Shirvalkar Pain Neuromodulation Lab
Advancing innovative brain and spine stimulation therapies for pain.
Current Research: NIH-Sponsored Clinical Trials for the Treatment of Chronic Neuropathic Pain
Chronic pain affects 1 in 4 US adults, and many cases are resistant to almost any treatment. Deep brain stimulation (DBS) holds promise as a new option for patients suffering from treatment-resistant chronic pain, but traditional approaches target only brain regions involved in one aspect of the pain experience and provide continuous 24/7 brain stimulation which may lose effect over time. By developing new technology that targets multiple, complimentary brain regions in an adaptive fashion, the investigators will test a new therapy for chronic pain that has potential for better, more enduring analgesia.
Closed-Loop Deep Brain Stimulation for Refractory Chronic Pain
Our Research
Chronic pain syndromes are often refractory to treatment and cause substantial suffering and disability. Pain severity is often measured through subjective report, while objective biomarkers that may guide diagnosis and treatment are lacking. Also, which brain activity underlies chronic pain on clinically relevant timescales, or how this relates to acute pain, remains unclear. Here four individuals with refractory neuropathic pain were implanted with chronic intracranial electrodes in the anterior cingulate cortex and orbitofrontal cortex (OFC). Participants reported pain metrics coincident with ambulatory, direct neural recordings obtained multiple times daily over months. We successfully predicted intraindividual chronic pain severity scores from neural activity with high sensitivity using machine learning methods. Chronic pain decoding relied on sustained power changes from the OFC, which tended to differ from transient patterns of activity associated with acute, evoked pain states during a task. Thus, intracranial OFC signals can be used to predict spontaneous, chronic pain state in patients.
First-in-human prediction of chronic pain state using intracranial neural biomarkers
In the News
Scientists Find Brain Signals of Chronic Pain

Welcome!

The Shirvalkar Lab (Pain Neuromodulation Lab) is led by Prasad Shirvalkar MD, PhD, a neurologist and pain physician-scientist who treats the full range of chronic pain syndromes.

Among the amazing things that the brain does, it is responsible for generating and representing the most fundamental human percept: Pain. We focus on studying basic brain mechanisms of acute and chronic pain in humans using neuropsychology, behavior, imaging (DTI, fMRI), neurophysiology (invasive recordings and EEG), computational neuroscience, signal processing and machine learning.  Our short term goal is to understand of how pain circuits live in the brain and how these circuits go awry to produce chronic pain states. The long term goal is to use this new knowledge to develop new technology for spine and brain stimulation to treat patients, and improve quality of life.

Our lab is physically located across three campuses: Parnassus, Mount Zion and Mission Bay. We collaborate with critical partners in anesthesiology, neurology and neurological surgery to tackle these urgent problems. We are always looking for enthusiastic and accomplished people to join us. Welcome!

Lab news update: 6/1/2023
See our latest publication on decoding human chronic pain in the brain here: 

https://www.nature.com/articles/s41593-023-01338-z

 

Media links about the publication:

NYT: Scientists Find Brain Signals of Chronic Pain

WSJ:  Brain Study Finds Clues to Treating Chronic Pain

New Scientist: Chronic pain linked to distinctive patterns of brain activity

Science Friday https://www.sciencefriday.com/segments/chronic-pain-brain-signals/#segment-transcript