Dr. Scott Holmes is developing innovative methods of understanding the impact of nociception and pain on the developing pediatric brain. Emanating from federally funded research, he is evaluating real-time fMRI signals in conjunction with long-short term memory models and transformers to develop person-specific models for pain detection. These models will be trans-modal with applications that range from detecting pain states in non-communicative patients in the MRI, to sedated patients in the OR – helping also to better titrate exposure to anesthetics.
Dr. Holmes is leveraging the use of variational auto-encoders and generative adversarial networks to better characterize the factors that differentiate pediatric pain conditions to improve diagnostic and therapeutic approaches. His work with MRI data compression uses both structural and functional brain images and can be used to support cross modal data generation, wherein a person’s structural brain image could be used to create a novel functional brain image. This process would dramatically decrease burden on patients, particularly in the neonatal and adolescent stages where imaging can at times require sedation. His work with generative data is also fueling new insights into how novel MRI images can be generated from prior image banks. This work will be foundational towards improving our understanding of pain in minority populations, including rare diseases, and women’s health where low volumes of data currently exist.
On a molecular level, Dr. Holmes is focused on identifying markers that can improve the clinical identification of persons at risk of developing chronic pain. His work with neonatal subjects aims to use mRNA technologies to identify the presence of sub-clinical nerve fiber injuries that can predispose persons to later in life disability and chronic pain. In older pediatric cohorts, his work with mRNA is focused on rehabilitation and markers of chronic pain related to NMDA receptor activity. He is evaluating competing roles for pain and motor circuits in the brain for neurological adaptation following nerve injury as motor programs respond by adapting to sustain goal-directed tasks, while pain networks adapt by integrating and degrading previously healthy brain networks.
Dr. Holmes has recently launched a new program called the Phoenix Initiative that focuses on bringing in advanced methods to understand pain in women’s health. Through the lens of movement and physical activity, Dr. Holmes is bringing his expertise in kinesiology and pain medicine to develop a program that will identify individualized markers of pain that integrates knowledge on women’s health. There will be a strong focus on including information relating to menstrual cycle health and gynecological considerations (e.g., endometriosis) to develop non-pharmacological methods of pain modulation. His work will be the first to integrate advanced techniques including MRI-safe electromyography and electroencephalography as well as motion tracking to develop individualized markers of pain and pain treatment options.