URMC researcher receives $8.3 million to study chronic pain and the brain

Jul. 19, 2023
Paul Geha, MD
Paul Geha, MD

Understanding the role of chronic pain in the brain could transform treatment and care for a condition that inflicts more than 20 percent of US adults. Paul Geha, MD, associate professor of Psychiatry has been studying the correlation between brain structure and chronic pain and was recently awarded $8.3 million from the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) to continue this work in understanding the link between pain and the brain.

His previous research found a possible explanation to why people with chronic pain often struggle with their weight. The research published in PLOS ONE suggests that circuitry in the brain responsible for motivation and pleasure is impacted when someone experiences pain, changing their brain’s response to fat and brain scans showed disrupted satiety signals.

“Our ongoing research focuses on unraveling the mechanisms underlying pain perception in the brain, as well as utilizing brain circuitries to gain insights into the pathophysiology of chronic pain. Additionally, we aim to develop quantitative biomarkers that can be derived from natural language processing of patients' pain narratives and multimodal brain imaging,” said Geha. “These biomarkers hold the potential to predict clinical outcomes in patients, including response to analgesics or the long-term persistence or remission of pain.”

The funding will focus on three specific research projects:

  • $3 million will support research that investigates whether language or facial expressions can be used to diagnose different groups of chronic pain patients and predict whether spinal cord stimulation is working in chronic lower-back pain patients receiving this treatment.
  • A $2.4 million grant will focus on finding structural gray and white matter biomarker in the brain that can help identify who is at risk of low-back pain becoming chronic. Previous research by Geha, found a smaller nucleus accumbens can indicate if someone is at a greater risk of developing chronic pain.
  • $2.9 million will test whether the brain signature of chronic low-back pain can also indicate other chronic musculoskeletal conditions, like knee arthritis pain or nervous system related chronic pain. The research will also consider of other chronic conditions, like major depressive disorder, and if an individual’s age or sex play a role in this neural signature.
“By employing these approaches, we anticipate that our projects will contribute to a significant advancement in revolutionizing the clinical approach to pain management,” Geha said. “Currently, the field heavily relies on subjective reports and clinical expertise. However, through the development of objective quantitative biomarkers, we aim to provide a more precise and reliable approach to assessing and understanding pain.”