Overview
My research is focused on understanding the modulation of experimentally induced and clinical pain states by endogenous analgesic systems in the central nervous system. I use this information to help guide the development of new and mechanism-driven therapies for chronic pain.
I have a BSc in Pharmacology (1st class) from University College London and a PhD in Systems Neuroscience from the University of Bristol. During my PhD, I researched descending noradrenergic control systems during neuropathic pain in the labs of Prof Tony Pickering and Prof Bridget Lumb.
After my PhD, I moved to Imperial College London, where I spent four years using non-invasive brain stimulation techniques in sciatica patients and in human pain models in Dr Paul Strutton’s lab. I then moved to Kings College London to start a research fellowship (Kings Prize/Anthony Mellow Award) investigating the effects of non-invasive deep brain stimulation on the sensitisation of central nociceptive pathways with Dr Matthew Howard.
In 2020 I joined the University of Plymouth as a Lecturer and started the Pain Modulation Lab at the Brain Research and Imaging Centre (BRIC). In 2022, I joined the University of Exeter as a Senior Lecturer in Pain Neuroscience.
Research
Research interests
Work carried out in my lab involves using neurotechnology (e.g. non-invasive brain stimulation, immersive virtual reality) to harness endogenous analgesic activity in descending pain control systems. We use a number of techniques to measure top-down modulation within central nociceptive pathways (e.g., quantitative sensory testing, neurophysiological assessment of spinal reflexes) in human pain models with a view to develop new, mechanism-driven therapeutics for chronic pain patients.
Through interdisciplinary collaborations across the UK, I have a number of research projects with aim to understand how the brain, brainstem and spinal cord work to modulate experimentally induced and clinical pain states.
Research projects
- The effects of motor cortex transcranial direct current stimulation (tDCS) on central sensitisation in sciatica patients. Collaborator: Dr Paul Strutton (Imperial College London)
- The effects of immersive virtual reality on cortical manifestations of secondary hyperalgesia. Collaborator: Dr Giorgio Ganis (University of Plymouth).
- Understanding the brain and brainstem mechanisms of secondary hyperalgesia. Collaborator: Dr Matthew Howard (Kings College London).
- Investigating the therapeutic potential of immersive natural environments using virtual reality in chronic low back pain patients. Collaborators: Dr Kayleigh Wyles and Prof Patricia Schofield (University of Plymouth).
- The effects of immersive virtual reality on the development of secondary hyperalgesia: a role for the descending pain modulation system? Collaborator: Dr Matthew Howard (Kings College London).
- The effects of transcranial ultrasound stimulation of the anterior cingulate cortex on experimentally induced secondary hyperalgesia. Collaborator: Dr Elsa Fouragnan (University of Plymouth)
Grants:
2022 – 2025: Engineering and Physical Sciences Research Council (EPSRC). Neurotechnology for Chronic Pain. £1,161,841.47 (Co-Investigator).
2022 – 2024: Academy of Medical Sciences Springboard Award. Virtually painless? Steps towards mechanism-driven use of immersive virtual reality for chronic pain. £98,156.00 (Principle Investigator).
2019 – 2020: The Pain Relief Foundation. The effects of non-invasive brain stimulation on chronic pain and central sensitisation in patients with radicular low-back pain (sciatica): a randomised, sham-controlled proof-of-principle study. £21,207. (Co-investigator).
2022 – 2023: Plymouth Institute of Health and Care Research (PIHR). The effects of transcranial ultrasound stimulation of the anterior cingulate cortex in a human model of secondary hyperalgesia: a pilot study. £2,947.60. (Co-investigator).
2020 – 2024: Kings Prize/Anthony Mellow Fellowship. Harnessing brain and brainstem mechanisms of secondary hyperalgesia. £148,601. (Principle Investigator).
Publications
Key publications | Publications by category | Publications by year
Publications by category
Journal articles
Bannister K, Hughes S (2023). One size does not fit all: towards optimising the therapeutic potential of endogenous pain modulatory systems.
Pain,
164(1), e5-e9.
Author URL.
Wong F, Reddy A, Rho Y, Vollert J, Strutton PH, Hughes SW (2023). Responders and nonresponders to topical capsaicin display distinct temporal summation of pain profiles. PAIN Reports, 8(3), e1071-e1071.
Mehesz E, Karoui H, Strutton PH, Hughes SW (2021). Exposure to an Immersive Virtual Reality Environment can Modulate Perceptual Correlates of Endogenous Analgesia and Central Sensitization in Healthy Volunteers.
JOURNAL OF PAIN,
22(6), 707-714.
Author URL.
Hughes SW, Ward G, Strutton PH (2020). Anodal transcranial direct current stimulation over the primary motor cortex attenuates capsaicin-induced dynamic mechanical allodynia and mechanical pain sensitivity in humans.
