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Stephanie O'Neill Shirley Avedon, 90,­­ had never been a cannabis user. But carpal tunnel syndrome that sends shooting pains into both of her hands and an aversion to conventional steroid and surgical treatments is prompting her to consider some new options. "It's very painful, sometimes I can't even open my hand," Avedon says. So for the second time in two months, she's climbed on board a bus that provides seniors at the Laguna Woods Village retirement community in Orange County, Calif., with a free shuttle to a nearby marijuana dispensary. The retired manager of an oncology office says she's seeking the same relief she saw cancer patients get from smoking marijuana 25 years ago. "At that time (marijuana) wasn't legal, so they used to get it off their children," she says with a laugh. "It was fantastic what it did for them." Avedon, who doesn't want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana's psychoactive ingredient. "It helped a little," she says. "Now I'm going back for the second time hoping they have something better." As more states legalize marijuana for medical or recreational use — 30 states plus the District of Columbia to date — the cannabis industry is booming. Among the fastest growing group of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternatives treatments for their aches, pains and other medical conditions. © 2018 npr

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 25458 - Posted: 09.17.2018

By Erin Blakemore Janet Jay is a cyborg. No, she’s not RoboCop or Darth Vader. But she shares a similarity with those characters: Her all-too-human body has been upgraded with a machine. A next-generation implant deep in Jay’s back stimulates her spinal cord, overriding her body’s pain signals to give her some relief from the back pain that has plagued her for years. In an article on Popular Science’s website, Jay writes about her experience with pain and the next-generation way she’s finding relief. She is hardly alone in her suffering. According to the National Center for Health Statistics, an estimated 25.3 million Americans, or 11.2 percent of U.S. adults, experience chronic pain. It can interfere with work and home life and leave patients debilitated, disabled and depressed. So it makes sense that Jay jumped at the chance to experience long-term pain relief with the help of a spinal-cord stimulator. Jay lays out the hows and whys of spinal stimulation, and she paints a vivid picture of a life in agony, a journey that has included skeptical doctors, plenty of painkillers and unanswered questions about the future. She also describes her path to spinal stimulation, how the device works with the body to short-circuit pain, and the many roadblocks to relief that patients face. “Even for me, the battle is not over,” Jay writes. “Since this surgery I’ve actually had another disc herniate, complicating everything. My spine isn’t cured, and I still hurt all the time. But the pain is far more controlled, and I can function much better at my current level of discomfort.” © 1996-2018 The Washington Post

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25455 - Posted: 09.17.2018

Aimee Cunningham Certain brain and personality characteristics may help predict whether a sugar pill can provide relief to someone suffering from chronic pain. In a small study, patients with persistent back pain who responded to a placebo treatment benefitted from up to a 33 percent reduction in their pain intensity. These people had distinctive features in their brains and certain personality traits, researchers report online September 12 in Nature Communications. About 20 percent of U.S. adults, or about 50 million people, had chronic pain in 2016, according to new data released September 13 by the U.S. Centers for Disease Control and Prevention. Chronic pain was defined as feeling pain on most days, if not every day, over the previous six months. Being able to identify people who respond to a placebo might mean doctors could give these individuals the option of a pain reliever that’s cheap, free of side effects and — unlike opioids, which are often prescribed to treat persistent pain — not addictive. “We need to seriously think about placebo as a treatment option, especially in chronic pain patients,” says neuroscientist and study coauthor A. Vania Apkarian of Northwestern University Feinberg School of Medicine in Chicago. |© Society for Science & the Public 2000 - 2018

