Different Disorders, Same Pain

Brain Changes May Explain Chronic Pain Symptoms in Different Disorders – August 23, 2017 In Fibromyalgia, Newsby Patricia Inacio, PhD

Even though fibromyalgia and urological chronic pelvic pain syndrome (UCPPS) are different disorders, new research suggests that patients suffering from these conditions may actually share alterations to the brain, perhaps explaining why certain UCPPS patients exhibit fibromyalgia characteristics, such as widespread pain.

The study “Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study” was published in the journal Pain.  

Chronic pain is diagnosed and assessed via severity score scales, determining the intensity of the pain. However, current clinical practice disregards the pain’s spatial distribution in the body.

Now, a team of researchers at the University of Michigan asked how widespread pain is and what may underlie its wide distribution.

They examined data from the brains of 1,709 participants in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network.

A subset of the study participants, which included 10 UCPPS, 23 fibromyalgia and 49 healthy controls subjects, underwent functional and structural magnetic resonance imaging (MRI) exams

Patients with UCPPS reported experiencing localized pain in the pelvic area, but also throughout the body, i.e., a widespread pain.

When researchers analyzed the brains of these patients they detected alterations, including increased gray matter volume and alterations to the brains’ connectivity circuits.

“What was surprising was these individuals with widespread pain, although they had the diagnosis of urological chronic pelvic pain, were actually identical to another chronic pain disorder: fibromyalgia,” Richard Harris, PhD, the study’s senior author and associate professor of anesthesiology and rheumatology at Michigan Medicine, said in a University’s press release written by Kylie Urban.

Most notably, the alterations to the brain’s gray matter volume and pattern of connectivity were similar to the ones seen in fibromyalgia patients, but were absent in the pain-free control group.

Overall, the results suggest that despite diagnoses as different disorders in patients experiencing widespread pain, the symptoms may have a common source.

To me, this seems due to “central sensitization” and/or the physical changes in the brain that are seen with any kind of constant pain. If allowed to persist too long, pain transitions from a symptom into a disease in itself, and no longer requires a separate “cause”.

From such gushing pain, it’s as though the pain signals wear a rut into the nervous system while the pain’s source develops a chronic leak: the tiniest dribbles of pain glide unimpeded along that smooth rut and right into the brain.

 

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