A new approach to spinal stimulation therapy under development at Carle Illinois College of Medicine could offer more effective relief for patients with chronic pain, especially those in rural areas. The innovative approach leverages real-time data on the patient’s emotional state as well as physical biomarkers to optimize pain relief through more personalized delivery of spinal stimulation.
For decades, spinal stimulation has been used to treat chronic pain. A small, implanted device delivers mild electrical impulses to the spine, disrupting pain signals by activating specific nerve fibers. Open-loop stimulators deliver a manually programmed level of electricity regardless of the patient’s unique characteristics. Closed-loop systems are more advanced, allowing for more personalized stimulation based on biomarkers detected in the patient.
CI MED student Prateek Dullur is part of a cross-disciplinary team at the University of Illinois Urbana-Champaign working to improve on existing closed-loop technology. “Prior research has investigated closed-loop systems built on objective biomarkers (e.g., movement and position) or subjective ones (such as mood and pain levels). A personalized approach incorporating both modalities has not yet been developed. We believe this approach is the future of closed-loop algorithms,” Dullur said.
Specifically, the team is working with experts from the University of Illinois Urbana-Champaign who specialize in advanced neural engineering and artificial intelligence. “Part of this work is inspired by seizure forecasting and closed-loop stimulation in epilepsy, which the DEPEND lab (headed by CI MED and Electrical and Computer Engineering Professor Ravishankar Iyer) has validated in a collaboration with the Mayo Clinic. We believe applying a similar architecture to chronic pain and spinal cord stimulation could hold tremendous promise,” Dullur said.
“Ultimately, we aim to provide improved quality of life to patients with chronic pain that is refractory to medication or other treatment,” said Dullur, who presented the team’s work at the Congress of Neurological Surgeons Annual Meeting in Los Angeles in October. “By improving our models, we hope to contribute to the fundamental understanding of chronic pain. This work may take us one step closer towards providing better daily outcomes and lowering the chance of device failure due to tolerance, which is a major concern with existing devices,” he said.
The team is building its proposed computer model for a personalized closed-loop spinal stimulation system. They’re also expanding their work to explore the effectiveness of spinal stimulation for treating rural patients living with chronic pain.
“We are conducting a retrospective study with patients in the Carle Foundation Hospital network. We believe these joint efforts may lead to novel insights into treating chronic pain in under-resourced settings,” Dullur said.
In addition to Dullur, the research team includes: Dr. Suguna Pappu, a CI MED faculty member and Carle Health neurosurgeon; CI MED students Meenakshi Singhal, Mehreen Ali, Brian Hong, and Neema Darabi; from the U. of I. Department of Electrical Engineering Professor Ravishankar Iyer (CI MED professor of Biomedical and Translational Sciences) and graduate student Yurui Cao; and from the Department of Bioengineering, Professor Yuan Yang, an expert in neural engineering and neural modeling.
Editor’s note: Part of this work is supported by the National Science Foundation CAREER award (NSF 2401215) granted to Yuan Yang as principal investigator.
The team’s work is published in the journal Neuromodulation and can be found here.