Anesthesiology, Perioperative and Pain Medicine

David Yeomans, PhD

The Future of Pain Therapies

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Dr. David Yeomans

            Imagine using magnets to inactivate areas of the brain responsible for pain, infecting patients with viruses to prevent postoperative pain, or using hypnosis to treat chronic pain. While these therapies may sound futuristic, David Yeomans, Ph.D., of the Stanford Department of Anesthesia is working to make these ideas into realities.

            “As Director of Pain Research, I get a lot of people coming to me with very cool ideas,” says Yeomans, who has filed seven patent applications to date. Scientists and businesspeople from all over the world approach Yeomans to design and carry out experiments to test their ideas.

             “It’s a lot of fun,” he says. “Busy, but fun.”

            One such idea blossomed into a company, for which Dr. Yeomans now serves as the Chairman of the Scientific Advisory Board. This company is currently testing the use of targeted magnetic fields to inhibit activity of the anterior singulate, an area of the brain that demonstrates activity when a person experiences pain.      

            “The machine is like three magnetic field generators that are all sort of triangulating on this one area,” explains Dr. Yeomans. These targeted magnetic fields, particularly if pulsed, disrupt the electrical current running through axons in the brain, thereby preventing activation of the dorsal anterior singulate and inhibiting the sensation of pain.

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The Yeomans Lab

            Pilot tests of healthy human volunteers have demonstrated the efficacy of the machine, Yeomans says. Based on these positive results, he speculates that perhaps other areas of the brain could be manipulated using deep brain targeted magnetic fields in order to cure addiction or influence other complex behaviors. 

            Gene therapy is another seemingly futuristic field that Yeomans believes has great potential for pain management. Yeomans and his collaborators employ a non-replicating herpes simplex virus that has been modified to contain the gene for the analgesic compound encephalin – an opiate peptide similar to endorphins. Wherever the virus is applied on the body, it is taken up by pain-sensing neurons known as nociceptors that are specific to that location. The modified virus subsequently infects those cells with the encephalin-encoding DNA. 

            When activated by a painful stimulus, these modified pain-sensing neurons immediately release encephalin, which binds to the cells’ opiate receptors, thereby inhibiting them. “It’s an auto-inhibition of nociceptors,” he explains, “But it’s very selective for region and for activity.”

            Having worked on gene therapy since 1997, Yeomans is excited to finally see some of his ideas being tested in clinical trials with cancer pain patients at the University of Michigan. “It’s a very difficult thing to get approval for doing clinical trials in gene therapy,” he says.

            Though most of his colleagues have M.D. degrees, Yeomans feels right at home in the Department of Anesthesia. “I really like being in a clinical department,” he explains.

            Yeoman’s favorite thing about Stanford is its collegiality. “It’s really a friendly, collaborative, collegial place,” he says. “It’s really unusual to have that in an institution at such a high level.”


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