# Identifying neuromodulation targets for pain in the human brain

> **NIH NIH R21** · BRIGHAM AND WOMEN'S HOSPITAL · 2022 · $268,500

## Abstract

Identifying neuromodulation targets for pain in the human brain
Neuropathic pain is prevalent across many different neurological and psychiatric disorders and has one of the
largest adverse effects on quality of life. Pharmacological pain treatments often have limited efficacy and
undesirable side effects, including dependence and addiction. Neuromodulation treatments such as transcranial
magnetic stimulation show promise for pain while avoiding the side effects associated with pain medications. An
obstacle to improving neuromodulation treatment is identifying the human brain regions responsible for pain.
Traditional functional neuroimaging studies only identify correlates of pain which could be causing symptoms,
compensating for symptoms, or simply serving as a marker of symptoms. This ambiguity is a problem when
seeking to identify therapeutic targets. Unlike functional neuroimaging, lesion studies allow for casual links
between symptoms and human neuroanatomy. The PI has developed and validated a new method to identify
neuromodulation targets in the human brain based on brain lesions and a map of human brain connectivity.
Called lesion network mapping, this approach has been used to map numerous neurological and psychiatric
symptoms to brain networks (Fox 2018, NEJM). Brain networks identified using this approach have proven to
be effective neuromodulation targets for symptoms such as tremor, Parkinson’s disease, dystonia, and
depression. Our preliminary data suggests this method is equally valuable for mapping pain, including
identification of therapeutic targets. Here, we will use this approach to map pain to a human brain circuit based
on lesion locations previously reported to cause pain (Aim 1), a dedicated dataset focused on thalamic lesions
causing or not causing pain (Aim 2), and a prospective dataset of patients longitudinally assessed for
development of post-stroke pain (Aim 3). We hypothesize that; (1) lesions causing pain will map to a common
brain network; (2) this network will show abnormal metabolism in patients with post stroke pain, (3) this network
will predict who will develop post-stroke pain; and (4) this pain network will include primary motor cortex, our
best validated neuromodulation target for pain. Completion of these aims will identify a candidate human brain
network causally linked to pain. Once identified, this network can be validated in future trials with more detailed
characterization of post stroke pain and used as an improved target for neuromodulation that can be tested in
clinical trials.

## Key facts

- **NIH application ID:** 10450987
- **Project number:** 1R21NS123813-01A1
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** MICHAEL D FOX
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $268,500
- **Award type:** 1
- **Project period:** 2022-03-15 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450987

## Citation

> US National Institutes of Health, RePORTER application 10450987, Identifying neuromodulation targets for pain in the human brain (1R21NS123813-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10450987. Licensed CC0.

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