Think Away Your Pain

By Rachel Metz
Wired.com

Pain can be mysterious, untreatable and debilitating, and its causes can be unknown. But if you could see the pain -- or, at least, your brain's reaction to it -- you might be able to master it.

A study from researchers at Stanford University and MRI technology company Omneuron suggests that's possible, and the results could lead to better therapies for those suffering from crippling chronic pain.

The researchers asked people in pain to try to control a pain-regulating region of the brain by watching activity in that area from inside a real-time functional magnetic resonance imaging, or fMRI, machine. Initial results showed subjects could reduce their pain, some quite dramatically.

It's the first evidence that humans can take control of a specific region of the brain, and thereby decrease pain, said Stanford professor Sean Mackey, who co-wrote the paper, which was published last week in Proceedings of the National Academy of Sciences.

"(Similar to) going to a gym and working muscle using weights, here we're using the real-time fMRI technology to exercise a certain brain region," he said.

Study co-leader and Omneuron CEO Christopher deCharms said for many people with chronic pain, available treatments like medication or surgery simply don't work. But this exercise, which researchers have termed "neuroimaging therapy," could one day help some of the millions of Americans who suffer from untreatable chronic pain.

In the study, eight healthy subjects who'd been subjected to a painful stimulus and eight chronic pain patients underwent a series of fMRIs. The images tracked activity in the brain's rostral anterior cingulate cortex -- an area deCharms said is related to pain. Subjects watched this area on a monitor in real time during the procedure. Prompted by researchers' suggestions of trying to lessen their own pain by ignoring it or imagining it as benign, they set out in a mental game of hot-and-cold to lessen their discomfort.

Twenty-eight healthy subjects and four pain patients were also put into control groups that tried to control pain by viewing other patients' brain data or using other mental strategies, but no fMRIs. These tactics didn't show a significant reduction in pain, deCharms said.

The pain patients reported that the fMRI helped them decrease their overall pain 64 percent. Healthy subjects said they saw a 23 percent increase in their ability to control the strength of their pain, and a 38 percent increase in their ability to master its unpleasantness.

"I think most people found it very exciting to be able to watch the activity in their own brain, moment by moment, as it took place," deCharms said.

Vera A. Gonzales, a pain psychologist in League City, Texas, said she thinks the study lends scientific data to what scientists already knew empirically -- that people can decrease their own pain by focusing on certain thoughts.

It probably also helped that subjects could watch their brain activity unfold on a screen, she said. For years, some therapy methods have allowed patients to monitor and try to control their biofeedback by concentrating on things like skin temperature and heart rate.

Mackey and deCharms cautioned it will be some time before such therapy could be available for commercial use. They're investigating the process of getting Food and Drug Administration approval, and right now they're focusing on a study to investigate the effects of long-term neuroimaging therapy, deCharms said. One day, patients may even be able to think away other problems like depression, anxiety and dyslexia.

"We don't yet have a good answer to what happens if you keep practicing and practicing," he said.

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