My Pain, My Brain" Article on Clinical Trails on Pain

[Christopher]

This is a write up on the MRI Real Time Biofeedback Clinical Trails on Pain, that I did at Stanford University in California this past winter. I was supposed keep you all updated as to my progress with this all and dropped the ball on that, my apologies. I meant to write about it after I had mastered the technique and could report a concise system of attack for dealing with this never ending and confounding BPI pain. Problem is, is that I haven't completely mastered it yet, and it's difficult, due to the nature of the frequency and intensity of the pain. Also I believe I'd benefit a lot more with more time practicing inside the MRI machine itself. I promise that I will get something to paper or screen soon, I've just got to suss out what the most replicable strategy is that works consistently.

I will say this, that my experience during the clinical trails was empowering! It was the first time I felt that I had some control over this whole BPI pain experience. And that was an awsome feeling! To actually curve the tidal waves of pain down into ripples was like difference of being lost in the forest in utter darkness to holding a flash light and seeing the night around you, you're not out, but at least you can see where the hell you're going.

I haven't read this whole article yet, so I can't comment on it. I just wanted to get it out to everyone for some useful Sunday reading. I'll comment on comparison of my experience after I finish it. Be well.

Christopher


http://www.nytimes.com/2006/05/14/magaz ... ref=slogin


My Pain, My Brain


By MELANIE THERNSTROM
Published: May 14, 2006


Who hasn't wished she could watch her brain at work and make changes to it, the way a painter steps back from a painting, studies it and decides to make the sky a different hue? If only we could spell-check our brain like a text, or reprogram it like a computer to eliminate glitches like pain, depression and learning disabilities. Would we one day become completely transparent to ourselves, and — fully conscious of consciousness — consciously create ourselves as we like?

The glitch I'd like to program out of my brain is chronic pain. For the past 10 years, I have been suffering from an arthritic condition that causes chronic pain in my neck that radiates into the right side of my face and right shoulder and arm. Sometimes I picture the pain — soggy, moldy, dark or perhaps ashy, like those alarming pictures of smokers' lungs. Wherever the pain is located, it must look awful by now, after a decade of dominating my brain. I'd like to replace my forehead with a Plexiglas window, set up a camera and film my brain and (since this is my brain, I'm the director) redirect it. Cut. Those areas that are generating pain — cool it. Those areas that are supposed to be alleviating pain — hello? I need you! Down-regulate pain-perception circuitry, as scientists say. Up-regulate pain-modulation circuitry. Now.

Recently, I had a glimpse of what that reprogramming would look like. I was lying on my back in a large white plastic f.M.R.I. machine that uses ingenious new software, peering up through 3-D goggles at a small screen. I was experiencing a clinical demonstration of a new technology — real-time functional neuroimaging — used in a Stanford University study, now in its second phase, that allows subjects to see their own brain activity while feeling pain and to try to change that brain activity to control their pain.

Over six sessions, volunteers are being asked to try to increase and decrease their pain while watching the activation of a part of their brain involved in pain perception and modulation. This real-time imaging lets them assess how well they are succeeding. Dr. Sean Mackey, the study's senior investigator and the director of the Neuroimaging and Pain Lab at Stanford, explained that the results of the study's first phase, which were recently published in the prestigious Proceedings of the National Academy of Sciences, showed that while looking at the brain, subjects can learn to control its activation in a way that regulates their pain. While this may be likened to biofeedback, traditional biofeedback provides indirect measures of brain activity through information about heart rate, skin temperature and other autonomic functions, or even EEG waves. Mackey's approach allows subjects to interact with the brain itself.

"It is the mind-body problem — right there on the screen," one of Mackey's collaborators, Christopher deCharms, a neurophysiologist and a principal investigator of the study, told me later. "We are doing something that people have wanted to do for thousands of years. Descartes said, 'I think, therefore I am.' Now we're watching that process as it unfolds."

Suddenly, the machine made a deep rattling sound, and an image flickered before me: my brain. I am looking at my own brain, as it thinks my own thoughts, including these thoughts.

How does it work? I want to ask. Just as people were once puzzled by Freud's talking cure (how does describing problems solve them?), the Stanford study makes us wonder: How can one part of our brain control another by looking at it? Who is the "me" controlling my brain, then? It seems to deepen the mind-body problem, widening the old Cartesian divide by splitting the self into subject and agent.

But most of all I want to know: Will I be able to learn it?


For most of history, the idea of watching the mind at work was as fantastical as documenting a ghost. You could break into the haunted house — slice the brain open — but all you would find would be the house itself, the brain's architecture, not its invisible occupant. Photographing it with X-rays resulted only in pictures of the shell of the house, the skull. The invention of the CT scan and magnetic resonance imaging (M.R.I.) were great advances because they reveal tissue as well as bones — the wallpaper as well as the walls — but the ghost still didn't show up. Consciousness remained elusive.

A newer form of M.R.I., functional magnetic resonance imaging (f.M.R.I.), used with increasingly sophisticated software, is accomplishing this, taking "movies" of brain activity. Researchers are able to watch the brain work, as the films show parts of the brain becoming active under various stimuli by detecting areas of increased blood flow connected with the faster firing of nerve cells. These films are difficult to read; researchers puzzle over the new images like Columbus staring at the gray shoreline, thinking, India? Most of the brain is uncharted, the nature of the terrain unclear. But the voyage has been made; the technology exists. Pain — a complex perception occupying the elusive space spanning sensation, emotion and cognition — is a particularly promising area of imaging research because, researchers say, it has the potential to make great progress in a short time.

Perhaps more than any other aspect of human existence, persistent pain is experienced as something we cannot control but desperately wish we could. Acute pain serves the evolutionary function of warning us of tissue damage, but chronic pain does nothing except undo us. Pain is the primary complaint that sends people to the doctor. Of the 50-odd million sufferers in the United States, half cannot get adequate relief from their chronic pain. Many do not even have a diagnosis.


Continued ----- http://www.nytimes.com/2006/05/14/magaz ... ted=2&_r=1
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Melanie Thernstrom is a contributing writer for the magazine. She is working on a book about pain.

[Christopher]

Found this "pain trial" today digging through some old links and checking in on any new developments. Looks like DeCharms has an online "clinical trial" for pain management. Not sure if this is a Beta form of it, and that it is out yet or not, because the link that lead me there was of a different URL:

http://www.chronicpainresearchstudy.com

I just tried the 15 minute DEMO version and had a positive experience. I meditate daily in attempts to better manage my pain, but this had a more significant response, and I'm going to incorporate it into my daily practice.

Good Luck!
Christopher


(***NOTE, below is a copy and paste of information I'd put together for an email for someone with the same injury - Brachial Plexus Injury)

Christopher DeCharms:
**functional magnetic resonance imaging (f.M.R.I.) clinical trials at Stanford University
http://www.omneuron.com
http://www.chronicpainresearchstudy.com

(video)
http://www.ted.com/talks/lang/en/christ ... _time.html

(articles)
http://www.nytimes.com/2006/05/14/magaz ... 72&ei=5070
http://www.pnas.org/content/102/51/18626.abstract
http://www.webmd.com/pain-management/ne ... RSS_PUBLIC
http://news.sciencemag.org/sciencenow/2 ... 12-01.html
http://www.foxnews.com/story/0,2933,178558,00.html

(audio)
http://www.npr.org/templates/story/stor ... Id=4731172

LINKS to my experiences with DeCharms trials back in 2006:
http://ubpn.org/forums/forums/3433/14652
http://ubpn.org/forums/forums/3429/16864
http://ubpn.org/forums/forums/3433/33993