Neurotechnology for Chronic Pain

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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.