutically interactive, and practically and clinically feasible. We will undertake a set of feasibility studies that test specific integrative strategies and show how these different pieces can be used to further design more comprehensive pain therapy systems. Ultimately this aims to build a new generation of cost-effective, patient-friendly, personalised and domestically usable technologies that can be developed with clinical and industry partners. Our major deliverables and outputs will i) a set of strategy documents and scientific reviews covering conceptual framework development, pathways to clinical translation, and ethics and accessibility, ii) a series of events including workshops, sandpits, and a major public exhibition, iii) a set of new collaborative research feasibility projects; iv) a major educational program including a comprehensive seminar series, an extensive researcher exchange program, dedicated funds for new ECR pilot projects, and an ambitious UK mentorship program, v) a set of web-based resources including public engagement media outputs and patient information; as well as open technical, software tools and data produced by the network (e.g. software APIs for closed-loop systems). The network will be outwardly looking with the aim to establish links with all related researchers and stakeholders across the UK, building a sustainable research infrastructure focused on research and impact delivery both now and into the long term.

至少有20%的英国人口患有临床显著的慢性疼痛，使慢性疼痛在临床和社会经济影响方面几乎无与伦比。目前可用的药理和非药理解决方案的缺乏加剧了这一问题。然而，我们对慢性疼痛的神经生物学机制的理解的最新进展为神经技术创造了巨大但尚未开发的机会，有能力完全改变慢性疼痛的临床景观。实现这一能力关键取决于创建一个技术和临床基础设施，将跨学科专业知识（研究人员，临床医生，患者），不同的慢性疼痛状况（伤害性，神经性，伤害性）和不同的技术工具结合在一起。从神经工程的角度来看，这将允许技术整合，重点关注神经生物学机制所告知的关键战略目标。这有能力驱动与慢性疼痛相关的神经变化-以及与之相关的疲劳，抑郁和焦虑，恢复正常的健康状态，并对多种医疗条件和慢性疾病产生重大影响，其中许多慢性疼痛是其最有问题的方面。我们的中心目标是建立一个全面的网络，致力于发现和提高慢性疼痛神经技术的能力，为目前可用的治疗方法带来一个台阶式的变化。我们将充分参与研究人员，临床医生，患者和其他利益相关者的范围，以i）定义当前的景观，并确定关键的机遇和挑战; ii）从事创新的发现研究，重点是技术开发慢性疼痛，iii）通过支持ECR，教育和培训，并播种新的英国和国际合作，为疼痛神经技术创建可持续的基础设施。我们的科学和技术重点是构建结合联合收割机核心技术的集成系统，通常作为闭环系统：例如，使用伤害性反射的外围传感器检测的闭环神经刺激，具有神经刺激的认知VR，认知和行为数字治疗中的EEG神经反馈等。其目的是建立能力，以目标明确、治疗互动、实际和临床可行的方式将联合收割机各种技术结合起来。我们将进行一系列可行性研究，测试特定的整合策略，并展示如何使用这些不同的部分来进一步设计更全面的疼痛治疗系统。最终，这旨在建立新一代具有成本效益，患者友好，个性化和国内可用的技术，可以与临床和行业合作伙伴一起开发。我们的主要交付成果和产出将是i）一套战略文件和科学审查，涵盖概念框架开发，临床翻译途径，伦理和可及性，ii）一系列活动，包括研讨会，沙坑和大型公共展览，iii）一套新的合作研究可行性项目; iv）一个主要的教育计划，包括一个全面的研讨会系列，一个广泛的研究人员交流计划，新的ECR试点项目的专项资金，以及一个雄心勃勃的英国导师计划，v）一套基于网络的资源，包括公众参与媒体输出和患者信息;以及网络产生的开放技术、软件工具和数据（例如闭环系统的软件API）。该网络将向外看，旨在与英国各地的所有相关研究人员和利益相关者建立联系，建立一个可持续的研究基础设施，专注于现在和长期的研究和影响交付。

项目成果

Post-injury pain and behaviour: a control theory perspective.

• DOI: 10.1038/s41583-023-00699-5
• 发表时间: 2023-06
• 期刊: Nature reviews. Neuroscience

Balancing safety and efficiency in human decision making

平衡人类决策的安全性和效率

• DOI: 10.1101/2024.01.23.576678
• 发表时间: 2024
• 作者: Mahajan P