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By Maria Konnikova Last year, Dimitris Xygalatas, the head of the experimental anthropology lab at the University of Connecticut, decided to conduct a curious experiment in Mauritius, during the annual Thaipusam festival, a celebration of the Hindu god Murugan. For the ten days prior to the festival, devotees abstain from meat and sex. As the festival begins, they can choose to show their devotion in the form of several communal rituals. One is fairly mild. It involves communal prayer and singing beside the temple devoted to Murugan, on the top of a mountain. The other, however—the Kavadi—is one of the more painful modern religious rituals still in practice. Participants must pierce multiple parts of their bodies with needles and skewers and attach hooks to their backs, with which they then drag a cart for more than four hours. After that, they climb the mountain where Murugan’s temple is located. Immediately after each ritual was complete, the worshippers were asked if they would be willing to spend a few minutes answering some questions in a room near the temple. Xygalatas had them rate their experience, their attitude toward others, and their religiosity. Then he asked them a simple question: They would be paid two hundred rupees for their participation (about two days’ wages for an unskilled worker); did they want to anonymously donate any of those earnings to the temple? His goal was to figure out if the pain of the Kavadi led to increased affinity for the temple. For centuries, societies have used pain as a way of creating deep bonds. There are religious rites, such as self-flagellation, solitary pilgrimages, and physical mutilation.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 11: Emotions, Aggression, and Stress
Link ID: 20444 - Posted: 12.27.2014

|By Claudia Wallis Touch a hot frying pan and the searing message of pain sprints up to your brain and back down to your hand so fast that the impulse to withdraw your fingers seems instantaneous. That rapid-fire signal begins in a heat-sensing molecule called a TRPV1 channel. This specialized protein is abundant on the surface of sensory nerve cells in our fingers and elsewhere and is a shape-shifter that can take an open or closed configuration. Heat opens a central pore in the molecule, so do certain spider toxins and capsaicin—the substance that gives chili peppers their burn. Once the pore is open, charged ions of sodium and calcium flow into the nerve cell, triggering the pain signal. Ouch! As neuroscientist-journalist Stephani Sutherland explains in “Pain that Won’t Quit,” in the December Scientific American, researchers have long been interested in finding ways to moderate the action of this channel—and other ion channels—in patients who suffer from chronic pain. Shutting down the TRPV1 channel completely, however, is not an option because it plays a vital role in regulating body temperature. In two papers published in Nature in December 2013 investigators at the University of California, San Francisco, gave pain researchers a big leg up in understanding TRPV1. They revealed, in exquisite atomic detail, the structure of the channel molecule (from a rat) using an electron cryomicroscope, an instrument designed to explore the 3-D structure of molecules at very low temperatures. One of those investigators, Yifan Cheng, also created this colorful animation, showing how the molecule looks when the channel is open. © 2014 Scientific American

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20411 - Posted: 12.13.2014

Ewen Callaway Nerve cells that transmit pain, itch and other sensations to the brain have been made in the lab for the first time. Researchers say that the cells will be useful for developing new painkillers and anti-itch remedies, as well as understanding why some people experience unexplained extreme pain and itching. “The short take-home message would be ‘pain and itch in a dish’, and we think that’s very important,” says Kristin Baldwin, a stem-cell scientist at the Scripps Research Institute in La Jolla, California, whose team converted mouse and human cells called fibroblasts into neurons that detect sensations such as pain, itch or temperature1. In a second paper2, a separate team took a similar approach to making pain-sensing cells. Both efforts were published on 24 November in Nature Neuroscience. Peripheral sensory neurons, as these cells are called, produce specialized ‘receptor’ proteins that detect chemical and physical stimuli and convey them to the brain. The receptor that a cell makes determines its properties — some pain-sensing cells respond to chilli oil, for example, and others respond to different pain-causing chemicals. Mutations in the genes encoding these receptors can cause some people to experience chronic pain or, in rare cases, to become impervious to pain. To create these cells in the lab, independent teams led by Baldwin and by Clifford Woolf, a neuroscientist at Boston Children’s Hospital in Massachusetts, identified combinations of proteins that — when expressed in fibroblasts — transformed them into sensory neurons after several days. Baldwin's team identified neurons that make receptors that detect sensations including pain, itch, and temperature, whereas Woolf’s team looked only at pain-detecting cells. Both teams generated cells that resembled neurons in shape and fired in response to capsaicin, which gives chilli peppers their kick, and mustard oil. © 2014 Nature Publishing Group

