New research from the University of Michigan has explored the use of brain imaging in order to track the clinical action of a drug used to treat chronic pain. This is according to a study published in the journal Anesthesiology.
Using three different brain imaging procedures, the investigators were able to track the actions of pregabalin – a drug commonly used to treat patients suffering from fibromyalgia and neuropathic pain.
The researchers say their findings suggest that brain imaging techniques could be used to create targeted treatment approaches for patients who suffer chronic pain.
To reach their findings, the investigators analyzed the actions of pregabalin in 17 patients who were suffering from fibromyalgia – a chronic pain disorder that is thought to be caused by an impairment in the way pain is processed in the central nervous system.
Image credit: University of Michigan.
Symptoms of the condition include tingling or numbness in the hands and feet, headaches, morning stiffness, irritable bowel syndrome and cognitive problems.
According to the researchers, fibromyalgia affects approximately 10 million people in the US and 3-6% of the population worldwide.
The investigators note that previous research has shown that patients with fibromyalgia can have increased neural activity in the insula of the brain – a region associated with processing pain and emotion.
Research has also shown that heightened activity in the insula could be linked to increased levels of glutamate – a stimulative neurotransmitter in the brain.
Using proton magnetic resonance spectroscopy, functional magnetic resonance imaging (fMRI) and functional connectivity magnetic resonance imaging, the researchers found that pregabalin, commercially known as Lyrica, partly works by reducing glutamate concentration in the insula – which the researchers say is consistent with animal studies.
Furthermore, it was found that alongside decreased glutamate concentration, there were reductions in insula connectivity and patients’ rating of clinical pain.
“These results corroborate our previous findings in both baseline fibromyalgia patients and in patients successfully treated by non-pharmacological therapy,” the researchers say.
“Accumulating evidence suggests that insula-DMN (default mode network) connectivity may be useful as an objective biomarker for clinical pain in chronic pain patients.”
Richard Harris, assistant professor of anesthesiology at the University of Michigan, says their findings are significant because it demonstrates that pharmacologic therapies for chronic pain can be studied with brain imaging.
He adds:
“The results could point to a future in which more targeted brain imaging approaches can be used during pharmacological treatment of chronic widespread pain, rather than the current trial-and-error approach.”
The investigators note that further work is needed to determine whether their findings can be applied to other pain syndromes and disorders associated with increased brain glutamate, such as neuropathic pain.
Medical News Today recently reported on a study revealing that researchers have identified hundreds of ‘pain genes’ through DNA sequencing.