Acoustical Neuromodulation for Chronic Pain Management
Stress always plays a key role in development of Central Sensitization (CS ) since it generates hyperalgesia and chronic pain through central and peripheral mechanisms.
CS causes spinal neuroinflammation, decreases in the mechanical nociceptor threshold, increases in sensory hypersensitivity, and long-lasting anxiety induced hyperalgesia.
Various inputs or sensitized neural circuits in the limbic system especially the amygdala, perpetuate the problematic emotions. Amygdala receives sensory input of all types, this establishes neural memories of fear and pain, that in turn progress to development of chronic pain.
The fortunate part is new treatments are in the horizon, as researches are rapidly driving the development of treatments / therapies focused on brain plasticity, with the most prospective ones based on modulating the activity of the limbic system. Since it is the mal-adoption of the brain plasticity that causes the chronic pain in first place.
The Bio-Acoustical Utilization Device (BAUD) is a sound-based treatment that was initially used for ADHD. It was later discovered to be useful in the treatment of stress and negative emotions. Since BAUD has been successful in reducing the negative emotional perceptions, it could be safe and effective adjunct for the treatment of chronic pain, with its close relationship with the circuits in the amygdala.
BAUD device emits two adjustable frequency tone which creates a binaural beat that can provide acoustical neuromodulation. This stimulation appears to affect amygdala and hippocampus of the limbic system by theta wave stimulation.1 Theta activity has been has proved to be essential to both the consolidation and re-consolidation of all memories that includes pain memories.” This therapy creates both stimulation and a temporary disruption of sensitized circuit. Hence it stimulates the neural “reset” based on the brain’s ability to self-regulate. Research has shown that once a memory circuit is activated, it can be modified.2
The treatment protocol requires the patient to focus their attention to the area or pain throughout the treatment, which increases the neural activity of the pain circuit and helps in the reset process. Research shows that fear memories are re-consolidated during the synchronous theta wave activity, lending support to the theory of disruption. The BAUD unit used is left on for 15 to 20 minutes, while the patient focuses on the painful areas to maintain the activation level necessary for acoustical neutralization.
People with chronic pain and central sensitization need to be treated for both physical and central nervous system dysfunction. These patients are good candidates for BAUD therapy, provided they are not overly sensitive to loud, noxious noises.
2. Loc. cit.
Tennant, Forest, MD, “Microglial Modulators: A New Therapeutic Class,” Practical Pain Management; last accessed 8/9/2018
Sanjay Trivedi, M.D. received training in general surgery from Seton Hall University in New Jersey, and studied physical medicine and rehabilitation at Kingsbrook Jewish Medical Center and David Minkin Rehabilitation Institute in Brooklyn, New York. Dr. Trivedi’s expertise is in the fields of acute and chronic spinal pain management, acute and chronic pharmaceutical pain management, musculoskeletal and joint pain management, and personal injury rehabilitation and care.