A state-of-the-art University of Essex study has developed a new scientific approach to understanding how pain is generated in the brain. 

The research led by Dr Elia Valentini focused on studying a potential indicator of pain – the oscillation in the alpha band.

These important brain waves fall in the middle of the spectrum and are generated as people take on day-to-day tasks. 

Dr Valentini developed a new method of studying how these waves change under stress and pain. 

As part of the study, 36 healthy volunteers were tested with an electroencephalogram (EEG) and electrical brain activity was recorded from different parts of their heads. 

They had five-minute sessions of rest, painful hot water immersion, warm water and an unpleasant sound listening. 

By studying brainwaves the team was able to pinpoint differences between heat, pain, and unpleasant sound. 

Dr Valentini and his colleagues identified specific parts of the head where the alpha waves slowed down during pain. 

Dr Valentini, from the Department of Psychology, said: “We made a critical study that addressed the important issue of sensitivity and specificity of pain biomarkers, which is a crucial methodological question to develop novel treatment for people suffering from chronic pain.” 

The research and advanced data analysis allowed the team to produce an accurate picture of alpha oscillations during pain. 

It is hoped the study – published in NeuroImage – will pave the way for further research which could lead to a better understanding of how pain is generated within the brain. 

Dr Valentini now hopes to expand upon this research with even more advanced data analysis and experiments – to discover more about alpha waves and pain. 

Acupuncture is a traditional Chinese technique that has been used for millennia to treat chronic pain and other health problems associated with inflammation, yet the scientific basis of the technique remains poorly understood. 

Now, a team of researchers led by neuroscientists at Harvard Medical School has elucidated the underlying neuroanatomy of acupuncture that activa

In a study conducted in mice and published Oct. 13 in Nature, the team identified a subset of neurons that must be present for acupuncture to trigger an anti-inflammatory response via this signaling pathway. 

The scientists determined that these neurons occur only in a specific area of the hindlimb region—thus explaining why acupuncture in the hindlimb works, while acupuncture in the abdomen does not. 

“This study touches on one of the most fundamental questions in the acupuncture field: What is the neuroanatomical basis for body region, or acupoint, selectivity?” said lead investigator Qiufu Ma, HMS professor of neurobiology at Dana-Farber Cancer Institute.

One area of particular interest to the research team is the so-called cytokine storm—the rapid release of large quantities of cytokines that frequently drives severe, systemic inflammation, and can be triggered by many things, including COVID-19, cancer treatment, or sepsis. 

“This exuberant immune response is a major medical problem with a very high fatality rate of 15 percent to 30 percent,” Ma said. Even so, drugs to treat cytokine storm are lacking. 

Adapting an ancient technique to treat aberrant inflammation

In recent decades, acupuncture has been increasingly embraced in Western medicine as a potential treatment for inflammation. 

In this technique, acupoints on the body’s surface are mechanically stimulated, triggering nerve signaling that affects the function of other parts of the body, including organs. 

In a 2014 study, researchers reported that electroacupuncture, a modern version of traditional acupuncture that uses electrical stimulation, could reduce cytokine storm in mice by activating the vagal-adrenal axis—a pathway wherein the vagus nerve signals the adrenal glands to release dopamine. 

In a study published in 2020, Ma and his team discovered that this electroacupuncture effect was region specific: It was effective when given in the hindlimb region, but did not have an effect when administered in the abdominal region. The team hypothesized that there may be sensory neurons unique to the hindlimb region responsible for this difference in response. 

In their new study, the researchers conducted a series of experiments in mice to investigate this hypothesis. First, they identified a small subset of sensory neurons marked by expression of the PROKR2^Cre receptor. They determined that these neurons were three to four times more numerous in the deep fascia tissue of the hindlimb than in the fascia of the abdomen. 

Then the team created mice that were missing these sensory neurons. They found that electroacupuncture in the hindlimb did not activate the vagal-adrenal axis in these mice. In another experiment, the team used light-based stimulation to directly target these sensory neurons in the deep fascia of the hindlimb. 

This stimulation activated the vagal-adrenal axis in a manner similar to electroacupuncture. “Basically, the activation of these neurons is both necessary and sufficient to activate this vagal-adrenal axis,” Ma said. 