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20362 - Posted: 11.26.2014

By RONI CARYN RABIN The Food and Drug Administration on Thursday approved a powerful long-acting opioid painkiller, alarming some addiction experts who fear that its widespread use may contribute to the rising tide of prescription drug overdoses. The new drug, Hysingla, and another drug approved earlier this year, Zohydro, contain pure hydrocodone, a narcotic, without the acetaminophen used in other opioids. But Hysingla is to be made available as an “abuse-deterrent” tablet that cannot easily be broken or crushed by addicts looking to snort or inject it. Nearly half of the nation’s overdose deaths involved painkillers like hydrocodone and oxycodone, according to a 2010 study by the Centers for Disease Control and Prevention. More than 12 million people used prescription painkillers for nonmedical reasons that year, according to the study. Prescription opioid abuse kills more adults annually than heroin and cocaine combined, and sends 420,000 Americans to emergency rooms every year, according to the C.D.C. Hysingla, however, will not be not abuse-proof, said officials at the F.D.A. and the drug’s manufacturer, Purdue Pharma. Its extended-release formulation, a pill to be taken once every 24 hours by patients requiring round-the-clock pain relief, will contain as much as 120 milligrams of hydrocodone. The F.D.A. warned that doses of 80 milligrams or more “should not be prescribed to people who have not previously taken an opioid medication,” but officials described the abuse-deterrent formulation as a step forward. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 20340 - Posted: 11.21.2014

By Emily Underwood WASHINGTON, D.C.—Rapid changes unfold in the brain after a person's hand is amputated. Within days—and possibly even hours—neurons that once processed sensations from the palm and fingers start to shift their allegiances, beginning to fire in response to sensations in other body parts, such as the face. But a hand transplant can bring these neurons back into the fold, restoring the sense of touch nearly back to normal, according to a study presented here this week at the annual conference of the Society for Neuroscience. To date, roughly 85 people worldwide have undergone hand replant or transplant surgery, an 8- to 10-hour procedure in which surgeons reattach the bones, muscles, nerves, blood vessels, and soft tissue between the patient's severed wrist and their own hand or one from a donor, often using a needle finer than a human hair. After surgery, studies have shown that it takes about 2 years for the peripheral nerves to regenerate, with sensation slowly creeping through the palm and into the fingertips at a rate of roughly 2 mm per day, says Scott Frey, a cognitive neuroscientist at the University of Missouri, Columbia. Even once the nerves have regrown, the surgically attached hand remains far less sensitive to touch than the original hand once was. One potential explanation is that the brain's sensory "map" of the body—a series of cortical ridges and folds devoted to processing touch in different body parts—loses its ability to respond to the missing hand in the absence of sensory input, Frey says. If that's true, the brain may need to reorganize that sensory map once again in order to fully restore sensation. © 2014 American Association for the Advancement of Science

