Study: Brain imaging could help to personalize chronic pain treatment

Researchers at the University of Michigan were able to use brain imaging to track the clinical action of the drug pregabalin--used in patients suffering from fibromyalgia and neuropathic pain--in research published in the December issue of the journal Anesthesiology.

Fibromyalgia is a condition that affects about 10 million people in the U.S., and 3 to 6 percent of the population worldwide. It is a chronic pain disorder that is believed to be the result of a disturbance in the way the central nervous system processes pain.

"The significance of this study is that it demonstrates that pharmacologic therapies for chronic pain can be studied with brain imaging," lead study author Richard Harris, an assistant professor of anesthesiology at the University of Michigan, said according to an announcement. "The results could point to a future in which more targeted brain imaging approaches can be used during pharmacological treatment of chronic widespread pain, rather than the current trial-and-error approach."

The Michigan researchers worked off of previous studies that have suggested that fibromyalgia patients have heightened neural activity in a region of the brain called the insula, and that this excess activity may be related to elevated levels of the excitatory neurotransmitter glutamate.

In their study, the researchers used three different types of imaging--proton magnetic resonance spectroscopy, functional MRI, and functional connectivity magnetic resonance imaging--on 17 patients with fibromyalgia. They found that the use pregabalin reduces glutamate and glutamine levels within the insula, which leads to a reduction in insula connectivity and in clinical pain ratings.

In a study published in the British Journal of Healthcare Computing and Information Management in June 2010, a team of Spanish researchers found that both mobile devices and virtual reality hold promise as psychological treatments for chronic pain due to fibromyalgia.

Meanwhile, in a paper published in the New England Journal of Medicine in April, Tor D. Wager, Ph.D., an associate professor of psychology and neuroscience at the University of Colorado at Boulder, and colleagues reported that in four studies involving 114 participants, they developed a fMRI-based measure that predicts pain intensity in individuals.

To learn more:
- see the study in Anesthesiology
- read the UM announcement

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