Chronic Pain - This came from Medscape

Submitted by Synapses on = Wed,=20 02/13/2008 - 16:31.

Main = Forum=20

Chronic Pain May Harm the Brain

Caroline Cassels
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Dr Daniel Mikol discusses the findings from the multicenter = REGARD=20 study.
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February 6, 2008 =E2=80=94 A new study indicates that chronic = pain has a=20 widespread impact on overall brain function, a finding that may = offer a=20 possible explanation for many of the common cognitive and = behavioral=20 comorbidities seen in such patients.

Using functional magnetic resonance imaging (fMRI), = investigators at=20 Northwestern University, in Chicago, Illinois, found individuals = with=20 chronic back pain (CBP) had alterations in the functional = connectivity of=20 their cortical regions =E2=80=94 areas of the brain that are = unrelated to pain =E2=80=94=20 compared with healthy controls.

"This is the first clue we have that conditions such as = depression,=20 anxiety, sleep disturbances, and decision-making difficulties, = which=20 affect the quality of life of chronic pain patients as much as the = pain=20 itself, may be directly related to altered brain function as a = result of=20 chronic pain," principal investigator Dante Chialvo, MD, told = Medscape=20 Neurology & Neurosurgery.

The study is published in the February 6 issue of the Journal = of=20 Neuroscience.

According to Dr. Chialvo, previous research has shown that, at = rest,=20 the healthy brain is in a state of cooperative equilibrium, so = that when 1=20 region is active, the others become less active or deactivated. = The brain=20 regions engaged in this resting state are known as the default = mode=20 network (DMN) and usually "shut off" when an individual is paying=20 attention or undertaking a task.

However, the study found that compared with healthy controls, = the=20 regions of the DMN in chronic pain patients never "quiet = down."

"Our paper shows pain not only hurts patients, but the = unrelenting=20 perception of pain also harms the brain. Using technology such as = fMRI, we=20 can objectively quantify this effect," said Dr. Chialvo.

Irreversible Changes?

For the study, investigators used fMRI to scan the brains of 15 = patients =E2=80=94 7 women and 8 men =E2=80=94 with CBP and = compared them with a group of=20 age- and sex-matched controls.

Study participants were required to complete a simple task, = which=20 involved tracking a moving bar on a computer screen while = undergoing fMRI.=20

While the CBP group was able to complete the task as well as = controls,=20 Dr. Chialvo said, it was at the expense "of using their brain = differently=20 from the pain-free group."

Furthermore, the study suggests that, over time, chronic pain = may lead=20 to permanent reorganization of the brain. "We observed that the = effect on=20 the cortical regions was greater among individuals who had had = chronic=20 pain for a longer period of time."

If the study's findings are confirmed, he added, this may = indicate a=20 need for early, aggressive treatment of pain to mitigate = discomfort and/or=20 prevent associated conditions such as depression, sleep = disturbances, and=20 cognitive impairment.

Dr. Chialvo's next research steps will include investigating = potential=20 functional differences in cortical regions of the brains of men = and women.=20

"It is well-known that chronic pain affects 3 times as many = women as=20 men, but no one has a clue why this is. We are going to look at=20 resting-state levels initially in healthy females and males and = ultimately=20 in individuals with chronic pain to determine whether the default = network=20 is different between the sexes," he said.

The study was supported by the National Institutes of = Health.

J Neurosci. 2008;28:1398-1403.

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There = is not=20 enough study

Submitted by Naly on Wed, = 02/13/2008=20 - 17:12.

There is not enough study done on chronic pain. I know I have=20 concentration problems and silly confusion. =20 Others who do not suffer from chronic pain are not capable of=20 understanding. It makes things very difficult and = discouraging.

=C2=BB=20

Durages= ic=20 Patch Recall On

Submitted by PeppermintPatti = on Thu,=20 02/14/2008 - 16:06.

Duragesic Patch Recall
On Tuesday, February 12, 2008, = patches=20 containing the prescription pain medication fentanyl were = voluntarily=20 recalled because of a flaw that could cause patients or caregivers = to=20 overdose on the potent medication inside. Sold in the United = States under=20 the brand name Duragesic by PriCara and generically by Sandoz, = Inc., the=20 recall includes all 25-microgram-per-hour patches with expiration = dates on=20 or before December 2009. Other strength patches (12.5, 50, 75 and = 100=20 mcg/hr) are not affected.

If you have recently received a new supply of the 25 mcg/hr = Duragesic=20 patch with an expiration date on or before December 2009, the = following=20 actions are recommended:

Check the box or foil pouch for the expiration date to see if = they have=20 patches that are being recalled (dates on or before December=20 2009).
Contact the following manufacturer immediately for = further=20 instructions:
Anyone with 25 mcg/hr Duragesic patches being = recalled=20 should call 800-547-6446.
Anyone with 25 mcg/hr Sandoz Inc. = patches=20 being recalled should call 800-901-7236.
Notify your healthcare = provider who prescribed this pain medication that you have = received a=20 recalled lot.

=C2=BB=20

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Chronic Pain - This came from Medscape

There = is not=20 enough study

Durages= ic=20 Patch Recall On

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