The University of Oxford is to lead a new six-year, £11 million project backed by the Engineering and Physical Sciences Research Council (EPSRC) which aims develop a new generation of personalised treatments capable of reducing or abolishing chronic pain.
Chronic pain, a leading global cause of disability , is one of the great unmet needs in medicine. In the UK alone, between one-third and one-half of the adult population (just under 28 million) are affected by chronic pain, costing health services millions in direct treatment, with indirect costs in lost productivity estimated to be billions. But despite its scale, progress in chronic pain treatments has stalled with few major breakthroughs in drug therapies for several decades.
The EPIONE (Effective Pain Interventions with Neural Engineering) programme will tackle this by combining world-leading engineering and neuroscience expertise to transform how chronic pain is managed.
World-first interdisciplinary innovations
The EPIONE research team. Unlike conventional drug discovery, EPIONE will use a systems engineering approach to target the brain's own pain networks. Chronic pain is increasingly recognised as a disease of the nervous system itself, often caused by errors in how the brain processes signals during injury or illness. By combining advanced sensor systems, neuromodulator technologies, adaptive control algorithms, and precise pain network targeting, EPIONE will result in novel therapies that directly modulate brain activity to reduce or even abolish pain.
Co-led by Professor Tim Denison (Department of Engineering Science) and Professor Ben Seymour (Nuffield Department of Clinical Neuroscience), EPIONE will combine expertise in biomedical engineering, neuroscience, and clinical medicine with input from patients who live with chronic pain, who will play a key role in shaping the design of new interventions. This broad expertise will enable the team to develop state-of-the art personalised technologies that are fundamentally different to any current chronic pain treatments.
Over the course of the programme, the researchers expect to deliver several world-first technologies, including:
- An adaptive brain implant that can sense and respond to pain signals in real time, ready for clinical trials at scale for ultimate NHS approval.
- An implantable 'closed-loop' drug delivery system, which automatically adjusts medication based on a patient's needs, minimising side effects and risk of addiction.
- Non-invasive ultrasound and magnetic stimulation techniques capable of targeting multiple brain regions at once.
- A combined "smart" therapy system that links brain sensors with feedback and stimulation technologies, helping patients actively retrain their brains to manage pain.
Left: Prototype of a flexible skin patch as a wearable device to control nerve signals. Right: Prototype of a soft, flexible implant that could precisely deliver drugs to specific areas of the brain or nerves. Credit for photographs: Yixuan Leng, Massimo Mariello, Oxford bioelectronics, Christopher Proctor.Professor Denison said: '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. We are including people with the lived experience of chronic pain to co-develop our technologies and research methods, especially how we explore the role of nocebo and placebo effects in novel interventions. Economics also factors into our work, as we want to ensure our technologies are viable for the NHS and beyond.'
EPIONE will develop "smart" therapies for chronic pain that monitor the body and adjust treatment dynamically -rather than delivering fixed doses.
Professor Tim Denison , Department of Engineering Science
Project collaborators include the University of Cambridge, University of Glasgow, and UCL, besides clinicians at NHS pain clinics. EPIONE will also partner with leading representatives from industry, both multi-nationals and SMEs, to translate new concepts into clinical treatments. These include University of Oxford spinout Amber Therapeutics (co-founded by Professor Denison), the company behind the Picostim-DyNeuMo deep brain stimulation implant. This device, which can both sense and respond to pain signals in real time, and synchronise with a patient's symptom rhythms will provide the technological platform for EPIONE's first clinical trials.
Professor Ben Seymour, who co-leads the Pain Theme at the NIHR Oxford Health Biomedical Research Centre, added: 'Neurotechnology has the potential to realise substantial impact on reducing the burden of chronic pain in the UK and worldwide. But to date, this has not been realised - chiefly because this requires combining diverse expertise to engineer integrated therapeutic systems, and translate these into clinical delivery. EPIONE will address this by leveraging Oxford's strengths in interdisciplinary research to design a new generation of pain technologies.'
