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February 5 | Researc= h=20

MEDIA CONTACT: Marla Paul at 312-503-8928 or marla-paul@northwestern.edu=20

Chronic Pain Harms the Brain

The red and blue lines on the right = represent the=20 level of activity over time found at two representative = brain areas.=20 The shaded landscape corresponds to the bar height to which = the=20 subjects are paying attention. The pictures on the left are = brain=20 images (seen from the head=E2=80=99s midline) of the average = activity during=20 the entire study. They illustrate with colors how much = activation=20 (red-yellow) or deactivation (dark/light blue) was found at = each=20 location.
Note that the blue lines in the healthy = subjects=20 deactivate more (for instance at the times indicated by the = arrows)=20 than in the chronic pain patients. Another consistent = difference is=20 the smaller territory of brain deactivating (in blue) during = the=20 task seen in the chronic pain patients' brain images = compared with=20 the healthy individuals.

This illustration shows the same brain = images from=20 a different angle (same color codes as above). These show = the brain=20 from the left side, again demonstrating striking differences = between=20 chronic pain patients and healthy = subjects.

Video: View = evidence of=20 brain disturbance in a chronic pain patient.
Audio: = Dante Chialvo, associate research professor of = physiology at=20 Northwestern University's Feinberg School of Medicine, discusses = the=20 study's possible implications on clinical = treatments.

CHICAGO=20 -- People with unrelenting pain don't only suffer from the nonstop = sensation of throbbing pain. They also have trouble sleeping, are = often=20 depressed, anxious and even have difficulty making simple = decisions. =20

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

Researchers found that in a healthy brain all the = regions=20 exist in a state of equilibrium. When one region is active, the = others=20 quiet down. But in people with chronic pain, a front region of the = cortex=20 mostly associated with emotion "never shuts up," said Dante Chialvo, = lead author=20 and associate research professor of physiology at the Feinberg = School. The=20 region is stuck on full throttle, wearing out neurons and altering = their=20 connections to each other.

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

This is the = first=20 demonstration of brain disturbances in chronic pain patients not = directly=20
related to the sensation of pain. The study will be published = Feb. 6=20 in The Journal of Neuroscience.

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=20 the pain sufferers performed the task well but "at the expense of = using=20 their brain differently than the pain-free group," Chialvo said.=20

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

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

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

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

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

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

The study was supported by the National = Institute=20 of Neurological Disorders and Stroke.

Students |=20 Faculty and Staff | = Alumni=20 Association | Prospective Students = |

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Last updated 02/05/2008 World Wide Web = Disclaimer=20 and Policy = Statements=20 =C2=A9 2008 Northwestern University =

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