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25452 - Posted: 09.15.2018

Laurel Hamers A draft of the poppy’s genetic instruction book is providing clues to how the plant evolved to produce molecules such as morphine. Scientists pieced together the genome of the opium poppy (Papaver somniferum). Then, they identified a cluster of 15 close-together genes that help the plant synthesize a group of chemically related compounds that includes powerful painkillers like morphine as well as other molecules with potential medical properties (SN: 6/10/17, p. 22). A group of genes that help poppy plants produce some of these molecules, collectively known as benzylisoquinoline alkaloids, have been clustered together for tens of millions of years, researchers report online August 30 in Science. But the plant’s morphine production evolved more recently. Around 7.8 million years ago, the plant copied its entire genome. Some of the resulting surplus genes evolved new roles helping poppies produce morphine, because the plant already had at least one other copy of those genes carrying out their original jobs. It wasn’t a one-step process, though. An even earlier gene duplication event caused two genes to fuse into one. That hybrid gene is responsible for a key shape-shift in alkaloid precursors, directing those molecules down the chemical pathway toward morphinelike compounds instead of other benzylisoquinoline alkaloids (SN Online: 6/25/15). |© Society for Science & the Public 2000 - 2018.

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 25399 - Posted: 08.31.2018

By Susana Martinez-Conde Research has shown that the experience of pain is highly subjective: people feel more or less pain, in identical physical situations, as a function of their mood and attention. This flexibility showcases the potential for cognitive manipulations to decrease the pain associated with a variety of pathologies. As an example, the virtual-reality game “Snow World” (in which game in which players shoot snowballs to defeat snowman Frosty and his penguins) reportedly works better than morphine at counteracting the pain of patients in burn units. Other studies have indicated that virtual reality manipulations of the patient’s own body can also help ameliorate pain: an experiment conducted by neuroscientist Maria Victoria Sanchez-Vives and her team at the University of Barcelona in Spain showed that heat applied to experimental participants’ wrists felt more painful when their virtual arms turned red than when they turned blue or green. Following on this tradition, a study published PeerJ last month showed that visuotactile illusions can help the pain experienced by patients suffering from knee osteoarthritis. According to lead author Tasha Stanton, from the University of South Australia, the idea for the study originated from her observation that “people with knee osteoarthritis have an altered perception of their own body. [Their affected knee] often feels too big, and they also have changes to the way that touch and movement information is represented in the brain.” She hypothesized that patients may “respond to illusions that change the way their knee looks.” © 2018 Scientific American,

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 14: Attention and Consciousness
Link ID: 25390 - Posted: 08.28.2018

Sarah Boseley Health editor A new drug to relieve pain during labour works better than pethidine, which has been in widespread use since the 1950s even though it has long been known it does not help all women, say researchers. Pethidine is given as an injection, but a new study funded by the National Institute for Health Research shows that remifentanil, which women control by pressing a button when they feel pain, appears to be more effective. Women using remifentanil were half as likely to end up asking for an epidural, which blocks all pain and sensation and often leads to a forceps delivery. Pethidine was the first opioid drug that was allowed to be given by a midwife alone and was very widely adopted, said Dr Matthew Wilson, a senior lecturer at the University of Sheffield and the lead author of the study published in the Lancet medical journal. More than a quarter of a million women in labour are given pethidine each year in the UK, even though up to 40% do not find it helpful, he said. “Some women do not report any useful pain relief at all and it has significant side effects,” he said. That includes sedation and potentially affecting the baby. “There has been a longstanding need for something else,” he said. Epidurals are by far the most effective form of pain relief, but women who have them are more likely to end up with their baby having a forceps or vacuum delivery. That can sometimes cause damage to the mother and have long-term consequences, including sexual problems. © 2018 Guardian News and Media Limited

