Swiss study finds chronic pain alters structure of brain

Chronic pain alters the structure of the brain Keystone-SDA

Chronic pain leaves its mark on the brain according to a study by the Inselspital in Bern and the University of Fribourg. The researchers found that the structure of the cerebral cortex in people suffering from chronic pain differs from that of healthy people.

As part of the research, funded by the Swiss National Science Foundation (SNSF), the team carried out structural magnetic resonance imaging (MRI) scans of the brains of thirty healthy individuals and thirty people with “primary chronic pain”, the SNSF states in a press release. This term refers to chronic pain conditions that cannot be entirely attributed to identifiable triggers such as injuries or illnesses. A typical example is fibromyalgia.

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Previous studies had shown that the chronic nature of pain is associated with changes in the brain. However, this study found that the cerebral cortex – the outermost layer of the cerebral hemispheres, folded into numerous convolutions – in people suffering from primary chronic pain exhibited certain structural differences compared with that of healthy individuals. It found that a region at the front of the left hemisphere was more deeply folded.

This area is involved, among other things, in the processing of emotions and memories and is also associated with the perception and assessment of chronic pain, explains the SNSF in a press release.

In the right cerebral hemisphere of people with primary chronic pain, compared with healthy individuals in the control group, the grooves were found to be shallower in several regions, including some located in the front of the brain. These areas are associated with the processing of sensory stimuli and pain.

“This is consistent with the hypothesis that, in the transition from acute to chronic pain, emotional and cognitive processes become increasingly significant,” explains neuroscientist Salome Häuselmann of the Inselspital. This could trigger a vicious circle in which the processing of pain signals, stress, negative emotions and cognitive evaluations become intertwined and reinforce one another.

According to Häuselmann, however, these findings represent only a snapshot. It is therefore unclear whether the brain structure has changed as a result of chronic pain or whether the people involved already had that particular structure beforehand and were therefore more vulnerable to chronic pain. Complex, long-term studies would be needed to answer these questions.

“The good news is that our brain is capable of adapting. This gives us hope,” the neuroscientist adds. It is possible that, in the course of effective pain management, the convolutions and sulci of the cerebral cortex may come to resemble those of people without pain once again.

However, it remains to be clarified whether, and in what way, such changes are associated with an improvement in symptoms.

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Translated from Italian, reviewed by an English Department journalist.