Inflammation Found in Brains of Chronic Pain Patients

Inflammation Found in Brains of Chronic Pain Patients

Researchers have found the first evidence of neuro-inflammation in the brains of chronic pain patients, a development that could lead to new treatments and better ways to measure the presence and intensity of pain.

Previous studies in animals have shown that elevated levels of an inflammation-linked protein in the brain are involved in the transmission of pain.

In the new study, published online in the journal Brain, researchers at Massachusetts General Hospital (MGH) enrolled 10 patients with chronic lower back pain and 9 healthy control participants. Brain images of the participants were conducted with a PET/MR scanner using a new radiopharmaceutical that binds to the translocator protein (TSPO).

Researchers found that levels of the protein in the thalamus and other brain regions were significantly higher in patients than in controls subjects. Elevated levels of the protein were so clear in the images that it was possible to spot which were the patients and which were the controls just by looking at them.

In the two images below, PET scan data from a chronic pain patient with lower back pain (left) and a healthy control subject (right) reveal higher levels of inflammation-associated protein (orange/red areas) in the thalamus and other brain regions of the pain patient.

Image courtesy of Marco Loggia, Martinos Center for Biomedical Imaging

Image courtesy of Marco Loggia, Martinos Center for Biomedical Imaging

“Finding increased levels of the translocator protein in regions like the thalamus – the brain’s sensory gateway for pain and other stimuli – is important, since we know that this protein is highly expressed in microglia and astrocytes, the immune cells of the central nervous system, when they are activated in response to some pathologic event,” says lead author Marco Loggia, PhD, of the MGH-based Martinos Center for Biomedical Imaging.

“Demonstrating glial activation in chronic pain suggests that these cells may be a therapeutic target, and the consistency with which we found glial activation in chronic pain patients suggests that our results may be an important step towards developing biomarkers for pain conditions.”

Another interesting finding is that when patients were asked to report their current levels of pain during the imaging session, those with the highest levels of TSPO reported lower levels of pain.

“While upregulation of TSPO is a marker of glial activation, which is an inflammatory state, animal studies have suggested that the protein actually limits the magnitude of glial response after its initiation and promotes the return to a pain-free, pre-injury status. This means that what we are imaging may be the process of glial cells trying to ‘calm down’ after being activated by the pain,” said Loggia.

“Those participants with less pain-related upregulation of TSPO may have a more exaggerated neuroinflammatory response that ultimately leads to more inflammation and pain. While larger studies would be needed to further support this interpretation, this evidence suggests that drugs called TSPO agonists, which intensify the action of TSPO, may benefit pain patients by helping to limit glial activation.”

Loggia says future studies should investigate whether the same glial activation patterns are seen in patients with other forms of chronic pain or whether particular “glial signatures” may differentiate between different pain syndromes.

Authored by: Pat Anson, Editor

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Cathleen Pearce

I’ve had chronic pain and fatigue due to interstitial cystitis, fibromyalgia, endometriosis the list goes on. I would definitely be a great candidate for this. I’ve been on narcotics for years.

vicky liberty

i have a great team of Drs they all have helped in some way but the pain will never go away the meds im on is crazy fibro osteo arthritis and osteoprosis and a heart condition heart attack and pace maker placed i need a cure to help me get through bad flares thank you

Vickie Tway

My post cut off – I would gladly tratravel to be a part of this study. Thanks!!

Vickie Tway

I would also like to see an expansion of the research. Especially interested in the results of those with “invisible” and often unbelieved illnesses like fibromyalgia.
It would also be great to see some before and after of those of us with fibro who use alternative treatment methods such as anti-inflammatory diets and various supplements, for instance glutathione. Perhaps we could have real evidence that these modalities are actually helping.
Thanks for this fantastic research. Looking forward to what you come up with in the future.
I am located in TX, but would gladly travel to be

Laura H

I suffer from scolios (back pain), Fibromyaliga(which many still don’t believe is real) endometriosis (pain in the female reproductive area) I have family with lupus, RA, bad backs for lack of a better term. I’m curious if the same results would happen on different types of pain patence. I would defenitly be will to work with the study to learn how to help those in everyday horrifying pain.

Essential oils and chemistry
When inhaling, it only takes 22 seconds for an oil to reach the brain. Since essential oils are lipid soluble and have very light molecular weight, they can pass through the blood brain barrier and effect their benefits.

Peggy Cavnar

Husband Paul that is what my MRI looks like and where I injured my brain six times. Darn now I am crying.

Marti Rippe

Would really appreciate any new developments on this. Have dealt with chronic pain for over 25 years, primarily diagnosed as RSD. This is really interesting from two standpoints: 1) new treatments for those who have chronic pain and 2) a way to possibly eliminate those who claim to have it but don’t and want the medication for drugging, not medicating.

Thank you.

Charles Strohm

I live with Severe Chronic Lumbar Arachnoiditis Pain and would be interested in learning about any research that could help people like me. I would also agree to participate in any Research as well… Thank You…

Kurt W.G. Matthies

Many have told me that I have an inflated opinion of myself. Now I know the reason why.

Jacob Hayden

I live in chronic pain every day an it is absolutely horrible and having to take narcotics every day to try and somewhat ease the misery is dreadful having to be 100% dependent on pills to be able to somewhat function as a normal human being with all that being said I would gladly enter a study like this to help research find another way and maybe a way to end the misery of living with severe chronic pain so we can get back to a real life and happiness

April Fiorentino

It’s a very small sample size. I’d be interested in hearing about a larger sample size, and with chronic pain patients that are in groups other than back pain, such as fibro, trigeminal neuraglia, polyneuropathy, etc.