M. Catherine Bushnell, PhD, scientific director, Division of Intramural Research, National Center for Complementary and Integrative Health, NIH, explained in a plenary session address that many chronic pain patients show associated anxiety and depression as well as deficits in cognitive functions. In addition, brain imaging studies in rats and humans have shown alterations in gray matter volume and white matter integrity in the brain caused by the effects of chronic pain.
“Imaging studies in multiple types of chronic pain patients show their brains differ from healthy control subjects,” said Bushnell. “Studies of people with depression show they also have reduced gray matter, and this could contribute to the gray matter changes in pain patients who are depressed. Our research shows that gray matter loss is directly related to the pain when we take depression into account,” said Bushnell.
Gray matter is brain tissue with numerous cell bodies and is located in the cerebral cortex and subcortical areas. The impact of gray matter loss depends on where it occurs in brain. Decreased gray matter can lead to memory impairment, emotional problems and decreased cognitive functioning.
She said the studies show yoga practitioners have more gray matter than controls in multiple brain regions, including those involved in pain modulation. “Some gray matter increases in yogis correspond to duration of yoga practice, which suggests there is a causative link between yoga and gray matter increases,” Bushnell noted.
Assessing the impact of brain anatomy on pain reduction, Bushnell said gray matter changes in the insula or internal structures of the cerebral cortex are most significant for pain tolerance. “Insula gray matter size correlates with pain tolerance, and increases in insula gray matter can result from ongoing yoga practice,” said Bushnell.
“Brain anatomy changes may contribute to mood disorders and other affective and cognitive comorbidities of chronic pain. The encouraging news for people with chronic pain is mind-body practices seem to exert a protective effect on brain gray matter that counteracts the neuroanatomical effects of chronic pain,” Bushnell added.
About the American Pain Society
Based in Chicago, the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering. APS is the professional home for investigators involved in all aspects of pain research including basic, translational, clinical and health services research to obtain the support and inspiration they need to flourish professionally. APS strongly advocates expansion of high quality pain research to help advance science to achieve effective and responsible pain relief. For more information on APS, visit www.americanpainsociety.org.
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