# Neural and Immune Correlates of Painful Chemotherapy-Induced Neuropathy, Feasibility and Preliminary Efficacy of a Motor Cortex Non-Invasive Brain Stimulation Intervention

> **NIH NIH U54** · MORGAN STATE UNIVERSITY · 2024 · $492,420

## Abstract

Project Summary – Project 3
More than half of patients treated with commonly used platinum- and taxane-based anti-cancer agents suffer
painful chemotherapy-induced peripheral neuropathy (CIPN). Non-Hispanic Black (NHB) patients have a greater
risk (risk ratio=1.6-2.4) of experiencing clinically relevant CIPN and consequent chemotherapy dose reductions
compared to non-Hispanic Whites (NHWs). Despite the greater risk of painful CIPN in NHB cancer patients,
clinical trials in patients suffering with CIPN have historically included homogeneous patient populations of
NHWs. Only duloxetine is approved to treat painful CIPN and is not effective for or tolerated by all patients.
Transcranial direct current stimulation (tDCS) of the motor cortex is emerging as a promising, safe, and effective
intervention for the pain of neuropathy. An additional benefit of tDCS is that it can be administered at home and
supervised remotely, minimizing stressful visits to a hospital venue for treatment. A recent randomized
experimental study in healthy individuals completed by the PI showed that one 20-minute session of motor cortex
tDCS reduced capsaicin-induced hyperalgesia. To understand the mechanism of pain ameliorating effects of
motor cortex tDCS, the PI found enhanced neurophysiological responses of the descending pain modulatory
network (DPMN), a group of brain structures activated in response to painful stimuli, after active compared to
sham stimulation. Previous investigations have observed differences in opioid receptor binding and pain
responses in the DPMN (notably the cingulate cortex and ventral striatum) between healthy NHBs and NHWs
as well as differences in pain sensitivity. Likely relevant to the mechanism of CIPN, PET scanning of
chemotherapy patients reveals neuroinflammation throughout the brain. The facts that 1) NHB individuals
experience a greater rate of CIPN, but have not been represented in relevant clinical studies, 2) non-invasive
tDCS is emerging as a safe and effective treatment for neuropathic pain and can be implemented in the home
3) the DPMN is implicated in central pain responses and is activity is enhanced after tDCS and 4)
neuroinflammation likely plays a role in CIPN have led us to the present research plan. The overarching goal of
this proposal to conduct an exploratory double-blind randomized controlled trial (RCT) addressing 3 specific
aims: 1) determine the feasibility and efficacy of active tDCS targeting motor cortex as an analgesic and anti-
hyperalgesic intervention in patients with painful CIPN, 2) determine structural and functional brain correlates of
painful CIPN in the DPMN in NHBs and NHWs, and 3) determine inflammatory mediators in patients with painful
CIPN and their relationship to the severity of painful CIPN and DPMN structure and function. We expect NHB
subjects will experience greater therapeutic effects of tDCS compared to NHW subjects, since NHBs have a
dysregulated DPMN potentially affected by neuroinflammat...

## Key facts

- **NIH application ID:** 11002071
- **Project number:** 2U54MD013376-06A1
- **Recipient organization:** MORGAN STATE UNIVERSITY
- **Principal Investigator:** Timothy J Meeker
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $492,420
- **Award type:** 2
- **Project period:** 2019-07-31 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11002071

## Citation

> US National Institutes of Health, RePORTER application 11002071, Neural and Immune Correlates of Painful Chemotherapy-Induced Neuropathy, Feasibility and Preliminary Efficacy of a Motor Cortex Non-Invasive Brain Stimulation Intervention (2U54MD013376-06A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/11002071. Licensed CC0.

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