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20336 - Posted: 11.20.2014

By Kate Baggaley WASHINGTON — Being stroked in the right place at the right speed activates specialized nerve fibers. The caresses that people rate most pleasant line up with the probable locations of the fibers on the skin, new research suggests. “Touch is important in terms of our physical health and our psychological well-being,” said Susannah Walker, who presented the research November 17 at the annual meeting of the Society for Neuroscience. “But very little attention has been paid to the neurological basis of that effect.” Sensors in the skin known as C-tactile afferents respond strongly to being stroked at between three and 10 centimeters per second. The sensors send signals to the brain that make touch rewarding, says Walker, a neuroscientist at Liverpool John Moores University in England. Walker and a colleague played videos for 93 participants, showing a hand caressing a person’s palm, back, shoulder or forearm, either at 5 cm/s or 30 cm/s. Participants rated the 5 cm/s stroking — the best speed to get the skin’s sensors firing — as the most pleasant, except on the palm, where there are no stroking sensors. The back got the highest pleasantness ratings, forearms lowest. The spots where people like to be touched may not line up with the areas traditionally considered most sensitive. Though less finely attuned to texture or temperature than the hands or face, the back and shoulders are sensitive to a different, social sort of touch. © Society for Science & the Public 2000 - 2014.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 11: Emotions, Aggression, and Stress
Link ID: 20335 - Posted: 11.20.2014

By Elahe Izadi Putting very little babies through numerous medical procedures is especially challenging for physicians, in part because reducing the pain they experience is so difficult. Typically for patients, "the preferred method of reducing pain is opiates. Obviously you don't want to give opiates to babies," says neurologist Regina Sullivan of NYU Langone Medical Center. "Also, it's difficult to know when a baby is in pain and not in pain." In recent years, research has shown environmental factors, like a mother or caregiver having contact with a baby during a painful procedure, appears to reduce the amount of pain felt by the baby, at least as indicated by the child's behavior, Sullivan said. But she and Gordon Barr of the University of Pennsylvania, an expert in pain, were interested in whether a mother's presence actually changed the brain functioning of a baby in pain. So Sullivan and Barr turned to rats. Specifically mama and baby rats who were in pain. And they found that hundreds of genes in baby rats' brains were more or less active, depending on whether the mothers were present. Sullivan and Barr presented their committee peer-reviewed research before the Society for Neuroscience annual meeting Tuesday. They gave mild electric shocks to infant rats, some of which had their mothers around and others who didn't. The researchers analyzed a specific portion of the infants' brains, the amygdala region of neurons, which is where emotions like fear are processed.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 12: Sex: Evolutionary, Hormonal, and Neural Bases
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 8: Hormones and Sex
Link ID: 20331 - Posted: 11.20.2014

By Tanya Lewis WASHINGTON — From the stroke of a mother's hand to the embrace of a lover, sensations of gentle touch activate a specialized set of nerves in humans. The brain is widely believed to contain a "map" of the body for sensing touch. But humans may also have an emotional body map that corresponds to feelings of gentle touch, according to new research presented here Sunday (Nov. 16) at the 44th annual meeting of the Society for Neuroscience. For humans and all social species, touch plays a fundamental role in the formation and maintenance of social bonds, study researcher Susannah Walker, a behavioral neuroscientist at Liverpool John Moores University in the United KIngdom, said in a news conference. [Top 10 Things That Make Humans Special] "Indeed, a lack of touch can have a detrimental effect on both our physical health and our psychological well-being," Walker said. In a clinical setting, physical contact with premature infants has been shown to boost growth, decrease stress and aid brain development. But not much research has focused on the basis of these effects in the nervous system, Walker said. The human body has a number of different kinds of nerves for perceiving touch. Thicker nerves surrounded by a fatty layer of insulation (called myelin) identify touch and temperature and rapidly send those signals to the brain, whereas thinner nerves that lack this insulation send sensory information more slowly.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 11: Emotions, Aggression, and Stress
Link ID: 20327 - Posted: 11.18.2014

