copied from alt.med.fibromyalgia

BBC Report:  Pain Linked To Permanent Brain Loss

Chronic pain may permanently shrink the brain, US researchers believe.

The Northwestern University team had previously shown patients with
back pain had decreased activity in the same brain region called the
thalamus.

This area is known to be important in decision-making and social
behaviour.

The team's current study in the Journal of Neuroscience suggests some
of the changes may be irreversible and render pain treatment
ineffective. More research is needed, they say.

Shrinkage

If true, it makes it all the more important to treat pain early to
prevent any permanent change, say Dr Vania Apkarian and colleagues.

They scanned the brains of 26 patients with chronic back pain and 26
healthy people.

The patients with chronic pain caused by damage to the nervous system
showed shrinks in the brain by as much as 11% - equivalent to the
amount of gray matter that is lost in 10-20 years of normal aging.

It does correspond with what other people have found.
Dr Nigel Lawes, senior lecturer in biomedical science at St Georges
Medical School

The decrease in volume, in the prefrontal cortex and the thalamus of
the brain, was related to the duration of pain.

Every year of pain appeared to decrease gray matter by 1.3 cubic
centimetres.

What the researchers now need to find out is whether this loss is
permanent or whether it can be reversed with treatment.

Dr Apkarian said: "It is possible that some of the observed decreased
gray matter shown in this study reflects tissue shrinkage without
substantial neuronal loss, suggesting that proper treatment would
reverse this portion of the decreased brain matter."

Permanent loss?

But Dr Apkarian said other research in rats had shown that spinal cord
neurons die, which suggests the brain changes could be irreversible.

Dr Nigel Lawes, senior lecturer in biomedical science at St Georges
Medical School, London, said: "This is a very interesting study.

"Other imaging studies have shown in chronic pain conditions these
areas of the brain are less active, so it does correspond with what
other people have found."

He said the brain areas involved, which control decision making such
as how to consciously move the body, might be important.

He said people with chronic back pain tended to move in automatic ways
that perpetuate the pain.

Therapies to teach people how to pay attention to and control their
movement to limit this pain might help, he said.

"Studies could look at whether any of these therapies improve the way
they cope with their pain, do you reverse the underactivity in that
part of the brain and, after you have reversed it for long enough,
will that then change the brain volume?

"It might well be that it is reversible, but that depends on whether
they get the right treatment or not."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/4031825.stm
Published: 2004/11/23 08:01:01 GMT

© BBC MMIV