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Timothy Y. Mariano, MD, PhD, MSc
Instructor, Harvard Medical School

Brigham and Women's Hospital
Department of Psychiatry
75 Francis Street
Boston, MA 02115

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Research Narrative:

Chronic pain is a critical challenge to medicine and has serious psychiatric implications; the “suffering” aspect of it is debilitating and leads to reduced quality of life and symptoms of anxiety and depression. Current therapies inadequately treat these symptoms, instead focusing on relieving the sensory component of pain with analgesic medications. These medications, including opioids and antiinflammatories, often only provide short-term relief and can have serious side effects.

 My work uses a non-invasive form of brain stimulation, known as transcranial direct current stimulation (tDCS), in an attempt to change the way individuals feel about their chronic pain. In this method, two sponge-rubber electrodes placed on the scalp provide a weak electrical current that can make targeted areas of the brain more or less active. The method is generally considered safe and can be given while someone is awake with minimal discomfort.

My preliminary work in healthy volunteers used tDCS to target the dorsal anterior cingulate cortex (dACC) and dorsolateral prefrontal cortex (DLPFC) in an attempt to modulate tolerability of acutely painful stimuli. The results suggested that (1) tDCS targeting left dACC may increase tolerability of certain painful experiences and (2) tDCS targeting left DLPFC may modulate pain ratings on a visual analog scale. Ongoing work is testing if tDCS targeting left dACC can effectively reduce the disability and suffering of patients with chronic low back pain. If so, it would be the first study to demonstrate the use of tDCS in this undertreated aspect of chronic pain.