In a final experiment, the scientists explored the distribution of the neurons in the hindlimb. They discovered that there are considerably more neurons in the anterior muscles of the hindlimb than in the posterior muscles, resulting in a stronger response to electroacupuncture in the anterior region. 

“Based on this nerve fiber distribution, we can almost precisely predict where electrical stimulation will be effective and where it will not be effective,” Ma explained. 

Together, these results provide “the first concrete, neuroanatomic explanation for acupoint selectivity and specificity,” Ma added. “They tell us the acupuncture parameters, so where to go, how deep to go, how strong the intensity should be.” 

He noted that while the study was done in mice, the basic organization of neurons is likely evolutionarily conserved across mammals, including humans. 

However, an important next step will be clinical testing of electroacupuncture in humans with inflammation caused by real-world infections such as COVID-19. Ma is also interested in exploring other signaling pathways that could be stimulated by acupuncture to treat conditions that cause excessive inflammation. 

“We have a lot of tough chronic diseases that still need better treatments,” he said, such as inflammatory bowel syndrome and arthritis. Another area of need, he added, is excessive immune reactions that can be a side effect of cancer immunotherapy.

Ma hopes that his research will ultimately advance scientific understanding of acupuncture and provide practical information that can be used to improve and refine the technique. 

Dr. Guy Fiocco, of NHRMC Physician Group – Rheumatology, discusses the impact of weather on joint pain and arthritis on Fox Wilmington’s Carolina in the Morning.

A comprehensive assessment of the benefits of medical cannabis for cancer-related pain found that for most oncology patients, pain measures improved significantly, other cancer-related symptoms also decreased, the consumption of painkillers was reduced, and the side effects were minimal. Published in Frontiers in Pain Research, these findings suggest that medicinal cannabis can be carefully considered as an alternative to the pain relief medicines that are usually prescribed to cancer patients.

Pain, along with depression, anxiety, and insomnia, are some of the most fundamental causes of oncology patient’s disability and suffering while undergoing treatment therapies, and may even lead to worsened prognosis.

“Traditionally, cancer-related pain is mainly treated by opioid analgesics, but most oncologists perceive opioid treatment as hazardous, so alternative therapies are required,” explained author David Meiri, assistant professor at the Technion Israel Institute of Technology.

“Our study is the first to assess the possible benefits of medical cannabis for cancer-related pain in oncology patients; gathering information from the start of treatment, and with repeated follow-ups for an extended period of time, to get a thorough analysis of its effectiveness.”

Need for alternative treatment

After talking to several cancer patients, who were looking for alternative options for pain and symptom relief, the researchers were keen to thoroughly test the potential benefits of medicinal cannabis.

“We encountered numerous cancer patients who asked us whether medical cannabis treatment can benefit their health,” said co-author Gil Bar-Sela, associate professor at the Ha’Emek Medical Center Afula. “Our initial review of existing research revealed that actually not much was known regarding its effectiveness, particularly for the treatment of cancer-related pain, and of what was known, most findings were inconclusive.”

The researchers recruited certified oncologists who were able to issue a medical cannabis license to their cancer patients. These oncologists referred interested patients to the study and reported on their disease characteristics.

“Patients completed anonymous questionnaires before starting treatment, and again at several time points during the following six months. We gathered data on a number of factors, including pain measures, analgesics consumption, cancer symptom burden, sexual problems, and side effects,” said Bar-Sela.

Improved symptoms

An analysis of the data revealed that many of the outcome measures improved, with less pain and cancer symptoms. Importantly, the use of opioid and other pain analgesics reduced. In fact, almost half of the patients studied stopped all analgesic medications following six months of medicinal cannabis treatment.

“Medical cannabis has been suggested as a possible remedy for appetite loss, however, most patients in this study still lost weight. As a substantial portion were diagnosed with progressive cancer, a weight decline is expected with disease progression,” reported Meiri.

He continued: “Interestingly, we found that sexual function improved for most men but worsened for most women.”

Meiri would like future studies to dig deeper and look at the effectiveness of medicinal cannabis in in different groups of cancer patients.

“Although our study was very comprehensive and presented additional perspectives on medical cannabis, the sex, age, and ethnicity, as well as cancer types and the stage of the cancer meant the variety of patients in our study was wide-ranging. Therefore, future studies should investigate the level of effectiveness of medicinal cannabis in specific subgroups of cancer patients with more shared characteristics.”