ISNR
The Interational Society of Neurofeedback & Research
Dirk De Ridder, MD, PhD
Dirk De Ridder, MD, PhD, is the Neurological Foundation professor of Neurosurgery at the Dunedin School of Medicine, University of Otago in New Zealand. His main interest is the understanding and treatment of phantom perceptions (sound, pain), especially by use of functional imaging navigated non-invasive (TMS, tDCS, tACS, tRNS, LORETA neurofeedback) and invasive (implants) neuromodulation techniques.
His main interest is to understand commonalities in different diseases such as in thalamocortical dysrhythmias (pain, tinnitus, Parkinson disease, depression, slow wave epilepsy) and Reward deficiency syndromes (addiction, OCD, Personality disorders).
A third pillar of his research relates to the neurobiological underpinnings of the ‘self” and ‘other’ in the brain, as it relates to social interactions, philosophy and religion.
He has developed “burst” and “noise” stimulation as novel stimulation designs for implants, and is working on other stimulation designs.
He has published 37 book chapters, co-edited the Textbook of Tinnitus, and has authored or co-authored 270 articles. He is reviewer for close to 90 scientific journals.
WEBSITE: https://www.otago.ac.nz/dsm/people/expertise/profile/?id=1297
Topic:
Presentation Title: The Central Brain Mechanisms of Pain and the Neuromodulation Techniques for Addressing It
Saturday, October 20 at 11:30 AM
Although chronic pain is one of the most important medical problems facing society, there has been limited progress in the development of novel therapies for this condition. The key to more successful pain treatment is to understand the mechanisms that generate and maintain chronic pain. Anatomically there exist at least two ascending pain input pathways and 1 descending pain inhibitory pathway. One input pathway encodes the painfulness, whereas the other pathway encodes the suffering or emotional pain associated with the painful stimulus. The pain inhibitory pathway probably encodes the percentage of the time the pain is dominantly present during the day. The anatomical pathways can be visualized using functional MRI meta-analyses, and LORETA EEG further shows that chronic pain is an imbalance between the ascending and descending pain inhibitory pathways. This is indeed confirmed both by activity, functional and effective connectivity EEG analyses.
Non-pharmacological treatment for chronic pain using spinal cord stimulation normalizes this imbalance, supporting the concept that pain is truly a balance disorder between pain input and pain suppression in the brain, and causally related to this imbalance. Pain thus is not merely the result of more pain input via the spinal cord or brainstem.
This imbalance mechanism might be universal in view of the pathophysiological analogy between pain, tinnitus, Parkinson’s disease, major depression, also known as thalamocortical dysrhythmia. Furthermore, thalamocortical dysrhythmia and and reward-deficiency syndrome (obesity, addiction, ADHD and personality disorders) may be two sides of the same coin as suggested by EEG source analyzed conjunction analyses between thalamocortical dysrhythmia and reward deficiency syndromes. As such, this new conceptualization of pain, Parkinson, tinnitus, depression, addiction, ADHD, OCD and personality disorders as imbalances in the brain paves the way for neuromodulation techniques such as transcranial electrical stimulation and infraslow neurofeedback to normalize this imbalance.
​