Colin Barras It's the sweetest relief… until it's not. Scratching an itch only gives temporary respite before making it worse – we now know why. Millions of people experience chronic itching at some point, as a result of conditions ranging from eczema to kidney failure to cancer. The condition can have a serious impact on quality of life. On the face of it, the body appears to have a coping mechanism: scratching an itch until it hurts can bring instant relief. But when the pain wears off the itch is often more unbearable than before – which means we scratch even harder, sometimes to the point of causing painful skin damage. "People keep scratching even though they might end up bleeding," says Zhou-Feng Chen at the Washington University School of Medicine in St Louis, Missouri, who has now worked out why this happens. His team's work in mice suggests it comes down to an unfortunate bit of neural crosstalk. We know that the neurotransmitter serotonin helps control pain, and that pain – from the heavy scratching – helps soothe an itch, so Chen's team set out to explore whether serotonin is also involved in the itching process. They began by genetically engineering mice to produce no serotonin. Normally, mice injected with a chemical that irritates their skin will scratch up a storm, but the engineered mice seemed to have almost no urge to scratch. Genetically normal mice given a treatment to prevent serotonin leaving the brain also avoided scratching after being injected with the chemical, indicating that the urge to scratch begins when serotonin from the brain reaches the irritated spot. © Copyright Reed Business Information Ltd.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20270 - Posted: 11.03.2014

By Rachel Feltman Sometimes the process of scientific discovery can be a real headache. In a recent Danish study, scientists were thrilled to give painful migraines to 86 percent of their study subjects. Migraines are a particularly painful mystery for researchers to solve: More than 10 percent of people worldwide are affected by these intense headaches, but no one has been able to pinpoint a specific cause. What makes these headaches, which can cause incapacitating pain and nausea, different from all other headaches? That's why scientists had to make their patients suffer -- researchers keep trying to trigger migraines using different mechanisms. The more successful they are, the more likely it is that the mechanism being tested is actually a common cause of migraines. And once we know what the common causes are, we can try to develop better treatments that target them. In this case the 86 percent "success" rate, which the researchers say is much higher than results with other triggers, was owed to increases of a naturally occurring substance called cyclic AMP, or cAMP. Our bodies use cAMP to dilate blood vessels, so an increase of it can increase the flow of blood. To see if cAMP might cause migraines, the researchers dosed their subjects with cilostazol, a drug that increases cAMP concentrations in the body.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20264 - Posted: 11.01.2014

By Elizabeth Pennisi Four years ago, Igor Spetic lost his right arm in an industrial accident. Doctors outfitted him with a prosthetic arm that restored some function, but they couldn't restore his sense of touch. Without it, simple tasks like picking up a glass or shaking hands became hit-or-miss propositions. The lack of touch also robs Spetic of basic pleasures. “I would love to feel my wife’s hand,” he says. In time, he may regain that pleasure: Two independent research teams have now equipped artificial hands with sensors that send signals to the wearer’s nerves to recreate this missing sense. The sensing technologies work only in the lab, but they have proved durable, and amputees who have tried them, including Spetic, say that they are effective. One technology advances the range of touch sensations available, while the other promises to enable touch through a better way to attach the prosthesis. “All of these results are very positive,” says Mandayam Srinivasan, a neuroengineer at the Massachusetts Institute of Technology in Cambridge, who was not involved in either project. “Each of them fills a piece of the puzzle in terms of [prosthesis] development.” Almost 40 years ago, researchers tried to provide sensory feedback by adding pressure sensors to prostheses that relayed the sensation through electrodes attached to nerves. But for the most part, they just made it seem like the hand was tingling. And durability has been an issue in such efforts, too. In February, Silvestro Micera, a neuroengineer at the Sant'Anna School of Advanced Studies in Pisa, Italy, and the Swiss Federal Institute of Technology in Lausanne and his team showed that it was possible for sensor-equipped prosthetic arms to gently or powerfully grab objects and even to distinguish a round from a square object. But the study lasted just 4 weeks, in part because of the delicate interface with the body. © 2014 American Association for the Advancement of Science.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20187 - Posted: 10.09.2014

