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Predicting post-surgical pain early by studying brain alpha waves

If medics can limit acute pain in the period directly following surgery, there is a real chance patients will not go on to develop chronic symptoms.

This handout photo released by the University of Maryland School of Medicine on January 10, 2022 shows surgeons performing a transplant of a heart from a genetically modified pig to patient David Bennett, Sr
This handout photo released by the University of Maryland School of Medicine on January 10, 2022 shows surgeons performing a transplant of a heart from a genetically modified pig to patient David Bennett, Sr - Copyright AFP/File JIM WATSON
This handout photo released by the University of Maryland School of Medicine on January 10, 2022 shows surgeons performing a transplant of a heart from a genetically modified pig to patient David Bennett, Sr - Copyright AFP/File JIM WATSON

The pain suffered by some people following an operation can be severe. However, for medics this can be difficult to predict and to treat promptly. A new technique could help to address this by providing an early indicator.

The technology is based on an assessment of alpha brain waves, where an analysis of this can help to predict post-surgery pain. Initial data, issued by the University of Birmingham, suggests that patients who are most likely to suffer severe pain following an operation can be reliably identified using a new technique.

With the study, scientists have demonstrated how electroencephalography (EEG) can be used to measure brain activity in patients about to undergo chest surgery, or thoracotomy. EEG measures voltage fluctuations resulting from ionic current within the neurons of the brain.

Prior to the start of surgery, the scientists measured alpha waves (brain signals which oscillate between 8 and 14 Hz) in a selected group of patients. Alpha waves appear to inhibit areas of the cortex not in use and they play an active role in network coordination and communication.

Following this, over 72 hours following surgery, patients were asked to score their pain on a scale from 1-10. Through the subsequent analysis, the researchers were able to demonstrate a clear link between the patient’s alpha waves and their responses to pain.

In particular, it was established that patients whose alpha waves oscillated below 9 Hz were far more vulnerable to severe pain post-surgery.

The reason why alpha waves are a good predictor of pain is thought to be connected to specific pathways in the brain that are known to relay sensory messages from the thalamus (this is the brain’s central hub for sensory information).

According to lead researcher Dr Ali Mazaheri: “The experience of being in pain is complicated and subjective, but it’s clear that these alpha waves are a reliable indicator of how severely an individual will experience pain.”

As to the advantage,  Mazaheri  explains: “That offers clinicians a really valuable biomarker that they can use to prevent pain becoming an issue, rather than treating it after it has taken hold and become a serious, and potentially chronic problem.”

The research appears in the British Journal of Anaesthesia, titled “Predicting postoperative pain in lung cancer patients using preoperative peak alpha frequency.”

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Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, business, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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