People with chronic pain often feel dismissed or unseen. But a new study finds such pain has a brain activity pattern that’s distinct from acute pain caused by, say, a stubbed toe or a broken arm, suggesting there may be an identifiable brain “signature” for the misery of arthritis, low-back pain and lingering injuries.
“Chronic pain is not just a more enduring version of acute pain,” study co-author Prasad Shirvalkar said in a media call. “It’s actually fundamentally different in the brain” and “really a disease unto itself.”
Shirvalkar hopes his research, reported in the journal Nature Neuroscience, will help provide an objective measure for this kind of agony and lead to new treatment approaches.
“Each patient is more unique than we sometimes treat them,” he said, calling for personalized therapies rather than just offering everyone the same pills.
Opioids are often prescribed for chronic pain, though they have been shown to be less effective than other approaches and carry more side effects, including potential addiction. One in five Americans suffers from chronic pain, making it more common than other medical conditions like high blood pressure, diabetes and depression, according to another recent study.
To study chronic pain, Shirvalkar’s team implanted electrodes in the brains of four patients with long-lasting, debilitating pain and followed their brain signals for months . Several times a day, the volunteers recorded the ebb and flow of their pain on a scale of 0 to 10.
Researchers found brain activity in different areas than seen in acute pain and different from those identified in other studies that were mostly short-term and conducted in laboratories, not as patients lived their lives.
Shirvalkar said he and his colleagues have begun trying to treat study participants by manipulating brain circuits, but it’s too early to tell whether this is working. They hope to add 20 to 30 more patients to better understand the diversity of pain signatures and treatment targets.
Identifying key brain circuits is crucial for being able to track them using wearable devices, instead of implanted electrodes, Shirvalkar said. “Now that we know where these signals live, we can try to track them non-invasively.” Tracking pain in the brain should also help with diagnosis and personalizing therapy, he said.
Shirvalkar described three dimensions to chronic pain:
- The physical feeling or sensation
- The emotional side and
- The cognitive or thought-related aspect
Most medical and research attention has focused on the sensation of pain, but this has “clearly failed most patients,” he said. His team’s research suggests the emotional and cognitive facets of chronic pain may be as or more important to address with treatments.
Contact Karen Weintraub at kweintraub@usatoday.com.
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