25 Aug A Short Review of Current Literature – Chronic Pain
The Role of the Amygdala
Study after study demonstrates the role of the amygdala in the perception of chronic pain. A 2012 meta-analysis in the journal “Human Brain Mapping”1 pointed to a universal acceptance of the role of the amygdala, but also to marked differences between brain imaging relating to acute and chronic pain.
A comprehensive study of the amygdala and other brain structures showed some interesting differences in brain activity dependent upon type of induced pain being experienced (eg inflammation, neuropathy, arthritis, etc)2.
fMRI studies consistently show that emotional pain triggers exactly the same brain activity as physical pain3.
More recently a 2016 meta-analysis of brain activation in patients with fibromyalgia4 showed similar but much-enhanced activation of the amygdala and other regions associated with conditioned learning.
Studies in Disruption of Conditioning
While scientists looking at brain imaging have pointed the way to an understanding of the brain’s role in production of pain signalling, others have gone further in hypothesizing that in many cases that pain signalling is a result of conditioned or associative learning5.
Interestingly, Moseley5 now postulates that the brain stores “maps” of injured areas and continues to behave as if those maps were real. By painstakingly delivering different sensory information, he believes the brain’s storage or interpretation of those maps can be altered. He does not yet realise that better outcomes can be achieved in just minutes using much more precisely-targeted disruption of conditioning, not just related to the pain sites, but to the whole gamut of pain triggers.
In another field altogether, scientists have been studying the disruption of the reconsolidation phase of conditioned responses. It has been found that if the conditioned response is triggered, and simultaneously disrupted utilising pharmaceutical manipulations, extinction can occur6.
De Koninck Yves De Koninck, a professor of neuroscience at Université Laval in Canada also claims such a mechanism, drawing attention to the key similarities between neurological process involved in chronic pain and memory. He refers to chronic pain as a “maladaptive memory” which can be “recalled and erased”.
De Koninck has demonstrated that the same neurochemical “trick” used by Soeter and Kindt to disrupt and extinguish conditioned responses such as trauma, also work to switch off chronic pain.
Our Own Work
Whilst we completely agree with the studies above, we strongly dispute that pharmacological disruption is necessary in order to eliminate chronic pain both rapidly and permanently.
In 2001 we first became aware of studies which showed the remarkable similarity between chronic pain perception, and associative or conditioned memory/responses. By this time we had been treating a wide range of emotional issues such as depression, anxiety and trauma by utilising multi-sensory disruption of identified conditioned responses and one of our had been peer reviewed and published.
We had also been treating chronic pain very successfully, but had wrongly hypothesized that outcomes were due to the pain being psychological in nature. We now know that this is only very partially the case, and that the chronic pain itself is a conditioned response.
This has enabled us to develop a much deeper understanding of the range of stimuli which can trigger the conditioned brain activity involved in pain signalling, and to be even more effective in extinguishing the conditioned response/s, and the pain along with it.
We ran two small clinical trials specifically testing our method (SDR Therapy) with efficacy measures of 100% and 85% respectively. A paper on the less successful of the two trials is available from the “Research” section on this web site.
1 Simons, Laura et al. “The Human Amygdala and Pain: Evidence from Neuroimaging.” Human brain mapping 35.2 (2014): 527–538 (2016)
2 Veinante, Pierre, Yalcin, Ipek, Barrot, Michael. “The amygdala between sensation and affect: a role in pain.” Journal of Molecular Psychiatry 1:9 (2013)
3 Kross, Ethan, et al. “Social rejection shares somatosensory representations with physical pain.” PNAS Vol 108, No 15 6270-6275 (2011)
4 Dehghan, M et al. “Coordinate-Based (ALE) Meta-Analysis of Brain Activation in Patients with Fibromyalgia.” Human brain mapping 37:1749-1758 (2016)
5 Moseley, G Lorimer and Vlaeyen, Johan W S. “Beyond Nociception: the imprecision hypothesis of chronic pain.” Pain Vol 156, No 1, 35-38 (January 2015)
6 Soeter, Marieke and Kindt, Merel. “Disrupting reconsolidation: Pharmacological and behavioural manipulations.” Learning and Memory 18:357.366 (2011)
7 Sutherland, C and Gomes, A. “Neuro-Somatic Treatment for Depression: A Preliminary Report on a Group Treatment Program.” Frontier Perspectives Vol 10, No 2, 60-64 (2001)
8 Sutherland, C. “MDR Therapy for Pain Management: a Preliminary Report on the Efficacy of Self Treatment with or without Pharmacotherapy”. The Lifeworks Group, self published in January 2001