Chronic pain impacts more than one in five adults in the United States (US) and the costs associated with the condition amount to hundreds of billions of dollars annually. Despite the tremendous impact of chronic pain in the US and worldwide, the standard of care for diagnosis depends on subjective self-reporting of pain state, with no effective objective assessment procedure available. This study investigated the application of signal processing and machine learning to electroencephalography (EEG) data for the development of classification algorithms capable of differentiating subjects in pain from pain free subjects. In this study, nineteen (19) channels of EEG data were obtained from subjects in an eyes closed resting state, and ultimately data from 186 participants were used for algorithm development, including 35 healthy controls and 151 chronic pain patients. Signal processing was applied to identify noise free segments of EEG data and 6375 quantitative EEG (qEEG) measures were calculated for each subject. Various machine learning methodologies were applied to the data, with Elastic Net chosen as the optimal methodology. The final classifier developed using Elastic Net contained 34 qEEG features with non-zero weights. The classifier was able to differentiate pain versus no pain subjects with an accuracy of 79.6%, sensitivity of 82.2%, and specificity of 66.7%. The features used in the classifier were evaluated and found to align well with contemporary literature regarding changes in neurological characteristics associated with chronic pain.

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Frank Minella is the owner of PainQx and is an investor on patents licensed by PainQx from NYU School of Medicine. Jonathan Miller, Skylar Jacobs, William Koppes, Federica Porta, and Joseph A. Lovelace were employed by PainQx at the time of the research.

Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number R44DA046964. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Approval was obtained from Advarra Institutional Review Board (study number Pro00042433) on March 12, 2020, and subsequently registered the study on www.clinicaltrials.gov (NCT04585451). Written informed consent was obtained from all participants prior to inclusion in the study.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors