Chronic Pain Forums of the Pain Relief Network = (PRN)

Torwards an educated, empowered and powerful pain patients=20 community...

You are not logged in.

Pages: 1

Index
=BB Casualities = of=20 Prohibition
=BB Chronic Pain Can Damage Brain

Topic = rating:=20 0=20

#1 200= 8-02-08=20 08:17:45

docalex=20: Admin=20; =20; =20; =20; Gender: =20; From: New York City=20; Registered: 2008-01-09=20; Posts: 213=20; Karma: 10=20; =20

Chronic Pain Can Damage Brain

Tags: [brain,=20 chronic=20 pain, damage,=20 symptoms]

Chronic Pain Can Damage=20 Brain - redOrbit Staff; 2008-02-06. Source.

See=20 also:
A=20 Modern Understanding of the Etiology of Chronic Pain = -=20 DeLuca; 2007-07-15

People who suffer chronic pain have constant brain activity in = areas of=20 the brain that would normally be at rest, according to a new study at=20 Northwestern University's Feinberg School of Medicine.

The study = suggests chronic pain changes the way information is processed in the = brain, and=20 the findings could explain why those who experience long-term pain = frequently=20 suffer other symptoms such as anxiety, depression, sleep disorders, and=20 difficulty making decisions.

During the study, researchers used=20 functional magnetic resonance imaging (fMRI) to scan the brains of 15 = people=20 with chronic low back pain and 15 pain-free volunteers while both groups = were=20 tracking a moving bar on a computer screen. Although the pain = sufferers=20 performed the task well, when researchers measured areas of the brain = activated,=20 differences emerged.

In the healthy brains all regions existed in = a state=20 of equilibrium -- when one region was active, the others quieted = down. But=20 in those with chronic pain, a front region of the cortex mostly = associated with=20 emotion "never shuts up," said Dante Chialvo, the study=92s lead author = and=20 associate research professor of physiology at the Feinberg School. The = region=20 was stuck on full throttle, wearing out neurons and altering their = connections=20 to each other. [See: Video of brain = disturbance=20 in chronic pain patient vs healthy volunteer]

"The = areas=20 that are affected fail to deactivate when they should," Chialvo=20 said.

"Where we were surprised is the difference in how much = brain they=20 used to do the task compared with the healthy group. It was 50 times = larger,"=20 Chialvo told Reuters.

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

When certain parts of the cortex were = activated in the=20 pain-free group, some others were deactivated, maintaining a cooperative = equilibrium between the regions. This equilibrium is known as the = resting state=20 network of the brain. In the chronic pain group, however, one of the = nodes of=20 this network did not quiet down as it did in the pain-free = subjects. =20 Instead, a front region of the cortex mostly associated with emotion is=20 constantly active, disrupting the normal equilibrium.

The = researchers=20 said disruptions in this default network could explain why pain patients = have=20 problems with attention, sleep disturbances and even = depression.

This=20 constant firing of neurons in these regions of the brain could cause = permanent=20 damage, Chialvo said. "We know when neurons fire too much they may = change their=20 connections with other neurons or even die because they can't sustain = high=20 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 your=20 life," Chialvo said. "That permanent perception of pain in your brain = makes=20 these areas in your brain continuously active. This continuous = dysfunction in=20 the equilibrium of the brain can change the wiring forever and could = hurt the=20 brain."

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

"These findings suggest that the brain of a chronic pain patient = is not=20 simply a healthy brain processing pain information but rather it is = altered by=20 the persistent pain in a manner reminiscent of other neurological = conditions=20 associated with cognitive impairments," the researchers wrote in their=20 report.

Chialvo said the study=92s findings show it is essential = to=20 research new approaches to treat patients not just to control their pain = but=20 also to evaluate and prevent the dysfunction that may be generated in = the brain=20 by the chronic pain.

The study was supported by the National = Institute of=20 Neurological Disorders and Stroke, and is published in the Feb. 6, 2008, = issue=20 of The Journal of Neuroscience.

[END]

..alex...
Alex DeLuca, M.D., = MPH
Senior=20 Consultant, PRN
doctordeluca@painrelie= fnetwork.org

#2 200= 8-02-08=20 10:54:09

MissDiva=20: Contributing-Member=20; =20; =20; Gender: =20; From: Somewhere between here + there=20; Registered: 2008-02-05=20; Posts: 18=20; Karma: 1

Re: Chronic Pain Can Damage Brain

Excellent study and information. *Methinks* that this could = explain the=20 'Fibro Fog' symptom assciated with Fibromyalgia. It also explains = why I=20 feel like I'm running on full throttle all the time, when physically I'm = not.

MissDiva ~ Pat

#3 200= 8-02-08=20 14:47:59

Tami=20: Administrative-Moderator=20; =20; =20; =20; Gender: =20; From: ND=20; Registered: 2008-01-09=20; Posts: 607=20; Karma: 15=20; =20

Re: Chronic Pain Can Damage Brain

Thanks Alex, great article. I thought I would add this as well. A bit = outdated, but relevant.

Chronic Back Pain May Shrink the = Brain
Brain=20 Cell Loss Is 10 to 20 Times That of Normal Aging

WebMD Medical = News=20

Nov. 19, 2004 =97 If you=92re one of the millions of = people with=20 chronic back pain, scientists say your brain may age up to 20 times = faster than=20 normal.
In the first study of its kind, researchers from = Northwestern=20 University have found that chronic back pain actually shrinks the brain = by as=20 much as 11%. Specifically, it shrinks the gray matter, which makes up = the part=20 of the brain responsible for memory and information processing.
It = is well=20 documented that chronic back pain negatively impacts quality of life and = increases anxiety and depression, but it has been assumed that any brain = changes=20 revert to a normal state after the pain stops, researcher A. Vania = Apkarian=20 writes in the Nov. 23, 2004 issue of The Journal of Neuroscience. =
Apkarian=20 and colleagues compared 26 healthy volunteers with 26 patients who had = chronic=20 back pain in the lower region for more than a year. Some patients=92 = pain radiated=20 through the buttock, thigh, and leg =97 a sign of sciatic nerve damage, = or=20 sciatica. The source of the pain was not considered.
MRI brain = images and=20 other sophisticated imaging tests, which measured gray matter size, were = performed on all patients. After adjusting for age and gender factors,=20 scientists found that, overall, chronic back pain patients lost about = 5%-11% of=20 gray matter a year =97 about the same as 10 to 20 years or normal aging, = the=20 researchers say. Typically, normal aging results in only about 0.5% of = gray=20 matter loss each year, they add.
Those with chronic back pain with = sciatica=20 had the largest decrease in gray matter. In addition, the more years = someone has=20 chronic back pain, the more brain loss they suffered.
It=92s = possible that=20 some of the brain shrinkage occurs without substantial nerve cell loss,=20 suggesting that certain medications could potentially help reverse = tissue=20 shrinkage, says Apkarian, in a news release.
What=92s Behind the = Brain=20 Shrinkage?
By definition, chronic back pain is a state of persistent = pain=20 sensation with associated negative mood and stress, says Apkarian. = Therefore,=20 one possible explanation for the decreased gray matter is that nerve = cells are=20 working overtime, he says.
The researchers hypothesize that as = chronic back=20 pain persists it may become more irreversible and less responsive to = treatment=20 due to these brain changes.

http://www.webmd.com/back-pain/news/20041122/chronic-back= -pain-may-shrink-brain

Tami ~ CPP ~ Advocate the Pain = Relief=20 Network

"The opposite of love is not hate, it's=20 indifference. The opposite of art is not ugliness, it's indifference. = The=20 opposite of faith is not heresy, it's indifference. And the opposite of = life is=20 not death, it's indifference." Elie Wiesel

#4 200= 8-02-08=20 23:29:56

docalex=20: Admin=20; =20; =20; =20; Gender: =20; From: New York City=20; Registered: 2008-01-09=20; Posts: 213=20; Karma: 10=20; =20

Re: Chronic Pain Can Damage Brain

Tami wrote:

Thanks Alex, great article. I thought I would add this as well. A = bit=20 outdated, but relevant.

Chronic Back Pain May Shrink the Brain = - Brain=20 Cell Loss Is 10 to 20 Times That of Normal Aging
WebMD Medical = News - Nov.=20 19, 2004
http://www.webmd.com/back-pain/news/20041122/chronic-back= -pain-may-shrink-brain

This was an important study, Tami, and one that has made it into the=20 footnotes of several legal documents authored by Dr. Fisher and myself = over the=20 years. The current study adds credence to this older work.

This = is a=20 crucially important point - because if chronic pain causes brain damage, = and if=20 opioids (and not NSAIDS etc) could prevent that damage, then all that = nonsense=20 about using opioids only as a last resort, the "analgesic ladder", all = of that=20 non-medical, confused thinking, goes right out the window.

Always = remember, the standard of care is what the science says it is. Not what = cops,=20 regulators or even scientists say it is - it is not a matter of opinion = - it is=20 what it is. This is a growing body of powerful research which WILL force = us to=20 think again.

..alex...
Alex DeLuca, M.D., = MPH
Senior=20 Consultant, PRN
doctordeluca@painrelie= fnetwork.org

#5 200= 8-02-09=20 01:30:17

wfmiii=20: Contributing-Member=20; =20; =20; =20; Gender: =20; From: GA=20; Registered: 2008-01-19=20; Posts: 23=20; Karma: 2

Re: Chronic Pain Can Damage Brain

This is an awesome development. The fact that it will be = ignored and=20 poo poo'd by prosecutors and investigators should shed some much needed = light on=20 their true goals. They IN NO WAY have pain patients' best = interests at=20 heart.

Is is just puritanical opiophobia on law enforcement's = part? =20 I understand that it is cruel and evil, but there must be a more = specific way to=20 define what their goals really are...absolute prohibition??? And = for what=20 purpose? To see to it that the <=3D3.9% of people don't become=20 accidentally "addicted" while the other 48 million sufferers stay in = pain? =20 I think it is more about job security for DEA diversion investigators = and the=20 significant surplus of Assistant US Attorneys this country currently = suffers=20 from.

#6 200= 8-02-09=20 17:08:36

David=20: Contributing-Member=20; =20; =20; =20; Gender: =20; From: OHIO=20; Registered: 2008-01-20=20; Posts: 27=20; Karma: 1

Re: Chronic Pain Can Damage Brain

Docalex, Fascinating study. It would have been even more=20 intersting when they tested subjects with the MRI they would have also = included=20 a subject with chronic pain AND on their pain medicine. Also I can = not=20 help but wonder; Over time does the continuous 24 hour a day = suffering=20 bring on more and more brain damage? And what other kinds of = damage=20 pain does to the brain? I have read before of this phenomenom of = the=20 re-wiring of the built-in hardwiring in a person. I wonder what = else this=20 damage could be responsible for besides the depression, insomnia, and = difficulty=20 making decisions? I also can not help wonder if thid damage to the = brain=20 is responsible for any criminal types of behavior? David

LIVE FREE OR DIE

#7 Yes= terday=20 11:05:54

pauly=20: Contributing-Member=20; =20; =20; =20; Gender: =20; From: Chicago=20; Registered: 2008-01-30=20; Posts: 28=20; Karma: 1

Re: Chronic Pain Can Damage Brain

And here I was worried that Tami's brain was going to waste away from = inactivity! 3Dsmile=20 I pray that = the=20 powers that be start using these & similar studies that show = negative=20 effects of CP on other organs of the body & start relieving CP. Many = dr's=20 say learn to live w/ it but these studies show that by doing so, it may = be=20 hurting us if not killing us. The high suicide rate in the CP community = shows=20 it's doing both! Everyone should make copies & give it to all their = dr's,=20 not just their pain dr's. Maybe our pcp's will take a more active role = in our CP=20 if they are made aware of studies like this that are sometimes lost in = the world=20 of neurology. After all, they are the quarterbacks of our health care = team or=20 are supposed to be.
Take care,
Pauly

#8 Yes= terday=20 15:06:21

pauly=20: Contributing-Member=20; =20; =20; =20; Gender: =20; From: Chicago=20; Registered: 2008-01-30=20; Posts: 28=20; Karma: 1

Re: Chronic Pain Can Damage Brain

Chronic pain is one of the biggest medical health issues in the = Western=20 world; it costs the United States about $150 billion a year. Unlike with = acute=20 pain, the causes of chronic pain are often unclear--for example, doctors = can=20 identify a physical source in only about 10 percent of those with = chronic back=20 pain. A growing number of studies suggest that chronic pain should be = viewed as=20 a progressive disease, likely triggered by aberrant but potentially = permanent=20 changes in the brain.

The painkillers that help headaches and = broken=20 bones do little for chronic pain, leaving a huge need for new = treatments. But=20 developing them has been difficult. Perception of pain depends strongly = on our=20 level of attention and our emotional state--two factors that are = difficult to=20 study in animal models. "We don't have one drug developed from = preclinical=20 models of pain that works for chronic pain," says Irene Tracey, a = scientist at=20 the University of Oxford, in England, who studies pain.

Now = scientists=20 are aiming to develop and test new drugs using human brain imaging. A. = Vania=20 Apkarian and his colleagues at Northwestern University have found a = series of=20 abnormalities in the brains of chronic pain sufferers: the part of the=20 prefrontal cortex linked to decision making appears to have shrunk in = chronic=20 pain patients. And another part of the prefrontal cortex linked to = emotion is=20 hyperactive. In fact, a unique study assessing background pain in = chronic=20 back-pain patients suggests that the constant pain these people = experience is=20 linked to activity almost entirely in emotion-regulating parts of the=20 brain.

Researchers used functional magnetic resonance imaging = (fMRI),=20 which measures brain activity, to study background pain. They asked = back-pain=20 patients to continually rate their pain while lying in the scanner, and = then the=20 researchers compared brain activity patterns during periods of constant = pain=20 with those during periods of worsening pain.

While activity = patterns=20 during flare-ups resembled those previously linked to acute pain, the = pattern=20 associated with constant background pain was distinct: it centered on = the medial=20 prefrontal cortex, a brain area involved in emotion and sense of self. = "It=20 almost seems like they've turned off the sensory part and are suffering = entirely=20 from the emotional aspect," Apkarian says.

Given these findings, = the=20 scientists are beginning human tests of a compound called d-cycloserine, = an=20 FDA-approved antibiotic that also blocks certain receptors in the brain. = (It is=20 currently being tested for treating post-traumatic stress disorder and = other=20 conditions.) "We think it increases transmission within the prefrontal = cortex to=20 better control the emotional component of pain," says Apkarian. "This = will be=20 the first hypothesis-driven test for a pain drug driven by human-imaging = studies."
I found this in Technology Review. It seems I may not be = so crazy=20 after all about antibiotics! I love studies that help the CP community. = I have=20 to research to see if I can become a guinea pig again! First I have to = make sure=20 there's no venom in the compound!
Pauly

Northwestern was = starting a=20 study in May & I'm very close to them but I'm not eligible! There's = no way I=20 can hide the scars on my back & surgery is just one of the things = that=20 vetoed me.

Last edited by pauly (Yesterday=20 15:35:03)

#9 Yes= terday=20 16:12:07

Tami=20: Administrative-Moderator=20; =20; =20; =20; Gender: =20; From: ND=20; Registered: 2008-01-09=20; Posts: 607=20; Karma: 15=20; =20

Re: Chronic Pain Can Damage Brain

3Dhttp://d.yimg.com/us.yimg.com/p/rids/20080206/i/r1391950705.jpg?=20 =

#10 Yes= terday=20 16:25:34

Tami=20: Administrative-Moderator=20; =20; =20; =20; Gender: =20; From: ND=20; Registered: 2008-01-09=20; Posts: 607=20; Karma: 15=20; =20

Re: Chronic Pain Can Damage Brain

Pauly, such a sweetie worrying about my brain wasting away!!=20

Appreciate the discussion, like Alex said, this is a growing and = powerful body of research that will force us to think again. I am just = amazed=20 daily, by the stories people tell, and the Docs lack of understanding of = chronic=20 pain as a malignancy, a disease.

"Learn to live with it." I am = sure each=20 of us at some point have been told that, it is this lack of = understanding,=20 prejudice, cowardice, fear, that is costing thousands of lives each year = and=20 immeasurable suffering.

Tami

#11 Yes= terday=20 16:52:57

Tami=20: Administrative-Moderator=20; =20; =20; =20; Gender: =20; From: ND=20; Registered: 2008-01-09=20; Posts: 607=20; Karma: 15=20; =20

Re: Chronic Pain Can Damage Brain

wfmiii wrote:

This is an awesome development. The fact that it will be = ignored and=20 poo poo'd by prosecutors and investigators should shed some much = needed light=20 on their true goals. They IN NO WAY have pain patients' best = interests=20 at heart.

Is is just puritanical opiophobia on law = enforcement's=20 part? I understand that it is cruel and evil, but there must be = a more=20 specific way to define what their goals really are...absolute=20 prohibition??? And for what purpose? To see to it that the = <=3D3.9% of people don't become accidentally "addicted" while the = other 48=20 million sufferers stay in pain? I think it is more about job = security=20 for DEA diversion investigators and the significant surplus of = Assistant US=20 Attorneys this country currently suffers from.

Hi wfmiii,
I think it to some degree it is a combination of all = the above=20 mentioned. Opiophobia, opioignorance, fear, prejudice, morality. And of = course=20 our Gov't with the need, to justify the billions and billions spent, and = the=20 decades, now past, of failed policy. The corruption it takes to maintain = this=20 state of prohibition is astounding. This is now such a monolithic, = perverse,=20 white elephant, moneymaking scheme, that I cannot ever see it going = down,=20 without the stand PRN is taking.

Oh yes, lets not forget, we now = build=20 more prisons than schools, more job security.

Tami

#12 Yes= terday=20 17:10:06

FrankA=20: Moderator=20; =20; =20; =20; Gender: =20; From: All Be Quirkey, NM=20; Registered: 2008-01-14=20; Posts: 90=20; Karma: 11=20; =20

Re: Chronic Pain Can Damage Brain

Here's three more links related to this subject..

Pain, Proof = in brain=20 using magnetic resonance imaging...
http://www.boston.com/news/nation/arti= cles/2006/12/19/imaging_could_furnish_proof_of_chronic_pain/

M= orphine=20 for chronic pain maintains cognitive function lost due to CP... http://www.im= wr.com/issues/articles/2006-11_42.asp

Chronic=20 Pain can drive a person to distraction...
http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=3D7= 1418

I'll=20 tell you this much, I have been very forgetful lately with the increase = in my=20 pain. Things I do usually without thinking about it wind up creating a = mess ie=20 sitting my glass of milk on a side table but not quite getting it on the = table=20 and spilling milk all over the carpet. The wife made me switch to a = sippy cup;=20 leaving keys in the door, forgetting how to spell the simplest of words, = forgetting what day it is, where I laid down my reading glasses, = forgetting to=20 pay bills on time etc... All of those things I did perfectly on morphine = I now=20 mess up! It takes me forever to compose a post or reply to one, I double = check=20 the spelling and meaning of every sentence and still find mistakes. Some = times I=20 get cut off because i do take so long.

