A new technique can predict which patients with sore backs will end up enduring it as chronic back pain.
According to a new study, there’s a difference in brain scans between two groups of patients – those whose pain subsides and those whose pain lasts for years. And this difference appears early in the course of the pain.
By analyzing the scans, researchers were able to predict whether the patients would develop chronic pain with an 85% level of accuracy – leading to ways of identifying patients who are the most at risk and to new treatments or preventions.
“Chronic pain is one of the most expensive health care conditions in the US, yet there still is not a scientifically validated therapy for this condition,” says study researcher Vania Apkarian of Northwestern University.
- Over the course of a year, his team tracked 39 patients who reported back pain.
- They scanned the patients’ brains four times and followed their pain.
- While 20 patients recovered during this time, the pain persisted in 19.
- The team then looked at a number of brain characteristics, including the amount of communication between two areas of the brain previously seen to have altered activity in back pain patients: the insula and the nucleus accumbens. (These regions are involved in emotional responses to a person’s environment and in how the brain learns.)
They found more communication between the two areas in chronic back pain patients than in those whose pain subsided. And the increased crosstalk could be seen as far back as the start of the study, ScienceNOW reports, suggesting that it could have predicted which patients would suffer the whole year.
The findings also suggest that brain regions involved in learning and emotions are important in the development of chronic pain – and not just brain regions directly responsible for sensing pain.
“This is the very first time we can say that if we have two subjects who have the same type of injury for the same amount of time, we can predict who will become a chronic pain patient versus who will not,” Apkarian says.
And drugs could be developed to dampen the communication between the brain areas to treat or prevent chronic pain.
The work was published in Nature Neuroscience this week.
Image by Andreanna Moya via Flickr