Baseline brain activity predicts response to neuromodulatory pain treatment

Jensen, Mark P.; Sherlin, Leslie H.; Fregni, Felipe; Gianas, Ann; Howe, Jon D.; Hakimian, Shahin

doi:10.1111/pme.12546

Cited by 35Pain Management and Placebo EffectPain Management and TreatmentTranscranial Magnetic Stimulation Studies

Baseline brain activity predicts response to neuromodulatory pain treatment

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Jensen, Mark P., Sherlin, Leslie H., Fregni, Felipe, Gianas, Ann, Howe, Jon D., Hakimian, Shahin·2014·Pain Medicine

DOI 10.1111/pme.12546PMC PMC4467571

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Abstract

OBJECTIVES: The objective of this study was to examine the associations between baseline electroencephalogram (EEG)-assessed brain oscillations and subsequent response to four neuromodulatory treatments. Based on available research, we hypothesized that baseline theta oscillations would prospectively predict response to hypnotic analgesia. Analyses involving other oscillations and the other treatments (meditation, neurofeedback, and both active and sham transcranial direct current stimulation) were viewed as exploratory, given the lack of previous research examining brain oscillations as predictors of response to these other treatments. DESIGN: Randomized controlled study of single sessions of four neuromodulatory pain treatments and a control procedure. METHODS: Thirty individuals with spinal cord injury and chronic pain had their EEG recorded before each session of four active treatments (hypnosis, meditation, EEG biofeedback, transcranial direct current stimulation) and a control procedure (sham transcranial direct stimulation). RESULTS: As hypothesized, more presession theta power was associated with greater response to hypnotic analgesia. In exploratory analyses, we found that less baseline alpha power predicted pain reduction with meditation. CONCLUSIONS: The findings support the idea that different patients respond to different pain treatments and that between-person treatment response differences are related to brain states as measured by EEG. The results have implications for the possibility of enhancing pain treatment response by either 1) better patient/treatment matching or 2) influencing brain activity before treatment is initiated in order to prepare patients to respond. Research is needed to replicate and confirm the findings in additional samples of individuals with chronic pain.

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The pilot findings align with hypotheses that theta oscillations and reduced left anterior brain activity may help facilitate hypnosis response.
“These preliminary findings are consistent with hypotheses regarding the role that theta oscillations and inhibition of left anterior brain activity may play in facilitating response to hypnosis.[37, 39]”
From The chronic pain skills study: Protocol for a randomized controlled trial comparing hypnosis, mindfulness meditation and pain education in Veterans (2020) · cites this paper as [39]
The Primary Study Hypothesis section (p. 4) reports that higher baseline theta activity predicted pain reduction with hypnosis. Exploratory Analyses (p. 5) also report that lower gamma activity at left anterior electrodes predicted response to hypnosis. The paper does not establish that this finding represents inhibition of left anterior brain activity or that such inhibition facilitates response; the Limitations section (p. 7) cautions against strong interpretations of the exploratory result. (LLM, conf=0.83)
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Authors: Jensen, M. P., Sherlin, L. H., Fregni, F., Gianas, A., Howe, J. D., & Hakimian, S.
Affiliations: University of Washington (US)
Southwest College of Naturopathic Medicine & Health Sciences (US)
Harvard University (US)
ORCID: Jensen, Mark P.
Sherlin, Leslie H.
Fregni, Felipe
Howe, Jon D.
Hakimian, Shahin
Venue: Pain Medicine
Publisher: Oxford University Press (OUP)
Published: 2014-12
Volume: 15
Issue: 12
Pages: 2055-2063
ISSN: 1526-2375 (ISSN-L)
1526-4637
DOI: 10.1111/pme.12546
PMC: PMC4467571
OpenAlex: W1907976367
Cited by: 35
References: 61
Citations by year: 2026: 4 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 3 · 2015: 3 · 2014: 1
FWCI: 2.05
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm, 274 d)
Locations: Pain Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: University of Washington
National Institutes of Health
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD058049)
National Center for Medical Rehabilitation Research
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords: treatment response prediction, EEG oscillations, theta power, alpha power, hypnotic analgesia, meditation, neurofeedback, transcranial direct current stimulation, spinal cord injury, chronic pain, patient-treatment matching
MeSH terms: Adult, Aged, Brain, Electroencephalography, Female, Humans, Hypnosis, Male, Middle Aged, Spinal Cord Injuries, Cross-Over Studies, Meditation, Young Adult, Neurofeedback, Chronic Pain, Pain Management, Transcranial Direct Current Stimulation

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Baseline brain activity predicts response to neuromodulatory pain treatment

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