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CHRONIC PAIN: UTRASOUND MAY HELP



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Pain’s supposed to be the body’s fire alarm. Stub your toe, cut your finger, and it shouts, “Hey! Something’s wrong!” But for people living with chronic pain, the alarm system breaks down. Their brains keep crying emergency—even for injuries that have healed, limbs that are long gone, or aches no doctor can easily explain.

For these folks, relief is always just out of reach. But a group at the University of Utah might have finally found something that actually works.

Researchers from the John and Marcia Price College of Engineering and the Spencer Fox Eccles School of Medicine have been working on an experimental therapy that does some pretty wild things—and it’s already helping people after just one session. Now, they’re moving into the final phase of clinical trials and are looking for volunteers.

At the heart of this research is a device called Diadem. Instead of medicine or surgery, Diadem uses ultrasound—like the kind in prenatal scans, but souped up—to reach deep into the brain. By gently zapping certain regions, it might actually shut down the “broken alarm” that causes chronic pain.

They just published results from a clinical trial in the journal Pain, building on earlier studies in Nature Communications Engineering and IEEE Transactions on Biomedical Engineering. Those studies covered the device specs and proved it could actually work.

The team, led by professor Jan Kubanek, postdoc Thomas Riis, anesthesiologist Akiko Okifuji, and several others, ran a randomized sham-controlled trial with 20 people who have chronic pain. Each participant sat through two 40-minute sessions, getting either real or fake ultrasound treatment—no one knew which. A day and a week later, participants checked in about their pain. Here’s the kicker: of those who got real treatment, 60% reported a significant drop in pain that lasted at least a week.

Riis was floored by the results. “We were not expecting such strong and immediate effects from only one treatment,” he said.

Kubanek added, “It’s not just how quickly it worked, but the fact that the relief stuck around that really surprised us. With a treatment this noninvasive, we might have a real shot at reaching patients that nothing else helps.”

Diadem does something other techniques can’t: it targets the anterior cingulate cortex, a part of the brain that plays a significant role in the experience of pain. While other neuromodulation methods use electricity or magnetic fields—and have trouble hitting that exact spot—ultrasound can get there, provided you know how to aim. So, the team scanned each patient’s brain with an fMRI, mapped out the best location, and then fine-tuned the device to bounce soundwaves right where they’d do the most good. (That targeting process is described in detail in their Nature Communications Engineering paper.)

Next up: a significant Phase 3 clinical trial—the last hurdle before the FDA will consider making Diadem available to everyone.

Kubanek is putting out a call: “If you or someone you love battles chronic pain that no treatment touches, we want to hear from you. We need people for the next round of tests so this therapy can be approved and used widely. Chronic pain doesn’t have to be a life sentence. And who knows—giving doctors better treatment options might even help us finally get ahead of the opioid crisis, too.”



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