Track pain medicines with brain imaging

A new study suggests a role for brain imaging in the assessment and potential treatment of chronic pain.

University of Michigan researchers are the first to use brain imaging procedures to track the clinical action of pregabalin, a drug that is prescribed to patients suffering from fibromyalgia and neuropathic pain.

Three different brain imaging procedures were performed – proton magnetic resonance spectroscopy, functional magnetic resonance imaging and functional connectivity magnetic resonance imaging – in 17 patients with fibromyalgia.

Fibromyalgia is a chronic pain disorder thought to result from a disturbance in the way the central nervous system processes pain. It affects an estimated 3 to 6 percent of the world population.

Previous research has shown that fibromyalgia patients may have heightened neural activity in the insula, and that this excess activity may be related to elevated levels of the excitatory neurotransmitter glutamate.

Brain imaging in the current study suggests pregabalin works in part by reducing the concentration of glutamate within the insula, which is consistent with animal studies. These reductions in glutamate were also accompanied by decreases in insula connectivity and reductions in clinical pain ratings.

This type of brain activity imaging may help in the development of new pain medicines and personalised chronic pain treatment.

“The significance of this study is that it demonstrates that pharmacologic therapies for chronic pain can be studied with brain imaging,” says lead author Richard Harris, PhD, assistant professor of anesthesiology at the University of Michigan.

“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 study is published in the journal Anaesthesiology.

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