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    Test Maps Your Brain in Pain

    Scientists have rigged an experiment to watch the flow of the brain's natural painkillers in response to discomfort.

    The study helps researchers understand why some people have a higher threshold for pain than others. And in the process, they've shown convincingly that the brain's reaction to pain spreads across a wide range of regions involved in both sensory perception and emotion.

    Dr. Jon-Kar Zubieta and his colleagues at the University of Michigan used positron emission tomography (PET) and radioactive tracers to map the brain activity of 20 volunteers who agreed to receive painful injections of salt water into their jaw muscles. The sensation was designed to mimic the symptoms of temporomandibular joint disorder. The experiment is reported in today's issue of Science.

    The subjects, men and women ages 20 to 30, were asked to rate their pain levels on a computer every 15 seconds, and the computer kept that level roughly even during the 20-minute test.

    The pain stimulus spurred intense activity, between 10 and 15 percent higher than baseline, in the so-called mu opioid system. The system involves endorphins, or painkilling molecules that dampen the brain's experience of discomfort. Drugs like morphine and heroin also target the mu opioid system.

    Volunteers with more mu opioid action scored lower on scales of subjective pain and emotion than those with less activity. "There was a wide variation in how people responded. Some people were more able to release or activate this anti-pain system," Zubieta says.

    Mu opioid receptors on neurons were switched on across several brain regions, including the amygdala, thalamus, hypothalamus, frontal cortex and the nucleus accumbens, the researchers say. These areas, which communicate with each other, are involved in both physical and emotional components of pain sensation.

    Zubieta says what's needed now is a greater understanding of the variability between people in their mu opioid responses. "Some pain conditions may be more frequent in women than men. We also need to know if this system is disregulated in people with chronic pain."

    These details could help pain researchers come up with better treatments and perhaps even customized therapy based on a person's individual neurochemistry.

    Donald Price, a University of Florida brain researcher who reviewed the Michigan research for Science, says the study is particularly useful for what it reveals about the importance of the emotional aspect of pain.

    "Emotion is the bottom line because it's the emotion that makes people do things to get rid of [pain]," such as see a doctor or turn to medication, says Price, author of the book Psychological Mechanisms of Pain and Analgesia.

    The emotional component of pain is influenced by both sensory factors and its context, he says. "If someone is in pain or injured and they go to the emergency room, until they know the cause of the pain or its implications, they are going to remain anxious and the affective response is going to be really intense," Price says.

    On the other hand, once the product of pain is clear, the emotional component fades and makes the sensation more tolerable.



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