Chronic pain, a leading global cause of disability, remains one of the most significant unmet needs in medicine. In the UK alone, between one-third and one-half of the adult population—just under 28 million people—are affected by chronic pain. This condition not only burdens health services with millions in direct treatment costs but also results in indirect costs in lost productivity estimated to be in the billions. Despite its widespread impact, progress in chronic pain treatments has stagnated, with few major breakthroughs in drug therapies over the past several decades.
The EPIONE (Effective Pain Interventions with Neural Engineering) programme, led by the University of Oxford, aims to address this challenge by leveraging world-class engineering and neuroscience expertise to revolutionize the management of chronic pain. This initiative marks a significant departure from conventional drug discovery methods, focusing instead on a systems engineering approach to target the brain’s pain networks.
Innovative Interdisciplinary Approach
Chronic pain is increasingly recognized as a disease of the nervous system, often resulting from errors in how the brain processes signals during injury or illness. EPIONE seeks to transform treatment by combining advanced sensor systems, neuromodulator technologies, adaptive control algorithms, and precise pain network targeting. These innovations are expected to yield novel therapies that directly modulate brain activity to significantly reduce or even eliminate pain.
The programme is co-led by Professor Tim Denison from the Department of Engineering Science and Professor Ben Seymour from the Nuffield Department of Clinical Neuroscience. Their collaboration brings together expertise in biomedical engineering, neuroscience, and clinical medicine, with invaluable input from patients living with chronic pain. This patient involvement is crucial in shaping the design of new interventions, ensuring that the technologies developed are both effective and user-friendly.
Breakthrough Technologies on the Horizon
Over the course of the EPIONE programme, researchers anticipate delivering several groundbreaking technologies, including:
- An adaptive brain implant capable of sensing and responding to pain signals in real time, paving the way for large-scale clinical trials and eventual NHS approval.
- An implantable ‘closed-loop’ drug delivery system that automatically adjusts medication based on a patient’s needs, minimizing side effects and the risk of addiction.
- Non-invasive ultrasound and magnetic stimulation techniques designed to target multiple brain regions simultaneously.
- A combined “smart” therapy system that integrates brain sensors with feedback and stimulation technologies, empowering patients to actively retrain their brains to manage pain.
Professor Denison emphasized the unique nature of the EPIONE programme, stating,
‘Each of EPIONE’s members are world-renowned experts in their own field, and the programme is unique in bringing this level of expertise to work together closely on such a highly integrated project. This will allow us to develop “smart” therapies for chronic pain that monitor the body and adjust treatment dynamically—rather than delivering fixed doses.’
Collaborative Efforts and Future Prospects
The project is a collaborative effort involving the University of Cambridge, University of Glasgow, and UCL, in addition to clinicians at NHS pain clinics. EPIONE will also partner with leading industry representatives, including both multi-nationals and SMEs, to translate new concepts into clinical treatments. Among these partners is Amber Therapeutics, a University of Oxford spinout co-founded by Professor Denison. Amber Therapeutics is behind the Picostim-DyNeuMo deep brain stimulation implant, a device that can sense and respond to pain signals in real time and synchronize with a patient’s symptom rhythms. This technology will serve as the platform for EPIONE’s initial clinical trials.
As the EPIONE programme progresses, it promises to not only advance the scientific understanding of chronic pain but also to deliver practical solutions that could alleviate the suffering of millions. By integrating cutting-edge technology with patient-centered design, EPIONE represents a significant step forward in the quest to effectively manage and treat chronic pain.
Looking ahead, the success of EPIONE could pave the way for broader applications of neural engineering in medicine, potentially transforming how other neurological conditions are treated. As the programme continues to develop, it will be closely watched by the medical community and patients alike, hopeful for a future where chronic pain no longer dictates the lives of those affected.