It's embarrassing and = aggravating=20 and some days I feel like I'm turning into a idiot!
When the VA = tested me in=20 the late 80s to see if I needed more of a college education to get = different=20 work after losing the last career they educated me for, they said I = tested near=20 genius and that I was smart enough to figure out how to make money = without going=20 back to college. If I had to go to college now, I doubt I could pass an = art=20 class muchless anything harder.
IP and CP definantly does something = to the=20 brain, IMO.
Later, FrankA.

X-News Journalist Disabled Vet Musician Artist CP & IP patient in=20 pain!

#13 Yes= terday=20 18:10:06

wfmiii=20: Contributing-Member=20; =20; =20; =20; Gender: =20; From: GA=20; Registered: 2008-01-19=20; Posts: 23=20; Karma: 2

Re: Chronic Pain Can Damage Brain

FrankA wrote:

I'll tell you this much, I have been very forgetful lately with the = increase in my pain. Things I do usually without thinking about it = wind up=20 creating a mess ie sitting my glass of milk on a side table but not = quite=20 getting it on the table and spilling milk all over the carpet. The = wife made=20 me switch to a sippy cup; leaving keys in the door, forgetting how to = spell=20 the simplest of words, forgetting what day it is, where I laid down my = reading=20 glasses, forgetting to pay bills on time etc... All of those things I = did=20 perfectly on morphine I now mess up! It takes me forever to compose a = post or=20 reply to one, I double check the spelling and meaning of every = sentence and=20 still find mistakes. Some times I get cut off because i do take so=20 long.

I'm so glad to see this post. The drug warriors would swear = that=20 forgetfulness, clumsiness, etc is DUE to the morphine use. This is = the=20 kind of information that needs to be digested by the public to turn back = the=20 decades of demonization of opioids. The drug warriors have had = their way=20 with causing lay people (and sadly many health practitioners) to believe = that=20 opioids are evil because of their misuse by a minority of people. = These=20 studies and testimonials should go a long way to refuting the lies of = the drug=20 warriors.

#14 Tod= ay=20 11:58:39

Kim=20: Administrative-Moderator=20; =20; =20; =20; Gender: =20; From: Alaska=20; Registered: 2008-01-09=20; Posts: 327=20; Karma: 12=20; =20

Re: Chronic Pain Can Damage Brain

I definitely had memory problems and confusion when I was in pain and = not=20 treated for it. I have noticed a difference since I have been on meds = the last 8=20 months. My memory is not what it use to be before pain but it has slowly = improved with meds. I swear I would go into work and a specific job I = have done=20 hundreds of time I would all of the sudden forget what I was suppose to = do.=20 People will bring things up that happened in the last several years and = I have=20 no memory of it.

Kim~~CPP~~PRN=20 Advocate

#15 Tod= ay=20 13:14:09

pauly=20: Contributing-Member=20; =20; =20; =20; Gender: =20; From: Chicago=20; Registered: 2008-01-30=20; Posts: 28=20; Karma: 1

Re: Chronic Pain Can Damage Brain

You don't remember that night we shared in Nome last year? 3Dsmile=20 That's ok, = I don't=20 either! 3Dsad On=20 the serious side I noticed concentration & memory issues long ago = but dr's=20 always blamed the meds. My fiance would ask me something & I would = say I=20 don't remember. She would say you used to remember everything! I would = have to=20 say some of it could have something to do w/ all the meds I've been on = over the=20 years but most of it is due to the pain. The brain is so focused on the = pain=20 that it can't absorb everything else. At least that's how it is now. = When I was=20 at a level 6, things were much better. I pray these studies lead to = better pain=20 relief for all!
Take care,
Pauly

Pages: 1

Index
=BB Casualities = of=20 Prohibition
=BB Chronic Pain Can Damage Brain

Board footer

Jump to
= Welcome = The Disease of Chronic Pain =20 = = =20

Mega Pun is = Powered by PunBB 1.2.16
=A9 Copyright = 2002=962007 Rickard=20 Andersson
3D"Valid