Non-invasive Neuromodulation of the Brain as an Adjuvant in Cancer Pain Management
Pain is the major symptom of approximately 50% of all cancer patients. In advanced or terminal cancer patients, pain is almost an absolute presence due to multiple surgical procedures, chemotherapy, tumor progression and associated pathologies. Their suffering represents a clinical challenge, in which palliative treatments, primarily opioids, fail to provide relief for a large number of them; either because of issues related to drug tolerance and side-effects, or the limitation on prescription dictated by the patient’s significant organ(s) dysfunction. A novel treatment modality that could potentially have significant impact would directly modulate the endogenous analgesic and anti-inflammatory mechanisms in the brain, bypassing such frail organs. Interestingly, cortical modulation can now be achieved non-invasively and safely by transcranial direct current stimulation (tDCS), which has been reported, by our group and others, to produce lasting therapeutic effects in chronic pain, including fibromyalgia, neuropathic pain and migraine. In this study, we aim to first investigate the analgesic effects of 5-daily tDCS applications as an adjuvant in cancer pain management, based on clinical pain levels and amount of rescue drugs needed during treatment (e.g., opioids, NSAIDS); Second, we intend to evaluate the safety of this intervention on cancer pain patients via a battery of neurocognitive tests; and third, we aim to study the effect of direct modulation of the central pain neuromatrix on the patients’ salivary levels of proinflammatory cytokines. The new treatment paradigm proposed in our project addresses several methodologic issues in clinical trials for cancer pain patients, and has the potential to provide significant alleviation of patient suffering.
Feasibility of Non-Invasive Brain Modulation for Pain Management in Patients Undergoing Chemoradiotherapy for Advanced Head and Neck Cancer
Presented at the Society for Neurology 2016, San Diego, CA
Presented at the Organization for Human Brain Mapping 2016, Geneva, Switzerland
Non-Invasive Neuromodulation of the Brain as an Adjuvant in Cancer Pain Management for Patients Undergoing Definitive Chemoradiotherapy for Locally Advanced Head and Neck Cancer
Presented at Presented at University of Michigan Dental School Research Day, 2016