Rein for pain lays mainly in the brain, Stanford researchers find

December 12, 2005

Chronic pain sufferers may be able to reduce pain levels by studying their own live brain images, researchers at the Stanford University School of Medicine report in a new study.

With training and the use of high-tech imaging equipment, subjects were able to influence their pain by controlling activity in one of the pain centers of the brain through the use of mental exercises and by visualizing their own brain activity in real time.

Compare it to exercising your muscles in a top-of-the-line weight room. After repeated practice, you get better at it.

The scientists are hopeful the new technique may have potential for future use as long-term treatment for chronic pain patients - possibly even without all the high-tech equipment. They caution that significantly more work is needed before it can be thought of as a clinical treatment.

"We believe these subjects and patients really learned to control their brain and, through that, their pain," said Sean Mackey, MD, PhD, assistant professor of anesthesia and co-author of the study to be published in the Dec. 12 online issue of the Proceedings of the National Academy of Sciences.

The study posed two questions: "Can healthy subjects and patients with chronic pain learn to control activity in specific regions of their brain? And, in doing so, does this lead to an improved control of their pain?" The answer to both was a resounding "Yes." A second, larger study is under way to test the potential for long-term use in future therapy.

"Pain has a huge impact on individual patients, their families and society," said Mackey, who is also associate director of Stanford's pain management division. A recent national survey showed that more than half of all Americans suffer from chronic pain. "I got incredibly jazzed by the results [of the imaging study]," Mackey added. "We could change people's lives. However, significantly more science and testing must be done before this can be considered a treatment for chronic pain."

Using new technology called real-time functional magnetic resonance imaging, or rtfMRI, scientists placed subjects inside an MRI scanner where they were able to watch their brain activity on a moment-by-moment basis. The subjects were then shown "live" action images of their rostral anterior cingulate cortex, an area of the brain responsible for processing pain.

Subjects were given various mental strategies to try to change their brain activity. "As an example, we asked them to think about changing the meaning of the pain," Mackey said.

"Instead of thinking of it as a terrible experience, to think of it as something relatively pleasant. Then the patients were turned loose. Over time, subjects showed an increased ability to change their brain and by doing so to modulate their pain."

How did they do it exactly? "We really don't know, but then we really don't know how anyone controls their brain to perform an action," Mackey said.

Laura Tibbitt, 31, one of the subjects in the study who suffers from chronic back pain caused by a horseback riding accident seven years ago, said she used different thoughts to decrease the pain while watching her "brain on pain."

"I'd think of little people on my back digging out the pain, or I'd think of snowflakes," she said. "The goal was to exercise your brain, to retrain your brain. Sometimes I felt like I had made a change in my brain. The pain was never completely gone, but it was better."

Mackey said extensive controls were used in the study to make sure the results reflected a direct correlation between brain imaging and pain control.

"One of the questions that always comes up is, 'Did we just design the world's most expensive placebo?' " Mackey said. Researchers used multiple control groups to ensure against this: The first remained outside the MRI machine; the second received no imaging feedback; the third was shown different areas of the brain that don't process pain, and members of the fourth group were shown someone else's brain activity.

None of these control subjects showed an ability to control pain levels.

"Real-time functional neuroimaging is a wonderful tool for investigating the neurosystems in the brain responsible for the perception and processing of pain," Mackey said. "It allows us to do that in ways that we've never been able to before."

The study, which included 36 healthy subjects and eight subjects with chronic pain, was co-sponsored by researcher Christopher deCharms and his Bay Area company, Omneuron Inc. It was co-funded by the National Institutes of Health and Stanford University. Mackey and his Stanford collaborators have no financial ties to the company. Other Stanford researchers involved in the study include Fumiko Maeda, MD, PhD, research associate; Gary Glover, PhD, professor of radiology, and John Pauly, PhD, associate professor of electrical engineering. Former Stanford collaborators include David Ludlow, Deepak Soneji and John Gabrieli.
-end-
Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.

PRINT MEDIA CONTACTS: Tracie White at (650) 723-7628 (tracie.white@stanford.edu)
Ruthann Richter at (650) 725-8047 (richter1@stanford.edu)

BROADCAST MEDIA CONTACT: M.A. Malone at (650) 723-6912 (mamalone@stanford.edu

Stanford University Medical Center

Related Chronic Pain Articles from Brightsurf:

Researchers are developing potential treatment for chronic pain
Researchers from the University of Copenhagen have developed a new way to treat chronic pain which has been tested in mice.

Molecular link between chronic pain and depression revealed
Researchers at Hokkaido University have identified the brain mechanism linking chronic pain and depression in rats.

How chikungunya virus may cause chronic joint pain
A new method for permanently marking cells infected with chikungunya virus could reveal how the virus continues to cause joint pain for months to years after the initial infection, according to a study published Aug.

Gastroesophageal reflux associated with chronic pain in temporomandibular joint
Gastroesophageal reflux (GERD) is associated with chronic, painful temporomandibular disorder -- pain in the temporomandibular joint -- and anxiety and poor sleep contribute to this association, according to a study in CMAJ.

One step closer to chronic pain relief
While effective drugs against chronic pain are not just around the corner, researchers from Aarhus University, Denmark, have succeeded in identifying a protein as a future potential target for medicinal drugs.

Gut bacteria associated with chronic pain for first time
In a paper published today in the journal Pain, a Montreal-based research team has shown, for the first time, that there are alterations in the bacteria in the gastrointestinal tracts of people with fibromyalgia.

Nearly 5.4 million cancer survivors suffer chronic pain
A new report finds about one in three cancer survivors (34.6%) reported having chronic pain, representing nearly 5.4 million cancer survivors in the United States.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

New target for chronic pain relief confirmed by scientists
A research group at Hiroshima University observed a potential new target for chronic pain treatment.

Menopause symptoms nearly double the risk of chronic pain
In addition to the other health conditions affected by estrogen, it has also been shown to affect pain sensitivity.

Read More: Chronic Pain News and Chronic Pain Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.