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25331 - Posted: 08.15.2018

Tina Hesman Saey Some snippets of RNA can be a real pain. A microRNA called miR-30c-5p contributes to nerve pain in rats and people, a new study finds. A different microRNA, miR-711, interacts with a well-known itch-inducing protein to cause itching, a second study concludes. Together, the research highlights the important role that the small pieces of genetic material can play in nerve cell function, and may help researchers understand the causes of chronic nerve pain and itch. MicroRNAs help regulate gene activity and protein production. The small molecules play a big role in controlling cancer (SN: 8/28/10, p. 18) and other aspects of health and disease (SN: 2/20/16, p. 18). Usually, microRNAs work by pairing up with bigger pieces of RNA called messenger RNAs, or mRNA. Messenger RNAs contain copies of genetic instructions that are read by cellular machinery to build proteins. When microRNAs glom onto the messengers, the mRNA can be degraded or the microRNAs can prevent the protein-building machinery from reading the instructions. Either way, the result is typically to dial down production of certain proteins. In the case of nerve pain, miR-30c-5p limits production of an important protein called TGF-beta that’s involved in controlling pain, María Hurlé, a pharmacologist at the University of Cantabria in Santander, Spain, and colleagues report August 8 in Science Translational Medicine. The researchers discovered the link in experiments with mice, rats and people. |© Society for Science & the Public 2000 - 2018.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25329 - Posted: 08.14.2018

Michaeleen Doucleff My back hurts when I sit down. It's been going on for 10 years. It really doesn't matter where I am — at work, at a restaurant, even on our couch at home. My lower back screams, "Stop sitting!" To try to reduce the pain, I bought a kneeling chair at work. Then I got a standing desk. Then I went back to a regular chair because standing became painful. I've seen physical therapists, orthopedic surgeons and pain specialists. I've mastered Pilates, increased flexibility and strengthened muscles. At one point, my abs were so strong my husband nicknamed them "the plate." All these treatments helped a bit, at first. But the pain never really went away. So a few years ago, I decided to accept reality: Sitting down is — and will always be — painful for me. Then back in November, I walked into the studio of Jenn Sherer in Palo Alto, Calif. She is part of a growing movement on the West Coast to teach people to move and sit and stand as they did in the past — and as they still do in other parts of the world. I was interviewing Sherer for a story about bending. But she could tell I was in pain. So I told her my story. Her response left me speechless: "Sitting is a place where you can find heaven in your joints and in your back," she says. "It's not sitting that's causing the pain, it's how you're sitting. "Do you want me to show you how?" © 2018 npr

Related chapters from BN8e: 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: 25322 - Posted: 08.13.2018

By Elizabeth Gamillo Conservationists trying to restore the United States’s grasslands kept running into a problem: As soon as they planted the seeds meant to bring back native flora, hungry mice would gobble them up. In an effort to deter the rodents, biologists tried coating the seeds with capsaicin, the active ingredient that gives chili peppers their signature fiery taste. It worked: Dusting the seeds with chili powder reduced the number of seeds consumed by deer mice by 86%, researchers report in Restoration Ecology. The hot discovery required some trial and error. One big challenge was finding a chili powder that would deter the mice but not prevent the seeds from germinating. Another was finding a coating that wouldn’t weather away after a few months outdoors. After 4 years of laboratory and field experiments in Montana’s Missoula Valley, researchers found a workable recipe. A powder made from the Bhut jolokia, or ghost pepper, from India—considered to be one of the world’s hottest chilis—did the trick. The scientists suggest their findings demonstrate how nontoxic, natural plant defense compounds—such as capsaicin—can be used to aid restoration efforts. © 2018 American Association for the Advancement of Science

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25294 - Posted: 08.06.2018

Ashley Yeager European health officials have approved the sale of the migraine-prevention drug Aimovig (erenumab), The Guardian reports today (July 31). In May, the US Food and Drug Administration gave the green light for the same drug, considered a first of its kind because it blocks a receptor that plays a role in transmitting signals of migraine pain. “Migraine is incredibly painful, and has symptoms that include vomiting and visual disturbance, so getting it frequently can literally ruin lives,” Wendy Thomas, chief executive of the Migraine Trust, tells The Guardian. “That is why it is important that [the drug] becomes available to patients as soon as possible.” Aimovig targets the calcitonin gene-related peptide (CGRP) receptor, and in clinical trials the compound was shown to reduce the number of days individuals suffered migraines each month. One in four patients with chronic migraines—those experiencing symptoms 15 days or more a month—were migraine-free for more than 15 months. “A treatment specifically designed for migraine prevention is a much welcomed innovation and could transform lives of patients for whom current therapies do not work or are not well tolerated,” Patrick Little, president of the European Migraine and Headache Alliance, said in a June 30 statement from Novartis, the company that manufactures Aimovig. In the trials, the drug was tested on migraine sufferers who did not get relief from two to four other commonly used migraine treatments. © 1986 - 2018 The Scientis