Aaron E. Carroll For a drug to be approved by the Food and Drug Administration, it must prove itself better than a placebo, or fake drug. This is because of the “placebo effect,” in which patients often improve just because they think they are being treated with something. If we can’t compare a new drug with a placebo, we can’t be sure that the benefit seen from it is anything more than wishful thinking. But when it comes to medical devices and surgery, the requirements aren’t the same. Placebos aren’t required. That is probably a mistake. At the turn of this century, arthroscopic surgery for osteoarthritis of the knee was common. Basically, surgeons would clean out the knee using arthroscopic devices. Another common procedure was lavage, in which a needle would inject saline into the knee to irrigate it. The thought was that these procedures would remove fragments of cartilage and calcium phosphate crystals that were causing inflammation. A number of studies had shown that people who had these procedures improved more than people who did not. However, a growing number of people were concerned that this was really no more than a placebo effect. And in 2002, a study was published that proved it. A total of 180 patients who had osteoarthritis of the knee were randomly assigned (with their consent) to one of three groups. The first had a standard arthroscopic procedure, and the second had lavage. The third, however, had sham surgery. They had an incision, and a procedure was faked so that they didn’t know that they actually had nothing done. Then the incision was closed. The results were stunning. Those who had the actual procedures did no better than those who had the sham surgery. They all improved the same amount. The results were all in people’s heads. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20167 - Posted: 10.07.2014

By Lisa Sanders, M.D. On Thursday, we challenged Well readers to solve the mystery of a 62-year-old man with severe neck pain that spread down his arm, a facial droop, and numbness on his torso. Nearly 200 of you wrote in, and 20 of you correctly diagnosed the patient. The correct diagnosis is… Lyme disease. And more precisely, the early disseminated form of Lyme disease with neurological involvement The first person with the correct answer was Dr. Arielle Hay, a pediatric rheumatologist in Miami, who nailed it just half an hour after the case was posted. Dr. Hay said that the biggest clue was the UConn letterhead. When combined with the odd neurological symptoms, this reminder of where the case took place brought Lyme disease to mind. Lyme disease is one of those diseases that hardly needs an explanation. It was first described in 1977, in a case series of 51 children and parents who had mysterious episodes of joint pain and swelling. The children were initially diagnosed with juvenile rheumatoid arthritis, but the clustering of cases eventually led the investigators, Dr. Allen Steere and Dr. Stephen Malawista, to consider an infectious disease. The illness was named after the Connecticut town where most of the initial cases were located. The disease is caused by a spirochete, a spiral shaped bacterium carried by the Ixodes tick, and usually presents first with a distinctive, expanding red rash (called erythema migrans) that appears at the site of the bite in the early, localized stage of the disease. It is thought that the rash appears in up to 80 percent of Lyme infections. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 11: Motor Control and Plasticity
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 5: The Sensorimotor System
Link ID: 20166 - Posted: 10.07.2014

By Kevin Hartnett You may have seen that deliberately annoying “View of the World from Ninth Avenue” map featured on the cover of the New Yorker a while back. It shows the distorted way geography appears to a Manhattanite: 9th and 10th avenues are the center of the world, New Jersey appears, barely, and everywhere else is just a blip if it registers at all. As it turns out, a similar kind of map exists for the human body — with at least some basis in neuroscience. In August I wrote a story for Ideas on the rise of face transplants and spoke to Michael Sims, author of the book, “Adam’s Navel: A Natural and Cultural History of the Human Form.” During our conversation Sims mentioned an odd diagram published in 1951 by a neurosurgeon named Wilder Penfield. The diagram is known as “Homunculus” (a name taken from a weird and longstanding art form that depicts small human beings); it shows the human body scaled according to the amount of brain tissue dedicated to each part, and arranged according to the locations in the brain that control them. In the diagram, the eyes, lips, nose, and tongue appear grotesquely large, indicating that we devote an outsized amount of brain tissue to operating and receiving sensation from these parts of the body. (Sims’s point was that we devote a lot of processing power to the face, and for that reason find it biologically disorienting that faces could be changeable.) The hand is quite large, too, while the toes, legs, trunks, shoulders, and arms are tiny, the equivalents of Kansas City and Russia on the New Yorker map. “Homunculus” seems like the kind of thing that would have long since been superseded by modern brain science, but it actually continues to have a surprising amount of authority, and often appears in neuroscience textbooks.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20158 - Posted: 10.04.2014

