PainRelief.com Interview with: John Traynor, PhD Edward F Domino Research Professor Professor and Associate Chair for Research Department of Pharmacology, Medical School Professor of Medicinal Chemistry, College of Pharmacy University of Michigan, Ann Arbor MI
Dr. Traynor
PainRelief.com: What is the background for this study? What are the main findings?
Response: Response: Morphine and related drugs acting at the mu-opioid receptor are the most effective treatment for moderate to severe pain, yet their use is limited by serious on-target side effects including respiratory depression, and physical and psychological dependence that has led to the opioid crisis. Current opioid drugs are required because our own endogenous pain relieving chemicals, the enkephalins and endorphins opioid peptides, cannot efficiently relieve pain.
We have discovered a class of drugs (positive allosteric modulators, PAMs) that bind to the mu-opioid receptor to enhance the activity of endogenous opioids. These “enkephalin amplifiers” afford pain relief in mouse models without the need for morphine-like compounds and do so with a much reduced side-effect profile.
Kao-Ping Chua, MD, PhD Susan B. Meister Child Health Evaluation and Research Center Department of Pediatrics, University of Michigan Medical School Ann Arbor MI 48109.
Dr. Kao-Ping Chua
PainRelief.com: What is the background for this study?
Response: Prior studies suggest that opioid prescriptions for surgical procedures are associated with increased overdose risk in patients. Additionally, studies suggest that opioid prescriptions are associated with increased overdose risk in patients’ family members, who often have access to patients’ opioids. However, studies have not specifically assessed whether opioid prescriptions for dental procedures are associated with increased overdose risk in patients and their family members.
PainRelief.com Interview with: Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan
Dr. Kao-Ping Chua,
PainRelief.com: What is the background for this study?
Response: Persistent opioid use occurs when opioid-naïve patients prescribed opioids after procedures continue to fill opioid prescriptions well past the time that acute post-procedural pain typically resolves. Studies have shown that privately insured adolescents and young adults undergoing wisdom tooth removal are more likely to develop persistent opioid use if they fill opioid prescriptions after the procedure than if they do not. However, it is unknown whether these findings generalize to a broader variety of dental procedures or to publicly insured patients covered by Medicaid.
PainRelief.com Interview with: Janet Currie, PhD Henry Putnam Professor of Economics and Policy Affairs Co-Director, Center for Health and Wellbeing Princeton University, Princeton NJ 08544
Janet Currie, PhD
PainRelief.com: What is the background for this study?
Response: There has been a great deal of discussion and media reports of disrupted access to care because of the pandemic, as well as reports (including the most recent numbers from the CDC which were just released) about increases in drug overdoses linked to opioids.
We wondered how this might be related to changes in patterns of opioid prescribing and also the prescribing of buprenorphine for opioid-use disorder.
PainRelief.com Interview with: Markus Ploner MD Professor of Human Pain Research Department of Neurology Technische Universität München Munich, Germany
Prof. Ploner
PainRelief.com: What is the background for this study?
Response: Recent studies in humans and animals have revealed that pain is associated with rhythmic brain activity termed neural oscillations. In particular, changes of neural oscillations at alpha (8 – 13 Hz) and gamma (30 – 100 Hz) frequencies in somatosensory and prefrontal brain areas have been related to pain. Thus, modulating neural oscillations to eventually modulate pain is a promising novel approach for pain treatment.
Transcranial alternating current stimulation (tACS) is an emerging neuromodulation technique which aims at non-invasively modulating neural oscillations in the human brain. During tACS, a weak alternating current is applied to the scalp with the goal of entraining neural oscillations at the stimulation frequency, thereby increasing their amplitude. The appeal of tACS is that it is non-invasive, safe, cost-efficient, and potentially mobile which allows for broad clinical applications. Thus, tACS is increasingly explored as a new treatment approach for neuropsychiatric disorders.
In our study, we therefore explored the potential of tACS to modulate pain. We systematically applied tACS at alpha and gamma frequencies or sham tACS over somatosensory and prefrontal cortices during tonic experimental pain in healthy human participants.
PainRelief.com: What are the main findings?
Response: Our main findings are that, using the current setup, tACS did not modulate the perception of pain. Bayesian statistics further supported a lack of tACS effects in most conditions including prefrontal and gamma tACS. The only exception was tACS at alpha frequencies over somatosensory cortex where evidence for tACS effects on pain perception was inconclusive.
PainRelief.com: What should readers take away from your report?
Response: Readers might take away three key points.
First, neurophysiological studies indicate that modulating neuronal oscillations to eventually modulate pain is a promising novel approach for the treatment of pain.
Second, tACS is one non-invasive and simple approach to modulate neuronal oscillations.
Third, our mostly negative findings show that we are not there yet.
PainRelief.com: What recommendations do you have for future research as a result of this work?
Response: A very general recommendation is that rigorous, well-controlled and transparent studies are needed to further explore the potential of tACS (and other neuromodulatory techniques) for treating pain. Furthermore, we should ideally make all our data available to the public so that the whole research community can take advantage of them. Finally, to advance the field, we should not only publish positive but also negative findings, as done here.
A more specific recommendation is that modulating neuronal oscillations at alpha frequencies over somatosensory brain areas is the most promising approach for further tACS studies.
Citation:
May ES, Hohn VD, Nickel MM, Tiemann L, Gil Ávila C, Heitmann H, Sauseng P, Ploner M. Modulating Brain Rhythms of Pain using Transcranial Alternating Current Stimulation (tACS) – A Sham-controlled Study in Healthy Human Participants. J Pain. 2021 Apr 9:S1526-5900(21)00191-7. doi: 10.1016/j.jpain.2021.03.150. Epub ahead of print. PMID: 33845173.
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The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, endorese, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. None of the content on PainRelief.com is warranted by the editors or owners of PainRelief.com or Eminent Domains Inc.
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