Symptom Clusters

People who suffer from constant pain, such as those who suffer from fibromyalgia tend to have other difficulties; for instance, sleep problems, depression, anxiety, and trouble making even the simplest of decisions can be some of the many side effects of fibromyalgia. A partial answer to why these symptoms tend to come in such specific clusters comes from Northwestern University’s Feinberg School of Medicine where researchers have found a clue that may explain how chronic pain triggers these associated symptoms.

The Northwestern researchers discovered that a healthy brain exists in a state of balance in which when one area is active, the others are quiet. In people with chronic pain, however, the frontal region of the cortex that is associated with emotions remains eternally active, according to lead author of the study Dante Chialvo, associate research professor of physiology at the Feinberg School. That means that the areas that should calm down, fail to do so at the allotted time. They continue to work full-steam ahead and in the process, wear out neurons and modify their connections one to the other.

This study is the first of its kind in that it shows brain abnormalities that stem from chronic pain rather than brain changes in direct relation to immediate pain sensation.

Chialvo’s team employed functional magnetic resonance imaging (fMRI) to scan the brains of a group of people with chronic back pain as well as those of a second group of healthy individuals as they tracked a moving bar on a computer screen. While the back pain sufferers managed to perform the task well, it was seen that they used their brains in a different manner than those participants in the study who were pain-free.

In the pain-free group, it was seen that while specific areas of the cortex were activated, others quieted down, so as to maintain a balanced equilibrium between these areas of the brain. This balance is called the resting state network of the brain. It was discovered that in the chronic pain group, one of the nodes of the network failed to deactivate.

Constant Neuron Firing

Chialvo is concerned that the constant firing of the neurons in this area of the brain might lead to permanent damage. Chronic pain is something sufferers live with 24/7. That means that the part of your brain that perceives pain is always going to be active. Says Chialvo, “This continuous dysfunction in the equilibrium of the brain can change the wiring forever and could hurt the brain.”

Professor Chialvo believes that this continual activity and lack of balance in the brain “may make it harder for you to make a decision or be in a good mood to get up in the morning. It could be that pain produces depression and the other reported abnormalities because it disturbs the balance of the brain as a whole.”

The scientist says that his findings show that we need to prevent or treat the brain dysfunction, rather than only work to control the pain that causes the malfunction.