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Rein for pain lays mainly in the brain, Stanford researchers find

his can be considered a treatment for chronic pain."

Using new technology called real-time functional magnetic resonance imaging, or rtfMRI, scientists placed subjects inside an MRI scanner where they were able to watch their brain activity on a moment-by-moment basis. The subjects were then shown "live" action images of their rostral anterior cingulate cortex, an area of the brain responsible for processing pain.

Subjects were given various mental strategies to try to change their brain activity. "As an example, we asked them to think about changing the meaning of the pain," Mackey said.

"Instead of thinking of it as a terrible experience, to think of it as something relatively pleasant. Then the patients were turned loose. Over time, subjects showed an increased ability to change their brain and by doing so to modulate their pain."

How did they do it exactly? "We really don't know, but then we really don't know how anyone controls their brain to perform an action," Mackey said.

Laura Tibbitt, 31, one of the subjects in the study who suffers from chronic back pain caused by a horseback riding accident seven years ago, said she used different thoughts to decrease the pain while watching her "brain on pain."

"I'd think of little people on my back digging out the pain, or I'd think of snowflakes," she said. "The goal was to exercise your brain, to retrain your brain. Sometimes I felt like I had made a change in my brain. The pain was never completely gone, but it was better."

Mackey said extensive controls were used in the study to make sure the results reflected a direct correlation between brain imaging and pain control.

"One of the questions that always comes up is, 'Did we just design the world's most expensive placebo?' " Mackey said. Researchers used multiple control groups to ensure against this: The first remained outside the MRI machine; the second received no imaging feed
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Contact: Tracie White
tracie.white@stanford.edu
650-723-7628
Stanford University Medical Center
12-Dec-2005


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