For people living with chronic pain, long-term relief has often seemed out of reach. Now, researchers have developed a brain implant that can detect pain signals in real time and respond with targeted deep-brain stimulation (DBS), offering significant, lasting improvements.
Chronic pain affects millions worldwide and often resists conventional treatments because it stems from subtle changes in brain circuitry that are difficult to identify. DBS, which delivers electrical pulses to the brain, has shown promise but with mixed results—largely because it has been applied using a one-size-fits-all approach.
Prasad Shirvalkar and his team at the University of California set out to test whether a personalised method could work better. They studied six patients with treatment-resistant pain, recording brain activity from 14 locations over 10 days using intracranial electroencephalography.
For five participants, the researchers identified optimal sites and stimulation frequencies for maximum relief. One participant, though not reporting major pain reduction, regained physical ability and embraced his wife for the first time in years—an improvement considered meaningful enough to continue.
Next, machine learning was used to distinguish brain signals linked to high versus low pain. Each participant received a permanent, custom-programmed DBS implant designed to deliver stimulation only when pain signals appeared, and to shut off while they slept.
The trial, conducted over six months, compared real stimulation against a sham version. Genuine, tailored stimulation reduced daily pain intensity by 50% on average, while sham stimulation led to an 11% increase. Participants also reported fewer depression symptoms, less interference of pain with daily life, and showed an 18 per cent increase in daily step counts compared to just 1% during the sham. The benefits held steady over a 3.5-year follow-up.
Tim Denison of the University of Oxford called it a “crucial study that capitalises on cutting-edge instrumentation.” He noted that DBS often fails due to habituation—the brain adjusting to constant stimulation. In this case, because stimulation was adaptive rather than continuous, the benefits persisted.
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Looking ahead, Denison said the next step will be to compare adaptive versus constant stimulation, while also addressing the challenges of cost, accessibility, and the need for less invasive neuromodulation approaches.
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