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25282 - Posted: 08.02.2018

Patti Neighmond If you're in the hospital or a doctor's office with a painful problem, you'll likely be asked to rate your pain on a scale of 0 to 10 – with 0 meaning no pain at all and 10 indicating the worst pain you can imagine. But many doctors and nurses say this rating system isn't working and they're trying a new approach. The numeric pain scale may just be too simplistic, says Dr. John Markman, Director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry. It can lead doctors to "treat by numbers," he says and as a result, patients may not be getting the most effective treatment for their pain. Take the case of 33-year-old Adam Rosette, who was recently hospitalized for fibrous dysplasia, a bone disorder that made it nearly impossible for him to chew or even speak. After brain surgery to remove benign tumors related to the disorder, he was definitely in pain. But he was reluctant to label the pain too high. "I don't think I ever answered higher than a '7' because an '8' would be, in my mind, like I'm missing half of my body or a limb," he recalls. On the pain scale a rating of 4 to 7 is considered moderate. Mild pain is rated 1 to 3. Over 7 is considered severe. Today, Rosette has recovered and is pain-free, but he wonders if "low balling" his pain level while in the hospital, meant he wasn't given adequate pain medication. "You realize you got less medicine and it's been eight hours and they're not allowed to give you more for a while," Rosette says. © 2018 npr

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25237 - Posted: 07.23.2018

Wade Goodwyn In hospitals around the country, anesthesiologists and other doctors are facing significant shortages of injectable opioids. These drugs, like morphine, Dilaudid and fentanyl are the mainstays of intravenous pain control and are regularly used in critical care settings like surgery, intensive care units and hospital emergency departments. The distance medical science has traveled over the last hundred years in pain management is practically miraculous. Walk into a pediatric intensive care unit at any major hospital in the country and, even though the children you'll see are critically ill from disease and surgery, you won't see any of them squirming in the bed in pain or discomfort. Though a child in this ICU may be diagnosed with an incurable disease, pediatric doctors are able to use hydromorphone, fentanyl and liquid morphine to keep the patient's suffering at a distance all the way to the end. The same is true for pain management in adults. It's not just the patient who's spared — relatives, friends, not to mention doctors, nurses and the other health care providers don't have to experience a cherished human being writhing in agony. That is why doctors across the country have grown increasingly concerned that hospitals and other medical facilities have been running low on or out of the supplies they need. Dr. Red Starks, a pediatric anesthesiologist who has been practicing for 26 years, said that for him the shortage "escalated late this spring when we didn't have any morphine." "Or one week we had morphine but we didn't have Dilaudid," he continued, "and two weeks later we'd get a little trickle of Dilaudid but we wouldn't have any morphine. And you're just thinking, 'Hello, am I in the 21st century?' " © 2018 npr

Related chapters from BN8e: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 5: The Sensorimotor System
Link ID: 25229 - Posted: 07.20.2018

