Research has shown that there are clear differences that distinguish the brains of those with chronic pain from those without such pain. Chronic pain sufferers consistently show reduced volume in the brain’s gray matter, the cortical structures key to perception, movement, memory and reasoning. Researchers have also shown that compared to healthy patients, the brains of chronic pain sufferers are wired differently, in ways that suggest that physical sensations and emotional responses are bound more tightly together.
But are those brain differences a response to chronic pain — the brain’s response to the experience of months or years of physical misery? Or do those differences predate chronic pain — nudging what for another patient would be a short-term experience of discomfort into a lifelong ordeal? The authors of the current study, working under a federal government initiative aimed at consolidating research on pain, devised a series of experiments designed to clarify which came first.
They did so by recruiting 46 subjects who had experienced a first episode of back pain that had already lasted four to 16 weeks, and performing regular brain scans on those subjects for a year. Focusing largely on the bundles of axons that carry nerve impulses across the brain, they found that within two months of recruiting patients, discernible differences in the structure and integrity of that “white matter” could be used to distinguish subjects whose pain persisted from those whose pain was beginning to resolve.
By the 12-month mark, the structural differences in white matter allowed researchers to distinguish — without error — subjects whose pain had disappeared from those whose pain was persistent. Compared to subjects whose pain resolved, subjects whose pain would become chronic also showed differences in the density of connections that lashed their nucleus accumbens — a central structure in the brain rewards, motivation, pleasure and reinforcement learning circuit — together with their medial prefrontal cortex, a switchboard for decision-making, emotional response and long-term memory.
Originally published in the LA Times but you can find more about it here
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