EUROPEAN JOURNAL OF PAIN,
24(6), 1130-1137.
Author URL.
Hughes SW, Basra M, Chan C, Parr C, Wong F, Gomes S, Strutton PH (2020). Capsaicin-Induced Changes in Electrical Pain Perception Threshold can be Used to Assess the Magnitude of Secondary Hyperalgesia in Humans.
PAIN MEDICINE,
21(11), 2830-2838.
Author URL.
Hughes SW, Hellyer PJ, Sharp DJ, Newbould RD, Patel MC, Strutton PH (2020). Diffusion tensor imaging of lumbar spinal nerves reveals changes in microstructural integrity following decompression surgery associated with improvements in clinical symptoms: a case report.
MAGNETIC RESONANCE IMAGING,
69, 65-70.
Author URL.
Hughes SW, Zhao H, Auvinet EJ, Strutton PH (2019). Attenuation of capsaicin-induced ongoing pain and secondary hyperalgesia during exposure to an immersive virtual reality environment.
PAIN Reports,
4(6), e790-e790.
Abstract:
Attenuation of capsaicin-induced ongoing pain and secondary hyperalgesia during exposure to an immersive virtual reality environment
Abstract
.
. Introduction:
. There is growing evidence that virtual reality (VR) can be used in the treatment of chronic pain conditions. However, further research is required to better understand the analgesic mechanisms during sensitised pain states.
.
.
. Objectives:
. We examined the effects of an immersive polar VR environment on capsaicin-induced ongoing pain and secondary hyperalgesia. We also investigated whether the degree of analgesia was related to baseline conditioned pain modulation (CPM) responses.
.
.
. Methods:
. Nineteen subjects had baseline CPM and electrical pain perception (EPP) thresholds measured before the topical application of capsaicin cream. Visual analogue scale ratings were measured to track the development of an ongoing pain state, and EPP thresholds were used to measure secondary hyperalgesia. The effects of a passive polar VR environment on ongoing pain and secondary hyperalgesia were compared with sham VR (ie, 2D monitor screen) in responders to capsaicin (n = 15).
.
.
. Results:
. Virtual reality was associated with a transient reduction in ongoing pain and an increase in EPP thresholds in an area of secondary hyperalgesia. Baseline CPM measurements showed a significant correlation with VR-induced changes in secondary hyperalgesia, but not with VR-induced changes in ongoing pain perception. There was no correlation between VR-induced changes in pain perception and VR-induced changes in secondary hyperalgesia.
.
.
. Conclusion:
. Virtual reality can reduce the perception of capsaicin-induced ongoing pain and secondary hyperalgesia. We also show that CPM may provide a means by which to identify individuals likely to respond to VR therapy.
.
Abstract.
Hughes SW, Hellyer PJ, Sharp DJ, Newbould RD, Patel MC, Strutton PH (2019). Diffusion tensor imaging reveals changes in microstructural integrity along compressed nerve roots that correlate with chronic pain symptoms and motor deficiencies in elderly stenosis patients. NeuroImage: Clinical, 23, 101880-101880.
Hughes S, Grimsey S, Strutton PH (2019). Primary Motor Cortex Transcranial Direct Current Stimulation Modulates Temporal Summation of the Nociceptive Withdrawal Reflex in Healthy Subjects.
PAIN MEDICINE,
20(6), 1156-1165.
Author URL.
Hughes SW, Ali M, Sharma P, Insan N, Strutton PH (2018). Frequency‐dependent top‐down modulation of temporal summation by anodal transcranial direct‐current stimulation of the primary motor cortex in healthy adults.
European Journal of Pain,
22(8), 1494-1501.
Abstract:
Frequency‐dependent top‐down modulation of temporal summation by anodal transcranial direct‐current stimulation of the primary motor cortex in healthy adults
AbstractBackgroundTranscranial direct‐current stimulation (tDCS) applied over the primary motor cortex has been shown to be effective in the treatment of a number of chronic pain conditions. However, there is a lack of understanding of the top‐down analgesic mechanisms involved.MethodIn this study, we investigated the effects of tDCS on the facilitation of subjective sensory and pain scores using a transcutaneous electrically evoked measure of temporal summation. In this randomized, blinded, cross‐over study healthy subjects received a single stimulus given at 0.9× pain threshold (pTh) over the L5 dermatome on the lateral aspect of the right leg, followed by a train of 5 stimuli given at 0.5, 1, 5 and 20 Hz before and after 20 min of sham or anodal tDCS (2 mA) applied over the primary motor cortex. Ratings of sensation and pain intensity were scored on a visual analogue scale (VAS).ResultsTemporal summation leading to pain only occurred at higher frequencies (5 and 20 Hz). Sham or real tDCS had no effect over temporal summation evoked at 5 Hz; however, there was a significant analgesic effect at 20 Hz. Sham or real tDCS had no effect over acute, single stimuli‐evoked responses.ConclusionThese results indicate that anodal tDCS applied to the primary motor cortex preferentially modulates temporal summation induced by high‐frequency electrical stimulation‐induced pain. The inhibitory effects of tDCS appear to be dynamic and dependent on the degree of spinal cord excitability and may explain the higher analgesic efficacy in patients with moderate to severe chronic pain symptoms.SignificanceThe analgesic effects of tDCS are dependent on spinal cord excitability. This work provides insight into top‐down modulation during acute pain and temporal summation. This knowledge may explain why tDCS has a higher analgesic efficacy in chronic pain patients.