Aimee Cunningham Painkillers crafted with a part of the wrinkle-smoothing drug Botox provide long-term pain relief in mice. Researchers added the modified Botox to molecules that target pain-messaging nerve cells. Mice given a single spinal injection of the new drugs showed signs of pain relief for the full duration of the experiments, around three weeks, researchers report online July 18 in Science Translational Medicine. Such painkillers could potentially one day be developed for humans as alternatives to more addictive drugs, such as opioids. Created by the bacterium Clostridium botulinum, botulinum toxin causes the food poisoning disease botulism. Botox, which is made from the toxin, is often injected into people to iron out worry lines and has been used to treat conditions that involve overactive muscles, such as repetitive neck spasms or overactive bladder (SN: 4/5/08, p. 213). The toxin has also been used to reduce the frequency of migraines. Biochemist Bazbek Davletov of the University of Sheffield in England and colleagues focused on botulinum toxin because it can stop certain nerve cells from communicating with one another for up to five months with each injection. And “you locally inject less than a millionth of a gram, which is helpful to avoid any immune response,” he says. Davletov and colleagues created their new drugs with a process he describes as a “molecular Lego system.” Taking the part of the botulinum toxin that blocks nerve cells from sending messages, the team attached the piece to one of two molecules that target neurons that relay pain information. The researchers removed the part of the toxin, found in Botox, that binds to muscle-controlling nerve cells. |© Society for Science & the Public 2000 - 2018.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25228 - Posted: 07.19.2018

By Nicholas Bakalar In a randomized clinical trial, researchers assigned 120 men and women with chronic back or neck pain to one of two treatments. The first group received the commonly recommended program of physical therapy and general exercises. The second received a program of “pain neuroscience education,” in which they learned about the function of neurons and synapses, the ways in which pain is transmitted along nerve fibers via the spinal cord to the brain, and how pain itself can modify central nervous system functions, producing pain with even the mildest stimulation. They also performed exercises, closely integrated with the education program, that gradually introduced increasingly difficult movements, concentrating on functionality rather than pain relief, and trying to continue exercising despite the pain. Treatment in both groups lasted three months, and researchers re-examined the participants at six and 12 months afterward. Compared to the controls, the neuroscience education group had higher pain thresholds, a significant reduction in disability, and improved self-reported physical and mental health. The study is in JAMA Neurology. “The main message is: Don’t be afraid of the pain,” said the lead author, Anneleen Malfliet, a doctoral candidate at the Free University of Brussels. “We know that worrying and giving attention to pain ultimately increases it. Staying active and moving is better than rest when it comes to chronic back and neck pain.” © 2018 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25199 - Posted: 07.13.2018

Will Stone It started with a rolled ankle during a routine training exercise. Shannon Hubbard never imagined it was the prologue to one of the most debilitating pain conditions known to exist, called ­­­­­­­complex regional pain syndrome. It's a condition that causes the nervous system to go haywire, creating pain disproportionate to the actual injury. It can also affect how the body regulates temperature and blood flow. For Hubbard, it manifested several years ago following surgery on her foot. That's a common way for it to take hold. "My leg feels like it's on fire pretty much all the time. It spreads to different parts of your body," the 47-year-old Army veteran says. Hubbard props up her leg, careful not to graze it against the kitchen table in her home east of Phoenix. It's red and swollen, still scarred from an ulcer that landed her in the hospital a few months ago. "That started as a little blister and four days later it was like the size of a baseball," she says. "They had to cut it open and then it got infected and because I have blood flow issues, it doesn't heal." She knows that soon it will happen again. "Over the past three years, I've been prescribed over sixty different medications and combinations, none have even touched the pain," she says. She holds up a plastic bag filled with discarded pill bottles — evidence of her elusive search for a solution to the pain. © 2018 npr

Related chapters from BN8e: 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: 25183 - Posted: 07.09.2018