By Sarah C. P. Williams Press the backs of your hands against the inside of a door frame for 30 seconds—as if you’re trying to widen the frame—and then let your arms down; you’ll feel something odd. Your arms will float up from your sides, as if lifted by an external force. Scientists call this Kohnstamm phenomenon, but you may know it as the floating arm trick. Now, researchers have studied what happens in a person’s brain and nerve cells when they repress this involuntary movement, holding their arms tightly by their sides instead of letting them float up. Two theories existed as to how this repression worked: The brain could send a positive “push down” signal to the arm muscles at the same time as the involuntary “lift up” signal was being transmitted to cancel it out; or the brain could entirely block the involuntary signal at the root of the nerves. The new study, which analyzed brain scans and muscle activity recordings from 39 volunteers, found that the latter was true—when a person stifles Kohnstamm phenomenon, the involuntary “lift” signal is blocked before it reaches the muscle. The difference between the repression mechanisms may seem subtle, but understanding it could help people repress other involuntary movements—including the tremors associated with Parkinson’s disease and the tics associated with Tourette syndrome, the team reports online today in the Proceedings of the Royal Society B. © 2014 American Association for the Advancement of Science

Related chapters from BP7e: Chapter 11: Motor Control and Plasticity; Chapter 9: Hearing, Vestibular Perception, Taste, and Smell
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 6: Hearing, Balance, Taste, and Smell
Link ID: 20113 - Posted: 09.24.2014

By Mo Costandi The nerve endings in your fingertips can perform complex neural computations that were thought to be carried out by the brain, according to new research published in the journal Nature Neuroscience. The processing of both touch and visual information involves computations that extract the geometrical features of objects we touch and see, such as the edge orientation. Most of this processing takes place in the brain, which contains cells that are sensitive to the orientation of edges on the things we touch and see, and which pass this information onto cells in neighbouring regions, that encode other features. The brain has outsourced some aspects of visual processing, such as motion detection, to the retina, and the new research shows that something similar happens in the touch processing pathway. Delegating basic functions to the sense organs in this way could be an evolutionary mechanism that enables the brain to perform other, more sophisticated information processing tasks more efficiently. Your fingertips are among the most sensitive parts of your body. They are densely packed with thousands of nerve endings, which produce complex patterns of nervous impulses that convey information about the size, shape and texture of objects, and your ability to identify objects by touch and manipulate them depends upon the continuous influx of this information. © 2014 Guardian News and Media Limited

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 20051 - Posted: 09.09.2014

Erin Allday It's well established that chronic pain afflicts people with more than just pain. With the pain come fatigue and sleeplessness, depression and frustration, and a noticeable disinterest in so many of the activities that used to fill a day. It makes sense that chronic pain would leave patients feeling weary and unmotivated - most people wouldn't want to go to work or shop for a week's worth of groceries or even meet friends for dinner when they're exhausted and in pain. But experts in pain and neurology say the connection between chronic pain and a lousy mood may be biochemical, something more complicated than a dour mood brought on from persistent, long-term discomfort alone. Now, a team of Stanford neurologists have found evidence that chronic pain triggers a series of molecular changes in the brain that may sap patients' motivation. "There is an actual physiologic change that happens," said Dr. Neil Schwartz, a post-doctoral scientist who helped lead the Stanford research. "The behavior changes seem quite primary to the pain itself. They're not just a consequence of living with it." Schwartz and his colleagues hope their work could someday lead to new treatments for the behavior changes that come with chronic pain. In the short term, the research improves understanding of the biochemical effects of chronic pain and may be a comfort to patients who blame themselves for their lack of motivation, pain experts said. © 2014 Hearst Communications, Inc.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 11: Emotions, Aggression, and Stress
Link ID: 20007 - Posted: 08.28.2014

