Pain Changes the Brain . . . . . . But Pain Treatment Changes the Brain Back

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  Functional magnetic resonance imaging showed that the brains of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are different from those of healthy men. Compared with 14 healthy men, 19 men with CP/CPPS had higher densities of gray matter in pain-processing brain regions (anterior insula and anterior cingulate cortices). The densities correlated with the intensity of their pain and how long they had had it. In addition, when men with CP/CPPS had pain while they were in the scanner, the researchers could see that the right anterior insula of the brain was activated, and the activation was related to how intense the pain was. Furthermore, in the men with CP/CPPS, the proportions of gray and white brain matter were not stable, unlike in the healthy men. The authors concluded that further research is needed into the central nervous system processes that may start and maintain CP/CPPS.
• Farmer MA, Chanda ML, Parks EL, Baliki MN, Apkarian AV, Schaeffer AJ. Brain functional and anatomical changes in chronic prostatitis/chronic pelvic pain syndrome. J Urol. 2011 Jul;186(1):117-24. Epub 2011 May 14.
  
  
• In patients with chronic pain, the brain’s gray matter is reduced and thinking ability is impaired. But when chronic low back pain patients in this study got effective pain treatment, their brains recovered. The researchers got MRI scans before and after spine surgery or facet joint injections in 14 patients and compared the scans with those of 16 healthy controls, including 10 who returned six months later. The investigators looked at the brains’ cortical thickness and activity during a task that demanded a lot of attention. Patients started out with a thinner left dorsolateral prefrontal cortex (DLPFC) than their healthy counterparts, but after treatment, this cortex got thicker. The increased thickness correlated with how much pain and physical disability were reduced. The increase in the thickness of the brain’s primary motor cortex correlated with the reduction in physical disability, and the increase in thickness of the right anterior insula correlated with reduced pain. The activity in the left DLPFC was abnormal before treatment, but was normal after treatment. It was concluded that treating chronic pain can restore normal brain function in humans.
  
• Seminowicz DA, Wideman TH, Naso L, Hatami-Khoroushahi Z, Fallatah S, Ware MA, Jarzem P, Bushnell MC, Shir Y, Ouellet JA, Stone LS. Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function. J Neurosci. 2011 May 18;31(20):7540-50.

Hypnosis May Ease Pelvic Pain Symptoms

Hypnosis seems to help men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Hypnosis was combined with cognitive behavioral therapy and guided imagery. Sixteen men who had had pain for a median of seven years and who had high pain scores underwent seven weekly sessions in which they learned to hypnotize themselves. The researchers looked at changes in their symptoms and whether the patients followed through with their home exercises, using audiotapes of their sessions and behavioral therapy workbooks. Six months later, the median score on the NIH Chronic Prostatitis Symptom Index (CPSI) went down by a median of 10.5 points in 57 percent of the patients. (The abstract did not note what the change was for the other 43 percent.) The pain and quality-of-life CPSI subscores improved significantly. McGill pain scores decreased by a median of 6.5 points. Most patients (88%) said that continued self-hypnosis was effective for relieving symptoms and coping.

Rodney U Anderson, Thomas F Nagy, Elaine K Orenberg, Angie Morey, Patricia Glowe. Feasibility Trial of Medical Hypnosis and Cognitive Behavioral Therapy for Men With Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome. UroToday Int J. 2011 Aug;4(4):art46. doi:10.3834/uij.1944-5784.2011.08.02.