Abstract.
Hughes S, Hickey L, Donaldson LF, Lumb BM, Pickering AE (2015). Intrathecal reboxetine suppresses evoked and ongoing neuropathic pain behaviours by restoring spinal noradrenergic inhibitory tone.
PAIN,
156(2), 328-334.
Author URL.
Hughes SW, Hickey L, Hulse RP, Lumb BM, Pickering AE (2013). Endogenous analgesic action of the pontospinal noradrenergic system spatially restricts and temporally delays the progression of neuropathic pain following tibial nerve injury. Pain, 154(9), 1680-1690.
Publications by year
2023
Bannister K, Hughes S (2023). One size does not fit all: towards optimising the therapeutic potential of endogenous pain modulatory systems.
Pain,
164(1), e5-e9.
Author URL.
Wong F, Reddy A, Rho Y, Vollert J, Strutton PH, Hughes SW (2023). Responders and nonresponders to topical capsaicin display distinct temporal summation of pain profiles. PAIN Reports, 8(3), e1071-e1071.
2021
Mehesz E, Karoui H, Strutton PH, Hughes SW (2021). Exposure to an Immersive Virtual Reality Environment can Modulate Perceptual Correlates of Endogenous Analgesia and Central Sensitization in Healthy Volunteers.
JOURNAL OF PAIN,
22(6), 707-714.
Author URL.
2020
Hughes SW, Ward G, Strutton PH (2020). Anodal transcranial direct current stimulation over the primary motor cortex attenuates capsaicin-induced dynamic mechanical allodynia and mechanical pain sensitivity in humans.
EUROPEAN JOURNAL OF PAIN,
24(6), 1130-1137.
Author URL.
Hughes SW, Basra M, Chan C, Parr C, Wong F, Gomes S, Strutton PH (2020). Capsaicin-Induced Changes in Electrical Pain Perception Threshold can be Used to Assess the Magnitude of Secondary Hyperalgesia in Humans.
PAIN MEDICINE,
21(11), 2830-2838.
Author URL.
Hughes SW, Hellyer PJ, Sharp DJ, Newbould RD, Patel MC, Strutton PH (2020). Diffusion tensor imaging of lumbar spinal nerves reveals changes in microstructural integrity following decompression surgery associated with improvements in clinical symptoms: a case report.
MAGNETIC RESONANCE IMAGING,
69, 65-70.
Author URL.
2019
Hughes SW, Zhao H, Auvinet EJ, Strutton PH (2019). Attenuation of capsaicin-induced ongoing pain and secondary hyperalgesia during exposure to an immersive virtual reality environment.
PAIN Reports,
4(6), e790-e790.
Abstract:
Attenuation of capsaicin-induced ongoing pain and secondary hyperalgesia during exposure to an immersive virtual reality environment
Abstract
.
. Introduction:
. There is growing evidence that virtual reality (VR) can be used in the treatment of chronic pain conditions. However, further research is required to better understand the analgesic mechanisms during sensitised pain states.
.
.
. Objectives:
. We examined the effects of an immersive polar VR environment on capsaicin-induced ongoing pain and secondary hyperalgesia. We also investigated whether the degree of analgesia was related to baseline conditioned pain modulation (CPM) responses.
.
.
. Methods:
. Nineteen subjects had baseline CPM and electrical pain perception (EPP) thresholds measured before the topical application of capsaicin cream. Visual analogue scale ratings were measured to track the development of an ongoing pain state, and EPP thresholds were used to measure secondary hyperalgesia. The effects of a passive polar VR environment on ongoing pain and secondary hyperalgesia were compared with sham VR (ie, 2D monitor screen) in responders to capsaicin (n = 15).
.
.
. Results:
. Virtual reality was associated with a transient reduction in ongoing pain and an increase in EPP thresholds in an area of secondary hyperalgesia. Baseline CPM measurements showed a significant correlation with VR-induced changes in secondary hyperalgesia, but not with VR-induced changes in ongoing pain perception. There was no correlation between VR-induced changes in pain perception and VR-induced changes in secondary hyperalgesia.
