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Seeing Your Pain
Learning to consciously alter brain activity through MRI feedback could help control pain and other disorders.
In last December’s paper in the National Academy journal, deCharms, Mackey, and their collaborators described a study in which participants learned a series of mental exercises derived from strategies used in pain clinics. For example, they might have been asked to imagine the sensation of their brains’ releasing painkilling compounds into the aching area, or to imagine that their painful tissue was as healthy as a pain-free part of their body. Subjects then climbed into the MRI scanner, where they wore special virtual-reality goggles that displayed the activity in a part of the brain involved in feeling pain – the anterior cingulate cortex. They were instructed to try to increase or decrease the activity by performing the exercises. The MRI data gave them direct feedback on how well their mental strategies were working, allowing them to adjust their technique. Some people picked up the knack quickly, while others needed several sessions to learn appropriate control methods.
Eight patients with chronic pain that wasn’t adequately controlled by more conventional means reported a 44 to 64 percent decrease in pain after the training, three times the pain reduction reported by a control group. Those who exercised the greatest control over brain activity showed the greatest benefit.
The researchers also designed an elaborate set of controls to show that the results didn’t simply reflect the placebo effect or an artifact of the experimental process. For example, subjects who did not get fMRI feedback but were instructed to focus attention to and away from their pain did not show as much pain relief. Patients who got fMRI feedback from another part of the brain also did not benefit; nor did patients who got feedback from the cingulate of another person. “If expectation or being in the scanner were contributing … then that group should have seen a similar result,” says deCharms. The researchers also conducted tests in which chronic-pain patients were given more-traditional biofeedback data, such as heart rate or blood pressure. Patients who received fMRI feedback had a significantly greater reduction in pain. www.technologyreview.com...