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IMAGE: NEUROSCIENCE IS CLOSER THAN EVER TO UNDERSTANDING HOW CHRONIC PAIN AFFECTS THE BRAIN (MEDIA FOR MEDICAL/UIG VIA GETTY IMAGES)
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At least one in five Australians lives with chronic pain, and often the cause is unknown.
Scientists are just now discovering the crucial role the brain plays in how pain is experienced, and how it might pave the way for innovative treatment, write Lynne Malcolm and Olivia Willis.
The economic and social burden of chronic pain is enormous.
While analgesic drugs can provide pain relief for many, their side-effects, tolerance issues and addictiveness mean that scientists are on the hunt for alternative treatments.
Every emotion and every cognition is amplified. People with ongoing pain, they anticipate pain with a lot of fear and they worry a lot of the time.
DR SYLVIA GUSTIN, NEUROSCIENCE RESEARCH AUSTRALIA
The challenge of developing such treatments has led to more research on the brain’s role in chronic pain.
‘At the moment we have focused our work to two areas in the brain,’ says Dr Sylvia Gustin from Neuroscience Research Australia. ‘One is called the thalamus—the other is the prefrontal cortex.’
Described as the ‘border in the brain’, the thalamus acts as the gateway between the spinal cord and higher brain
When you sustain an acute injury there is an opening in the thalamus for information to pass through from the affected body part to the brain.
‘This is very important because then we need to heal, we need to relax, we need to look after ourselves. After an acute injury is healed, we know that this border should actually close.’
When researching people who experience chronic pain, Gustin identified a key neurological difference: the opening in the thalamus remains open long after acute pain is gone.
Gustin’s team found a decrease in the volume of the thalamus, resulting in a decrease of a specific neurotransmitter: gamma-aminobutyric acid, or GABA.
‘What this means,’ Gustin says, ‘is that in people with ongoing pain, this border is always open. Every signal gets amplified and it results in the experience of pain.’
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