.
.
. Conclusion:
. Virtual reality can reduce the perception of capsaicin-induced ongoing pain and secondary hyperalgesia. We also show that CPM may provide a means by which to identify individuals likely to respond to VR therapy.
.
Abstract.
Hughes SW, Hellyer PJ, Sharp DJ, Newbould RD, Patel MC, Strutton PH (2019). Diffusion tensor imaging reveals changes in microstructural integrity along compressed nerve roots that correlate with chronic pain symptoms and motor deficiencies in elderly stenosis patients. NeuroImage: Clinical, 23, 101880-101880.
Hughes S, Grimsey S, Strutton PH (2019). Primary Motor Cortex Transcranial Direct Current Stimulation Modulates Temporal Summation of the Nociceptive Withdrawal Reflex in Healthy Subjects.
PAIN MEDICINE,
20(6), 1156-1165.
Author URL.
2018
Hughes SW, Ali M, Sharma P, Insan N, Strutton PH (2018). Frequency‐dependent top‐down modulation of temporal summation by anodal transcranial direct‐current stimulation of the primary motor cortex in healthy adults.
European Journal of Pain,
22(8), 1494-1501.
Abstract:
Frequency‐dependent top‐down modulation of temporal summation by anodal transcranial direct‐current stimulation of the primary motor cortex in healthy adults
AbstractBackgroundTranscranial direct‐current stimulation (tDCS) applied over the primary motor cortex has been shown to be effective in the treatment of a number of chronic pain conditions. However, there is a lack of understanding of the top‐down analgesic mechanisms involved.MethodIn this study, we investigated the effects of tDCS on the facilitation of subjective sensory and pain scores using a transcutaneous electrically evoked measure of temporal summation. In this randomized, blinded, cross‐over study healthy subjects received a single stimulus given at 0.9× pain threshold (pTh) over the L5 dermatome on the lateral aspect of the right leg, followed by a train of 5 stimuli given at 0.5, 1, 5 and 20 Hz before and after 20 min of sham or anodal tDCS (2 mA) applied over the primary motor cortex. Ratings of sensation and pain intensity were scored on a visual analogue scale (VAS).ResultsTemporal summation leading to pain only occurred at higher frequencies (5 and 20 Hz). Sham or real tDCS had no effect over temporal summation evoked at 5 Hz; however, there was a significant analgesic effect at 20 Hz. Sham or real tDCS had no effect over acute, single stimuli‐evoked responses.ConclusionThese results indicate that anodal tDCS applied to the primary motor cortex preferentially modulates temporal summation induced by high‐frequency electrical stimulation‐induced pain. The inhibitory effects of tDCS appear to be dynamic and dependent on the degree of spinal cord excitability and may explain the higher analgesic efficacy in patients with moderate to severe chronic pain symptoms.SignificanceThe analgesic effects of tDCS are dependent on spinal cord excitability. This work provides insight into top‐down modulation during acute pain and temporal summation. This knowledge may explain why tDCS has a higher analgesic efficacy in chronic pain patients.
Abstract.
2015
Hughes S, Hickey L, Donaldson LF, Lumb BM, Pickering AE (2015). Intrathecal reboxetine suppresses evoked and ongoing neuropathic pain behaviours by restoring spinal noradrenergic inhibitory tone.
PAIN,
156(2), 328-334.
Author URL.
2013
Hughes SW, Hickey L, Hulse RP, Lumb BM, Pickering AE (2013). Endogenous analgesic action of the pontospinal noradrenergic system spatially restricts and temporally delays the progression of neuropathic pain following tibial nerve injury. Pain, 154(9), 1680-1690.
Refresh publications
External Engagement and Impact
Awards
2014: Faculty of Biomedical Sciences Commendation for PhD thesis (University of Bristol)
2018: Nominated for a Student Academic Choice Award for ‘Project Supervision’ (Imperial College London).
2019: Anthony Mellows Medal (Kings College London)
2021: Nominated for ‘Personal Tutor of the Year’ (University of Plymouth).
Editorial responsibilities
- Frontiers in Pain Research (Editorial Board)
Invited lectures
- European Pain Federation (EFIC)
- Aalborg University (Denmark)
- Kings College London (Wolfson CARD seminar series)
- British Pain Society (BPS)
Media Coverage
Daily Telegraph: Immersive Arctic images can slash pain, scientists find.
Daily Mail: Watching soothing 360-degree scenes of the Arctic in virtual reality can help to ease chronic pain, scientists claim
Interview on BBC radio Cornwall on the use of immersive virtual reality in pain research (2021).
Featured on the British Psychological Society podcast on the topic of ‘how to cope with pain’.
Teaching
Pain and sensory neuroscience
Modules
2023/24
