Objective measure of pain during surgery using fNIRS

Key Researchers: David Borsook, Boston Children’s Hospital; David Boas, BU; Lino Becerra; Ke Peng; Meryem Ayşe Yücel, BU; Alexander von Lühmann, BU;

Summary: Assessing pain in individuals not able to communicate (e.g. infants, under surgery, or following stroke) is difficult due to the lack of non-verbal objective measures of pain. Near Infrared spectroscopy (NIRS) being a portable, non-invasive and inexpensive method of monitoring cerebral hemodynamic activity has the potential to provide such a measure. In this context, we aimed to identify objective markers of pain. Using fNIRS on healthy subjects, we were able to differentiate painful stimuli from a nonpainful stimuli based on their signal size and profile. We observed similar pain-related brain responses during catheter ablation of arrhythmias under general anesthesia and during routine screening colonoscopy. Our most recent data (unpublished) reveals that the brain response shows significant difference under morphine as compared to placebo. Overall, our results support the notion that fNIRS has utility as an objective measure of pain in the operating room.

Publications:

Yücel MA, Aasted CM, Petkov MP, Borsook D, Boas DA, Becerra L, “Specificity of Hemodynamic Brain Responses to Painful Stimuli: A functional near-infrared spectroscopy study.” Scientific Reports, 30; 5:9469, 2015.

Aasted CM, Yücel MA (co-first author), Steele SC, Peng K, Boas DA, Becerra L and Borsook D. “Frontal Lobe Hemodynamic Responses to Painful Stimulation: A Potential Brain Marker of Nociception” PLoS One, 2016.

Kussman BD, Aasted CM, Yücel MA, Steele SC, Alexander ME, Boas DA, Borsook D and Becerra L., “Capturing Pain in the Cortex during General Anesthesia: Near Infrared Spectroscopy Measures in Patients Undergoing Catheter Ablation of Arrhythmias.” 14; 11(7) PLoS One, 2016.

Becerra LR, Aasted CM, Boas DA, George E, Yücel MA, Kussman BD, Kelsey P, Borsook D., “Brain Measures of Nociception using Near Infrared Spectroscopy in Patients Undergoing Routine Screening Colonoscopy”, 157(4):840-8, Pain, 2016.

Peng K., Yücel MA, Aasted CM, Steele SC, Boas DA, Borsook D, Becerra L “Using pre-recorded hemodynamic response functions in detecting prefrontal pain response: a functional near infrared spectroscopy study” accepted for publication in Neurophotonics, 2017.

Funding: NIH R01 – GM104986