By Sandra G. Boodman When the Philadelphia specialist gently tweaked a spot deep inside Heidi Gribble Camp’s back, she screamed, an expression of both anguish and elation.Camp’s vindication was fueled in large part by her persistence. In 2006, her complaints of severe abdominal pain early in her first pregnancy were brushed aside by her doctor — until she nearly bled to death from a ruptured ectopic pregnancy. That near-fatal hemorrhage was swiftly followed by her sudden lapse into unconsciousness and the discovery of large blood clots in her lung and abdomen, requiring additional emergency surgery. “I told him, ‘You found the pain, this is the best day of my life!’ ” Camp, 32, recalled saying during the June 18 procedure at the Hospital of the University of Pennsylvania. The fact that the interventional radiologist, an expert in minimally invasive surgical procedures, was able to pinpoint and replicate the stabbing pain she had suffered for more than eight years was sweet validation. It proved that Camp wasn’t exaggerating her pain and that it had an identifiable, physical cause, something a series of doctors had come to doubt. Months of recovery followed — as did the first episode of searing back pain. But doctors in Florida, Toronto and Northern Virginia, where Camp lived at various times with her husband, a recently retired professional baseball player — told her they could not find a reason for her agony. Some implied that she was dramatizing normal aches; others rebuffed her inquires about a potential cause that would later prove to be prescient.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 19992 - Posted: 08.26.2014

By GRETCHEN REYNOLDS Regular exercise may alter how a person experiences pain, according to a new study. The longer we continue to work out, the new findings suggest, the greater our tolerance for discomfort can grow. For some time, scientists have known that strenuous exercise briefly and acutely dulls pain. As muscles begin to ache during a prolonged workout, scientists have found, the body typically releases natural opiates, such as endorphins, and other substances that can slightly dampen the discomfort. This effect, which scientists refer to as exercise-induced hypoalgesia, usually begins during the workout and lingers for perhaps 20 or 30 minutes afterward. But whether exercise alters the body’s response to pain over the long term and, more pressing for most of us, whether such changes will develop if people engage in moderate, less draining workouts, have been unclear. So for the new study, which was published this month in Medicine & Science in Sports & Exercise, researchers at the University of New South Wales and Neuroscience Research Australia, both in Sydney, recruited 12 young and healthy but inactive adults who expressed interest in exercising, and another 12 who were similar in age and activity levels but preferred not to exercise. They then brought all of them into the lab to determine how they reacted to pain. Pain response is highly individual and depends on our pain threshold, which is the point at which we start to feel pain, and pain tolerance, or the amount of time that we can withstand the aching, before we cease doing whatever is causing it. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 19952 - Posted: 08.13.2014

By Sandra G. Boodman At first the rash didn’t bother her, said Julia Omiatek, recalling the itchy red bumps that suddenly appeared one day on her palm, near the base of her first and third fingers. It was January 2013 — the dead of winter in Columbus, Ohio — so when the area reddened and cracked a few weeks later, she assumed her problem was simply dry skin and slathered on some cream. Omiatek, then 35, had little time to ponder the origin of her problem. An occupational therapist who works with adult patients, she was also raising two children younger than 3. A few weeks later when her lips swelled and the rash appeared on her face, she decided it was time to consult her dermatologist. Skin problems were nothing new; Omiatek was so allergic to nickel that her mother had had to sew cloth inside her onesies to prevent the metal snaps from touching her skin and causing a painful irritation. Over the years she had learned to avoid nickel and contend with occasional, inexplicable rashes that seemed to clear up when she used Elidel, a prescription cream that treats eczema. But this time the perpetually itchy rash didn’t go away, no matter what she did. Over the course of 11 months, she saw four doctors, three of whom said they didn’t know what was causing the stubborn eruption that eluded numerous tests. The fourth specialist took one look at her hand and figured it out. “The location was a tip-off,” said Matthew Zirwas, an assistant professor of dermatology at the Ohio State University Wexner Medical Center who specializes in treating unexplained rashes. Omiatek’s case was considerably less severe than that of many of the approximately 300 other patients he has treated for the same problem.

Related chapters from BP7e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 19900 - Posted: 07.30.2014