Health & Medicine - Posted by Marla Paul-Northwestern on Tuesday, July 3, 2012 12:41 - 4 Comments 
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(No Ratings Yet) Loading ...When brain talks, odds of chronic pain rise
"For the first time we can explain why people who may have the exact same initial pain either go on to recover or develop chronic pain," says senior author A. Vania Apkarian. (Credit: "woman with back pain" via Shutterstock)
NORTHWESTERN (US) — The more two sections of the brain related to emotional and motivational behavior communicate, the greater the chance chronic pain will develop, say researchers.
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The text of this article by Futurity is licensed under a Creative Commons Attribution-No Derivatives License.
The first longitudinal brain imaging study to track participants with a new back injury provides a new direction for developing therapies to treat intractable pain, which affects 30 to 40 million adults in the United States.
Researchers were able to predict, with 85 percent accuracy at the beginning of the study, which participants would go on to develop chronic pain based on the level of interaction between the frontal cortex and the nucleus accumbens.
The study is published in the journal Nature Neuroscience.
“For the first time we can explain why people who may have the exact same initial pain either go on to recover or develop chronic pain,” says A. Vania Apkarian, senior author of the paper and professor of physiology at Northwestern University Feinberg School of Medicine.
“The injury by itself is not enough to explain the ongoing pain. It has to do with the injury combined with the state of the brain. This finding is the culmination of 10 years of our research.”
The more emotionally the brain reacts to the initial injury, the more likely the pain will persist after the injury has healed. “It may be that these sections of the brain are more excited to begin with in certain individuals, or there may be genetic and environmental influences that predispose these brain regions to interact at an excitable level,” Apkarian says.
The nucleus accumbens is an important center for teaching the rest of the brain how to evaluate and react to the outside world, Apkarian notes, and this brain region may use the pain signal to teach the rest of the brain to develop chronic pain.
“Now we hope to develop new therapies for treatment based on this finding,” Apkarian adds.
Chronic pain participants in the study also lost gray matter density, which is likely linked to fewer synaptic connections or neuronal and glial shrinkage, Apkarian says. Brain synapses are essential for communication between neurons.
“Chronic pain is one of the most expensive health care conditions in the US yet there still is not a scientifically validated therapy for this condition,” Apkarian says.
Chronic pain costs an estimated $600 billion a year, according to a 2011 National Academy of Sciences report. Back pain is the most prevalent chronic pain condition.
A total of 40 participants who had an episode of back pain that lasted four to 16 weeks—but with no prior history of back pain—were studied. All subjects were diagnosed with back pain by a clinician. Brain scans were conducted on each participant at study entry and for three more visits during one year.
The study, authored by additional researchers from Northwestern, was funded by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health.
More news from Northwestern University: www.northwestern.edu/newscenter/index.html
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4 Comments
kimbee
I totally agree, as a young kid I used to play out side and would often get stung by nettles and wasps, I eventually learned that even though these stings were painful, they were not dangerous, just annoying. So after a while I started ‘ignoring’ this pain and found that it went away much quicker. Nowadays if I get stung by a nettle or a wasp (and it has also worked for small burns) my skin will still welt but I will feel no pain, unless I scratch it and remind myself it’s there.
the ability to image the brain as it works is a fantastic new device in the hands of medicine. I don’t think we should be making grand pronouncements based on this new information. We still haven’t attached it to specific behavior outside of these huge machines that allow us to look inside the working brain for the first time. We are much more aware of where activity seems to be taking place now, and it is clearer still that this brilliant device between our ears has trillions of connections. That’s right, trillions. When I took biology of brain courses in the 70′s we were taught there are about 4 billion brain cells and they don’t regenerate. The last numbers I’m familiar with are now over 100 billion neurons and we do indeed keep making brain cells into our later years. Trillions of connections is an amazing discovery. It speaks to the power of this magnificent organ that is truly the difference between us and almost all other animals. We have the most powerful brain in the known universe. That’s a pretty cool thing. Now if we can actually harness that energy to make a better future. That’s the real challenge now. Is to harness this new knowledge and take a leap forward that everyone can share. Longer lives don’t mean much unless they are also happier lives. Who wants to extend misery?
The Author listed about the pain is really good and we need to take the treatment before the symptoms starts and the valuable information about the chronic pain had given me a best information so far, Thanks for the valuable Post!
The emerging research into the brains role in the development of chronic pain will hopefully open the door the better interventions. Focusing on understanding the triggers behind neuroplastic changes associated with the development of sustained pain syndromes will be the key area to focus research on. The emotional side of pain is very important as this research has implied and hopefully will become more accepted rather than religated to the ‘pseudo’ science of psychology. Pain IS in your head, just not in the limited way that most practitioners think it is.