Naturalistic acute pain states decoded from neural and facial dynamics

Abstract Pain remains poorly understood in task-free contexts, limiting our understanding of its neurobehavioral basis in naturalistic settings. Here, we use a multimodal, data-driven approach with intracranial electroencephalography, pain self-reports, and facial expression analysis to study acute...

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Main Authors: Yuhao Huang, Jay Gopal, Bina Kakusa, Alice H. Li, Weichen Huang, Jeffrey B. Wang, Amit Persad, Ashwin Ramayya, Josef Parvizi, Vivek P. Buch, Corey J. Keller
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-59756-5
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author Yuhao Huang
Jay Gopal
Bina Kakusa
Alice H. Li
Weichen Huang
Jeffrey B. Wang
Amit Persad
Ashwin Ramayya
Josef Parvizi
Vivek P. Buch
Corey J. Keller
author_facet Yuhao Huang
Jay Gopal
Bina Kakusa
Alice H. Li
Weichen Huang
Jeffrey B. Wang
Amit Persad
Ashwin Ramayya
Josef Parvizi
Vivek P. Buch
Corey J. Keller
author_sort Yuhao Huang
collection DOAJ
description Abstract Pain remains poorly understood in task-free contexts, limiting our understanding of its neurobehavioral basis in naturalistic settings. Here, we use a multimodal, data-driven approach with intracranial electroencephalography, pain self-reports, and facial expression analysis to study acute pain in twelve epilepsy patients under continuous neural and audiovisual monitoring. Using machine learning, we successfully decode individual participants’ high versus low pain states from distributed neural activity, involving mesolimbic regions, striatum, and temporoparietal cortex. Neural representation of pain remains stable for hours and is modulated by pain onset and relief. Objective facial expressions also classify pain states, concordant with neural findings. Importantly, we identify transient periods of momentary pain as a distinct naturalistic acute pain measure, which can be reliably discriminated from affect-neutral periods using neural and facial features. These findings reveal reliable neurobehavioral markers of acute pain across naturalistic contexts, underscoring the potential for monitoring and personalizing pain interventions in real-world settings.
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issn 2041-1723
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spelling doaj-art-609bc89788e84c15b4eaa097bbd64b422025-08-20T02:25:17ZengNature PortfolioNature Communications2041-17232025-05-0116111310.1038/s41467-025-59756-5Naturalistic acute pain states decoded from neural and facial dynamicsYuhao Huang0Jay Gopal1Bina Kakusa2Alice H. Li3Weichen Huang4Jeffrey B. Wang5Amit Persad6Ashwin Ramayya7Josef Parvizi8Vivek P. Buch9Corey J. Keller10Department of Neurosurgery, Stanford University School of MedicineBrown UniversityDepartment of Neurosurgery, Stanford University School of MedicineDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of MedicineDepartment of Neurology, Stanford University School of MedicineDepartment of Anesthesia and Critical Care Medicine, The Johns Hopkins University School of MedicineDepartment of Neurosurgery, Stanford University School of MedicineDepartment of Neurosurgery, Stanford University School of MedicineDepartment of Neurology, Stanford University School of MedicineDepartment of Neurosurgery, Stanford University School of MedicineDepartment of Psychiatry and Behavioral Sciences, Stanford University School of MedicineAbstract Pain remains poorly understood in task-free contexts, limiting our understanding of its neurobehavioral basis in naturalistic settings. Here, we use a multimodal, data-driven approach with intracranial electroencephalography, pain self-reports, and facial expression analysis to study acute pain in twelve epilepsy patients under continuous neural and audiovisual monitoring. Using machine learning, we successfully decode individual participants’ high versus low pain states from distributed neural activity, involving mesolimbic regions, striatum, and temporoparietal cortex. Neural representation of pain remains stable for hours and is modulated by pain onset and relief. Objective facial expressions also classify pain states, concordant with neural findings. Importantly, we identify transient periods of momentary pain as a distinct naturalistic acute pain measure, which can be reliably discriminated from affect-neutral periods using neural and facial features. These findings reveal reliable neurobehavioral markers of acute pain across naturalistic contexts, underscoring the potential for monitoring and personalizing pain interventions in real-world settings.https://doi.org/10.1038/s41467-025-59756-5
spellingShingle Yuhao Huang
Jay Gopal
Bina Kakusa
Alice H. Li
Weichen Huang
Jeffrey B. Wang
Amit Persad
Ashwin Ramayya
Josef Parvizi
Vivek P. Buch
Corey J. Keller
Naturalistic acute pain states decoded from neural and facial dynamics
Nature Communications
title Naturalistic acute pain states decoded from neural and facial dynamics
title_full Naturalistic acute pain states decoded from neural and facial dynamics
title_fullStr Naturalistic acute pain states decoded from neural and facial dynamics
title_full_unstemmed Naturalistic acute pain states decoded from neural and facial dynamics
title_short Naturalistic acute pain states decoded from neural and facial dynamics
title_sort naturalistic acute pain states decoded from neural and facial dynamics
url https://doi.org/10.1038/s41467-025-59756-5
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