Chronic Pain

fMRI’s Ability to Show Pain

We are learning a great deal about pain from fMRI.  fMRI is a technique that allows us to look at areas of the brain that are metabolically active.  In this way, we can peer into the mind and see what parts of the brain light up when we are thinking about someone we love, or something we dislike.  We can also see what it looks like to feel pain.  Since we can see pain in the brain, we are able to study painful conditions.  What we are learning is very interesting.  First, we are beginning to be able to identify pain severity by viewing which parts of the brain light up when pain is being experienced. What we are able to see is that patients who suffer from chronic pain have these areas of the brain light up at lower levels of stimulation than normal controls. In other words, it takes less stimulation to cause pain in people who suffer from chronic pain.  They are more susceptible to pain.

So, we know that when a person says they are in pain, we can see signs of it in their brain.  People who suffer from chronic pain, actually experience more pain than normal people and that is also visible on fMRI. With this information, it is possible to see when the pain goes away.  With proper treatment, changes on fMRI normalize. The pain can be seen to resolve.  Can you learn to control your brain activity and control brain processes and will it lead to a change in pain perception The answer is yes. [Decharmes RC, et al. Proc Natl Acad Sci U S A. 2005 Dec 20;102(51):18626-31. Epub 2005 Dec 13.]Does it lead to durable changes? That is, changes that last?  Yes.[Presented by Mackey et al at IASP 2008.] Using real time fMRI training it is possible to teach people to control activation of areas of the brain associated with pain.  It seems to be similar to biofeedback or EEG feedback, but much more pronounced and effective.