[Sosfbay-discuss] The Strain in Pain Lies Mainly in the Brain

[Tian Harter]

*>Sean Mackey, M.D., Ph.D.*
 >
 >*The Strain in Pain Lies Mainly in the Brain:
*>*Applications of Engineering and Technology to Anesthesia and Pain 
Management*
 >
 >
 >Sean Mackey is Associate Director of the Pain Management Division at 
Stanford
 >University, and Co-Director of the Stanford Pain and Research and 
Clinical Center
 >at the Neuroscience Institute, also at Stanford University, as well as 
Assistant
 >Professor at Stanford University in the Departments of Anesthesia and 
Neurosciences.
 >
 >Dr. Mackey has authored over thirty scientific papers, book chapters 
and review
 >articles. His primary research interest involves the use of advanced 
imaging techniques,
 >primarily functional magnetic resonance imaging (fMRI), to investigate 
the neural
 >processing of pain and the factors that contribute to our perception 
of pain. He will
 >describe ongoing research in helping patients experiencing chronic 
pain “see”
 >their own brain activity in real time, and to use this information to 
control their brain
 >activation in the region associated with the processing and perception 
of pain.
 >
After a few jokes to wake us up, Dr. Mackey said that pain is the number one
reason people see doctors. He quoted this definition "Pain is an unpleasant
sensory and emotional experience associated with actual or potential tissue
damage." Forty to fifty million Americans are affected by pain every year.
His center has studied it since the mid 1990s, working with volunteer
patients and students mostly.

There are two kinds of nerve path that transmit pain signals from 
transducers
throughout the body to the brain. A-fibers give you a quick jolt immediately
after an experience, and C-fibers transmit that burning sensation that 
doesn't
go away quickly. Dr. Mackey then went into some detail about which centers
in the brain sense pain and how it is processed. One thing he mentioned was
"If you decide not to pay attention to it, there are nerve fibers that 
tell your
spine to "turn down that input.""

One of their big discoveries is that they are able to see the image of pain
response in the brain on an MRI machine in real time. Apparently what 
happens
is the brain saturates with blood in the area where pain is being 
experienced,
so the image of it develops a "bright spot". They have used this feedback to
learn a lot about how pain works. Several volunteers have been able to look
at the feedback from their brains and turn down their response to pain, 
leading
to more comfortable outcomes.

Dr. Mackey also said that many individual factors influence a persons 
feelings
of pain. For example, they have learned that depression and pain are often
connected, and that a patient experiencing both will probably need pain
medication and counseling for either treatment to be effective. Cultural
factors are also part of someone's experience of pain.

During Q&A the following came up:

Dr. Mackey believes that the placebo effect is real, and that it can be 
part
of an effective pain management solution. He gave an example from his own
experience, where patients consistently thought a cherry colored liquid did
more pain management than pills with exactly the same medicine content.

Dr. Mackey has noticed that different generations have different vocabulary
for discussing pain. For example, some of today's old Americans talk of
"discomfort" when they mean pain.

Dr. Mackey has not been contacted by, and is not interested in dealing
with the torture people from the U.S. Military.

Stanford's Pain Management Center does research with paid volunteers
and patients who know what they are getting into. Dr. Mackey doesn't
do experiments on animals.

At the Pain Management Center website are many links to articles, 
broadcasts,
and other information from the center. For that, please visit:
http://paincenter.stanford.edu/

-- 
Tian
http://tian.greens.org
Tuesday we picketed the Santa Clara County Republicans in Sunnyvale.