Neuropathic pain can be a disabling disorder and accounts for nearly 40 percent of chronic pain sufferers. Not only can it lead to anxiety and depression, but another result can be opioid addiction. Researchers at Baylor College of Medicine have teamed up with colleagues from Rice University and The University of Texas Health Science Center at Houston (UTHealth) to find an effective treatment to use as an alternative to opioids and be a part of the fight to end the opioid crisis.
The group has been awarded a grant as part of the Helping to End Addiction Long-term, or the NIH HEAL Initiative, to develop endovascular nerve stimulation technology, wirelessly powered nerve stimulators that help to reduce pain. The device will be small enough to be placed on stents and delivered within the blood vessels adjacent to specific areas in the central and peripheral nervous system.
At Baylor, the project is being led by Dr. Peter Tze Man Kan, associate professor of neurosurgery and director of cerebrovascular surgery and chief of the Neuroendovascular Service at Baylor St. Luke's Medical Center. His co-principle investigators are Dr. Sunil A. Sheth, assistant professor of endovascular neurology at McGovern Medical School at UTHealth and Dr. Jacob T. Robinson, associate professor of electrical and computer engineering and of bioengineering at Rice.
“In the last several years research has shown that electrical stimulation is an effective treatment for reducing pain when targeting the spinal cord and the dorsal root ganglia (DRG is a bundle of nerves that carry sensory information to the spinal cord),” Kan said. “There are currently available DRG stimulators, however they require surgery to implant a battery pack and pulse generator. Our goal is to develop a minimally invasive technology.”
Creating this type of technology helps to reduce potential risks associated with nerve stimulation therapies such as invasive surgeries and risk of infection. The smaller device also will help with more precise placement and more predictable outcomes.
“We have made tremendous advances recently in our ability to perform minimally invasive treatments for a number of neurological disorders. By navigating these devices through blood vessels, we can dramatically reduce the procedural risk, and in doing so, make these types of treatments much more accessible to the many people who suffer from unrelenting pain,” Sheth said.
Robinson is leading a team that includes Rice assistant professor Kaiyuan Yang to engineer the devices.
“The ability to manufacture extremely small bioelectronic devices creates tremendous opportunities for new bioelectronic medicines like non-addictive pain relief,” Robinson said.
According to the group, when the devices are made small enough to be delivered through the vasculature, conventional power delivery by electromagnetic waves or magnetic induction has poor power transfer efficiency. That is why electronic stimulation therapies currently rely on wired devices.
To create a wireless endovascular nerve stimulation technology, the group is using its own recent innovation in wireless power delivery system for millimeter-sized bioelectronics, which is better suited for small, implantable bioelectronics. The patient would use a wearable magnetic field generator to deliver power and data.
As research and development begin, Kan says preclinical and clinical trials will be needed to test the device for safety and efficacy.
“The ultimate goal of our work is to have a non-opioid alternative for patients with neuropathic pain that is resistant to medical therapy,” Kan said.
The National Institutes of Health launched the NIH HEAL Initiative in April 2018 to improve prevention and treatment strategies for opioid misuse and addiction. It aims to improve treatments for chronic pain, curb the rates of opioid use disorder and overdose and achieve long-term recovery from opioid addiction.