Multisite closed loop DBS for chronic pain

The National Institute of Neurological Disorders and Stroke awarded a Cooperative Agreement totaling $387,647 to The Regents of the University of California, San Francisco on May 1, 2026, under the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative (CFDA 93.372).

UCSF will develop a personalized multisite closed-loop deep brain stimulation (DBS) device platform targeting chronic pain. The work includes designing a brain stimulation system that delivers electrical stimulation only when pain signals in the brain are detected, rather than continuous 24/7 stimulation. The device incorporates personalized targeting across multiple brain regions to address individual patient variability in pain processing, and includes form factor and usability improvements based on patient feedback. UCSF will then conduct clinical testing to determine whether personalized closed-loop stimulation delivers reliable symptom relief for chronic pain patients over extended periods.

Place of performance is San Francisco, California 94115. The period of performance runs from May 1, 2026 through April 30, 2027.

The BRAIN Initiative aims to accelerate development and application of innovative neurotechnologies to produce a dynamic understanding of brain function at cellular and circuit levels, with ultimate application to prevention and treatment of brain disorders.

Abstract

Chronic pain affects one out of four americans and is often refractory to any treatment including medications, injections or surgery. Deep brain stimulation (DBS) involves implanting electrodes in key brain regions and holds promise as a new option for therapy, but we currently lack the technology to reliably achieve long-term pain symptom relief. A "one-size-fits-all" approach of continuous, 24/7 brain stimulation has helped patients with some movement disorders, but the key to reducing pain may be the activation of stimulation only when needed. This is called closed loop stimulation which may help to reduce side effects and keep the brain from adapting to stimulation effects. Further, because we know that an individual's pain experience is processed by many brain regions and no single target works for all patients, DBS that targets these many regions may serve more patients and pain syndromes then just targeting one or two brain regions. We aim to develop a new brain stimulation device platform using personalized brain targets for hard-to-treat chronic pain and to improve technology that will enable the delivery of stimulation only when pain signals in the brain are high. This device platform provides a form factor and ease of use that addresses needs expressed to our team by previous patients and includes necessary technical capabilities that exceed any existing device. We will then test whether personalized stimulation, possible with this device, leads to reliable symptom relief for chronic pain patients over extended periods of time.