MINNEAPOLIS/ST. PAUL (9/29/2026) — A University of Minnesota Medical School research team has received a five-year, $3.8 million grant from the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative to test a personalized approach to brain stimulation for people living with severe, treatment-resistant central neuropathic pain.
Central neuropathic pain can develop after damage to the central nervous system from conditions such as stroke, multiple sclerosis or spinal cord injury. It affects roughly one in 10 stroke survivors and can cause persistent burning or other painful sensations, sometimes in parts of the body that have lost sensation. Because the injury lies within the central nervous system, treatments aimed at the body, such as injections, procedures, surgeries and opioids, reliably fail.
The clinical trial, called Simultaneous Engagement of Networks for Alleviating Pain (SENAP), will investigate whether identifying and simultaneously using an implantable brain stimulator targeting two pain-related brain networks can provide relief for patients who have not responded to existing treatments.
“These patients have often exhausted the treatments currently available to them,” said David Darrow, MD, MPH , an associate professor at the University of Minnesota Medical School, neurosurgeon with M Health Fairview and the trial's principal investigator. “Because their pain originates within the central nervous system, we need approaches that address what is happening in the brain itself.”
Motor cortex stimulation has been used for decades to treat severe neuropathic pain, but results vary significantly among patients. The research team believes the answer lies in a newly discovered network within the motor cortex and its exact location, which differs from person to person, is the reason why.
“Those individual differences explain why motor cortex stimulation works for some patients but not others. Mapping this new network in each patient will let the research team place stimulation where it matters,” said Damien Fair, PA-C, PhD , co-director of the Masonic Institute for the Developing Brain and co-investigator on the trial. “No two brains put these networks in exactly the same place. Averages get you close, but they don't get you the patient in front of you.”
Using functional MRI, researchers will map each participant’s brain to identify individualized targets for stimulation. The team will then compare the personalized stimulation with a control condition and use participants’ responses to help refine stimulation settings.
“Pain is woven through the systems that guide attention, emotion and action,” said Alexander Herman, MD, PhD , an assistant professor at the U of M Medical School, psychiatrist with M Health Fairview and co-principal investigator. “That's why one target was never going to be enough.”
The trial will enroll up to 20 participants with severe, treatment-resistant central neuropathic pain beginning in late 2026. More information on the trial can be found at clinicaltrials.gov External link that opens in the same window or hermandarrowlab.com External link that opens in the same window.
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