By Nicola Twilley On a foggy February morning in Oxford, England, I arrived at the John Radcliffe Hospital, a shiplike nineteen-seventies complex moored on a hill east of the city center, for the express purpose of being hurt. I had an appointment with a scientist named Irene Tracey, a brisk woman in her early fifties who directs Oxford University’s Nuffield Department of Clinical Neurosciences and has become known as the Queen of Pain. “We might have a problem with you being a ginger,” she warned when we met. Redheads typically perceive pain differently from those with other hair colors; many also flinch at the use of the G-word. “I’m sorry, a lovely auburn,” she quickly said, while a doctoral student used a ruler and a purple Sharpie to draw the outline of a one-inch square on my right shin. Wearing thick rubber gloves, the student squeezed a dollop of pale-orange cream into the center of the square and delicately spread it to the edges, as if frosting a cake. The cream contained capsaicin, the chemical responsible for the burn of chili peppers. “We love capsaicin,” Tracey said. “It does two really nice things: it ramps up gradually to become quite intense, and it activates receptors in your skin that we know a lot about.” Thus anointed, I signed my disclaimer forms and was strapped into the scanning bed of a magnetic-resonance-imaging (MRI) machine. The machine was a 7-Tesla MRI, of which there are fewer than a hundred in the world. The magnetic field it generates (teslas are a unit of magnetic strength) is more than four times as powerful as that of the average hospital MRI machine, resulting in images of much greater detail. As the cryogenic units responsible for cooling the machine’s superconducting magnet clicked on and off in a syncopated rhythm, the imaging technician warned me that, once he slid me inside, I might feel dizzy, see flashing lights, or experience a metallic taste in my mouth. “I always feel like I’m turning a corner,” Tracey said. She explained that the magnetic field would instantly pull the proton in each of the octillions of hydrogen atoms in my body into alignment. Then she vanished into a control room, where a bank of screens would allow her to watch my brain as it experienced pain. © 2018 Condé Nast.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain; Chapter 2: Functional Neuroanatomy: The Nervous System and Behavior
Related chapters from MM:Chapter 5: The Sensorimotor System; Chapter 2: Cells and Structures: The Anatomy of the Nervous System
Link ID: 25145 - Posted: 06.26.2018

Christine Herman A painkiller prescription could become a ticket for medical marijuana in Illinois. Lawmakers there passed a bill making anyone with a prescription for opioids eligible for its medical cannabis program. With this move, Illinois joins a growing number of states turning to legal cannabis in the fight against painkiller addiction. "As we see the horrible damage inflicted by opioid use and misuse, it seems like a very low-cost and low-risk alternative," says state Sen. Don Harmon, a Democrat from Oak Park, Ill., and sponsor of the Senate version of the bill. The Alternatives to Opioids Act would allow millions of patients to apply for temporary access to the state's existing medical cannabis pilot program. The bill, which passed on May 31, is now awaiting Republican Gov. Bruce Rauner's signature. Though the bill has bipartisan support, marijuana advocates have some doubts about whether he'll sign it, given his past opposition to medical cannabis. Lawmakers in several states have taken action to initiate or expand their medical marijuana programs in light of the opioid crisis. Among them, in Georgia Gov. Nathan Deal signed a law adding PTSD and intractable pain to the list of conditions covered in its medical marijuana program in May. And New York state Sen. George Amedore, a Republican, introduced legislation that would allow doctors to prescribe cannabis oil as an alternative to opioids for certain conditions. Under Illinois' proposed new law, anyone 21 or older with a condition for which opioids might be prescribed could get near-immediate access to cannabis products at licensed dispensaries by presenting paperwork signed by their doctor. They would no longer be fingerprinted or need criminal background checks, or wait months for approval. The measure would reduce the backlog of applications, Harmon says. © 2018 npr

Related chapters from BN8e: 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: 25094 - Posted: 06.16.2018

Leah Rosenbaum Migraines have plagued humans since time immemorial. Now a new migraine prevention treatment, recently approved by the U.S. Food and Drug Administration, promises long-awaited relief from the debilitating condition. But whether the drug will turn out to be a real solution for the 1 in 7 Americans who suffer from migraines, severe headaches that often come with nausea and visual auras, isn’t yet clear. Here’s what we know, and don’t know, about the new therapy. How does the drug work in the body? The new drug, Aimovig, generically called erenumab, is a type of monoclonal antibody treatment, a class of medications that resemble the antibodies that the body naturally produces to bind to infectious pathogens. These treatments work by using specially designed antibodies to target specific proteins and their receptors that contribute to disease. Aimovig, released by pharmaceutical companies Amgen Inc. and Novartis, targets the receptor for a protein called calcitonin gene-related peptide, or CGRP, that is increased in people suffering a migraine attack. The protein is released from nerve endings throughout the body, including in the meninges, the membranes that surround the brain. When it attaches to the receptor, CGRP widens blood vessels and can contribute to inflammation and pain transmission. Aimovig, delivered once a month with an EpiPen-like injector, works by blocking the receptor for CGRP, reducing pain. Blocking the protein’s receptor is kind of like putting gum in a lock, says Elizabeth Loder, a neurologist at Brigham and Women’s Hospital in Boston and at Harvard Medical School. The CGRP protein “key” is still floating around, but it can’t become activated. |© Society for Science & the Public 2000 - 2018

