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Chronic Pain=20 Harms The Brain

People with unrelenting pain don=E2=80=99t only suffer from the = non-stop sensation of=20 throbbing pain. They also have trouble sleeping, are often depressed, = anxious=20 and even have difficulty making simple decisions.

In a new study, investigators at Northwestern University=E2=80=99s = Feinberg School of=20 Medicine have identified a clue that may explain how suffering long-term = pain=20 could trigger these other pain-related symptoms.

Researchers found that in a healthy brain all the regions exist in a = state of=20 equilibrium. When one region is active, the others quiet down. But in = people=20 with chronic pain, a front region of the cortex mostly associated with = emotion=20 =E2=80=9Cnever shuts up,=E2=80=9D said Dante Chialvo, lead author and = associate research=20 professor of physiology at the Feinberg School. =E2=80=9CThe areas that = are affected=20 fail to deactivate when they should.=E2=80=9D

They are stuck on full throttle, wearing out neurons and altering = their=20 connections to each other.

This is the first demonstration of brain disturbances in chronic pain = patients not directly related to the sensation of pain.

Chialvo and colleagues used functional magnetic resonance imaging = (fMRI) to=20 scan the brains of people with chronic low back pain and a group of = pain-free=20 volunteers while both groups were tracking a moving bar on a computer = screen.=20 The study showed the pain sufferers performed the task well but = =E2=80=9Cat the expense=20 of using their brain differently than the pain-free group,=E2=80=9D = Chialvo said.

When certain parts of the cortex were activated in the pain-free = group, some=20 others were deactivated, maintaining a cooperative equilibrium between = the=20 regions. This equilibrium also is known as the resting state network of = the=20 brain. In the chronic pain group, however, one of the nodes of this = network did=20 not quiet down as it did in the pain-free subjects.

This constant firing of neurons in these regions of the brain could = cause=20 permanent damage, Chialvo said. =E2=80=9CWe know when neurons fire too = much they may=20 change their connections with other neurons and or even die because they = can=E2=80=99t=20 sustain high activity for so long,=E2=80=9D he explained.

=E2=80=98If you are a chronic pain patient, you have pain 24 hours a = day, seven days=20 a week, every minute of your life,=E2=80=9D Chialvo said. =E2=80=9CThat = permanent perception of=20 pain in your brain makes these areas in your brain continuously active. = This=20 continuous dysfunction in the equilibrium of the brain can change the = wiring=20 forever and could hurt the brain.=E2=80=9D

Chialvo hypothesized the subsequent changes in wiring =E2=80=9Cmay = make it harder for=20 you to make a decision or be in a good mood to get up in the morning. It = could=20 be that pain produces depression and the other reported abnormalities = because it=20 disturbs the balance of the brain as a whole.=E2=80=9D

He said his findings show it is essential to study new approaches to = treat=20 patients not just to control their pain but also to evaluate and prevent = the=20 dysfunction that may be generated in the brain by the chronic pain.

The study will be published Feb. 6 in The Journal of Neuroscience. = Chialvo=E2=80=99s=20 collaborators in this project are Marwan Baliki, a graduate student; = Paul Geha,=20 a post-doctoral fellow, and Vania Apkarian, professor of physiology and = of=20 anesthesiology, all at the Feinberg School.

This entry was posted on Wednesday, = February=20 6th, 2008 at 12:59 am and is filed under Uncategorized. You can follow any responses to = this entry=20 through the R= SS 2.0=20 feed. You can leave a=20 response, or trackback from your own site. =

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