2023-06-13 17:11:03
Chronic pain can arise for a variety of reasons. A serious injury with lasting consequences, an amputation or so-called neuropain. Medicine still does not provide optimal treatment for such cases. Because it is not yet known how and where this pain arises.
A research group from the University of California San Francisco, led by Prasad Shirvalkar, has now gained new insights. Her Results they published in the journal Nature Neuroscience.
Studies on the pain brain
In order to understand pain, doctors have had to rely completely on what patients say. The researchers write: “Chronic pain syndromes are often resistant to treatment and cause significant distress and disability. Pain severity is often measured through subjective reports, while objective biomarkers that can guide diagnosis and treatment are lacking.”
An important aspect in the origin of the pain is the place where it originates. Here, too, research is still in its infancy, as Shirvalkar describes: “It also remains unclear which brain activity underlies chronic pain on clinically relevant time scales or how this is related to acute pain.”
In order to find out how the chronic pain develops in the patient, the scientists examined the affected people using imaging methods. For this purpose, several electrodes were implanted under the skullcap. The aim was “to find out which regions play a role in the processing of chronic pain. Above all, we were interested in whether there are brain signals that are related to the intensity of the pain.”
Orbitofrontal cortex is source of chronic pain
For the study, two patients with different diagnoses were monitored and regularly examined over a period of six months. Initial investigations immediately showed that both hemispheres of the brain are involved in the development of chronic pain.
A particularly severe pain was described when the region around the so-called orbitofrontal cortex was active. In order to find out whether this is also linked to acute pain, the researchers carried out further tests. They found that the anterior cingulate cortex was activated when there was an acute pain stimulus. The orbitofrontal cortex was only slightly active in this type of pain.
The researchers see previous studies confirmed by their tests. “This observation fits with previous imaging studies in which experimental pain stimuli also activated the ACC as a key node.”
Valuable results for further research
The research group assumes that their study will fundamentally change pain research. By determining the cause, physicians and scientists can now work on further diagnostic and therapeutic options. They assume that, for example, brain stimulation could be used as a therapy for chronic pain in the future.
picture of Josh Clifford on Pixabay
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