Chronic pain harms the brain

From: Lance <mailto:LanceGary@DOMAIN.HIDDEN>=20
Date: Wed, 6 Feb 2008 06:27:49 -0800 (PST)

ScienceDaily (Feb. 6, 2008) =97 People with unrelenting pain don't = only
suffer=20 from the non-stop sensation of throbbing pain. They also have
trouble = sleeping, are often depressed, anxious and even have
difficulty = making simple=20 decisions.

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

Researchers found that in a healthy = brain all=20 the regions exist in a
state of equilibrium. When one region is = active, the=20 others quiet
down. But in people with chronic pain, a front region of = the=20 cortex
mostly associated with emotion "never shuts up," said Dante=20 Chialvo,
lead author and associate research professor of physiology = at=20 the
Feinberg School. "The areas that are affected fail to deactivate=20 when
they should."

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

This is = the=20 first demonstration of brain disturbances in chronic pain
patients = not=20 directly related to the sensation of pain.

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

When=20 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=20 did not quiet down as it did
in the pain-free subjects.

This = constant=20 firing of neurons in these regions of the brain could
cause permanent = damage,=20 Chialvo said. "We know when neurons fire too
much they may change = their=20 connections with other neurons and or even
die because they can't = sustain=20 high activity for so long," he
explained.

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

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

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

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

Adapted from materials provided by = Northwestern=20 University.

Northwestern University (2008, February 6). Chronic = Pain=20 Harms The
Brain. ScienceDaily. Retrieved February 6, 2008, from
http://www.sciencedaily.com/releases/2008/02/080205171755.= htm

.

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