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25064 - Posted: 06.07.2018

By GINA KOLATA The first of a new class of drugs to prevent migraines was approved last week. The medication, called Aimovig, reduces the frequency of migraines among those severely afflicted, but the drug rarely prevents these episodes altogether. One expert called it “progress but not a panacea.” Migraine is the most disabling neurological disease in the world among people under age 50, beating epilepsy, strokes and chronic back pain. Yet many who have migraines don’t realize it or ever mention their symptoms to a doctor. Migraines are not just headaches. It is diagnosed in patients only if they have had a minimum of five attacks, each lasting four to 72 hours. Each attack has to include at least two of the following symptoms: throbbing headache with pain that is moderate to severe, that worsens with activity, and is only on only one side of the head. Also, a person suffering a migraine attack is nauseated or abhors sound or noise. What about auras? Are they part of a migraine? Sometimes, but not always. About 20 percent of migraine patients get an aura before the headache. Auras involve distortions of vision. People see jagged lights or have blind spots in their visual field. But auras can take other forms as well: a prickling pins-and-needles feeling on parts of the body, speech disturbances, distortions of sounds. Some get auras without a headache or only a mild headache. Auras actually involve different areas of the brain than migraines, and it is not clear why they are linked to migraine headaches. How common are migraines? They can start in childhood, although they usually begin in adolescence or young adulthood. They strike nearly one in five women worldwide, one in 16 men and one in 11 children. One out of four households has at least one member with migraine. The condition seems to spring from a combination of genetic and environmental factors. There is nothing a person can do to reduce the odds of developing migraine. © 2018 The New York Times Company

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 25020 - Posted: 05.25.2018

By Emily Underwood *Update, 18 May, 10 a.m.: Yesterday, the U.S. Food and Drug Administration approved the first in a new class of drugs designed to prevent migraines. This feature, originally published on 7 January 2016, describes the history of these drugs, the powerful relief they can bring some patients, and the limitations that still exist with them. As long as she can remember, 53-year-old Rosa Sundquist has tallied the number of days per month when her head explodes with pain. The migraines started in childhood and have gotten worse as she’s grown older. Since 2008, they have incapacitated her at least 15 days per month, year-round. Head-splitting pain isn’t the worst of Sundquist’s symptoms. Nausea, vomiting, and an intense sensitivity to light, sound, and smell make it impossible for her to work—she used to be an office manager—or often even to leave her light-proofed home in Dumfries, Virginia. On the rare occasions when she does go out to dinner or a movie with her husband and two college-aged children, she wears sunglasses and noise-canceling headphones. A short trip to the grocery store can turn into a full-blown attack “on a dime,” she says. Every 10 weeks, Sundquist gets 32 bee sting–like injections of the nerve-numbing botulism toxin into her face and neck. She also visits a neurologist in Philadelphia, Pennsylvania, who gives her a continuous intravenous infusion of the anesthetic lidocaine over 7 days. The lidocaine makes Sundquist hallucinate, but it can reduce her attacks, she says—she recently counted 20 migraine days per month instead of 30. Sundquist can also sometimes ward off an attack with triptans, the only drugs specifically designed to interrupt migraines after they start. © 2018 American Association for the Advancement of Science.

Related chapters from BN8e: Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 5: The Sensorimotor System
Link ID: 24996 - Posted: 05.19.2018