Tuesday, September 05, 2006

rtfMRI Study - Pain Management Center - Stanford University School of Medicine

Learned Volitional Control Over Brain fMRI Activation and Pain

Control over brain activation and pain learned by using real-time functional MRI. 
Proc Natl Acad Sci USA (2005) Link
deCharms, R. C., Maeda, F., Glover, G. H., Ludlow, D., Pauly, J. M., Soneji, D., Gabrieli, J. D., and Mackey, S. C.

We all consciously and unconsciously control our brain for every activity we initiate, every thought we have, and every emotion or sensation we experience. Until recently, it has been unclear as to what extent we can learn to control brain activity—more specifically, the activity of specific brain regions--and what impact that control would have on us. Well-defined regions of the brain are responsible for the perception of pain, and, in our pilot study, we sought to answer two questions:

  • Can people learn to control a specific region in the brain involved in pain perception known as the rostral anterior cingulate cortex (rACC)?
  • Does learned control of the rACC lead to changes in pain in both healthy subjects and in patients with chronic pain?

We enrolled 8 patients with chronic intractable pain to test our original two questions. The study was conducted much like the healthy controls, except the patients used their own spontaneous/endogenous pain rather than an externally applied stimulus. In the small group of pain patients, they too demonstrated an ability to control their brain activity and subsequently their pain level. Overall, the pain patients noticed a 64% decrease in pain ratings on the McGill Pain Questionnaire (a survey form that measures both the sensory and emotional aspect of pain) and an average of 44% decrease on a visual analogue scale.

Taken together, these results suggest that, using real time fMRI, people can learn to strengthen the function of a specific region of the brain and, through that change, the regions associated with the perception of pain. It is similar to exercising muscles, but, in this case, the “muscle” is an area in the brain. We are currently conducting experiments to determine if other regions of the brain involved in pain processing can also be controlled.


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