MRI reveals relationship between depression and pain

Nov 03, 2008

The brains of individuals with major depressive disorder appear to react more strongly when anticipating pain and also display altered functioning of the neural network that modifies pain sensitivity, according to a report in the November issue of Archives of General Psychiatry.

"Chronic pain and depression are common and often overlapping syndromes," the authors write as background information in the article. Recurring or chronic pain occurs in more than 75 percent of patients with depression, and between 30 percent and 60 percent of patients with chronic pain report symptoms of depression "Understanding the neurobiological basis of this relationship is important because the presence of comorbid pain contributes significantly to poorer outcomes and increased cost of treatment in major depressive disorder."

Irina A. Strigo, Ph.D., of the University of California San Diego, La Jolla, and colleagues studied 15 young adults with major depressive disorder (average age 24.5) who were not taking medication and 15 individuals who were the same age (average 24.3 years) and had the same education level but did not have depression. Patients with depression completed a questionnaire that evaluated their tendencies to magnify, ruminate over or feel helpless in the face of pain. All participants underwent functional magnetic resonance imaging (fMRI) while their arms were exposed to a thermal device heated to painful levels (an average of 46.4 degrees to 46.9 degrees Celsius, or about 115 degrees to 116 degrees Fahrenheit) and also to non-painful temperatures. Visual cues (a green shape for non-painful warmth and a red shape for painful warmth) were presented before the heat was applied.

Compared with the controls, patients with depression showed increased activation in certain areas of their brain—including the right amygdala—during the anticipation of painful stimuli. They also displayed increased activation in the right amygdala and decreased activation in other areas, including those responsible for pain modulation (adjusting sensitivity to pain), during the painful experience.

To examine whether the activation of the amygdala was associated with passive coping styles, the researchers compared the percentage change in the activations of the amygdala with the helplessness, rumination and ramification reported by the participants with depression. "Significant positive correlations were observed in the major depressive disorder group between greater helplessness scores and greater activity in the right amygdala during the anticipation of pain," the authors write.

"The anticipatory brain response may indicate hypervigilance to impending threat, which may lead to increased helplessness and maladaptative modulation during the experience of heat pain," the authors write. "This mechanism could in part explain the high comorbidity of pain and depression when these conditions become chronic."

Source: JAMA and Archives Journals

Explore further: Experimental Ebola drug heals all monkeys in study (Update)

add to favorites email to friend print save as pdf

Related Stories

Singapore grapples with smartphone addiction

Jun 14, 2014

Easily distracted? Can't be separated from your smartphone? Constantly checking your device for no real reason? Chances are you're an addict—and you may even need professional help.

Using harsh verbal discipline with teens found to be harmful

Sep 04, 2013

Many American parents yell or shout at their teenagers. A new longitudinal study has found that using such harsh verbal discipline in early adolescence can be harmful to teens later. Instead of minimizing teens' problematic ...

Help is on the phone: Reducing pain and depression of cancer

Jul 13, 2010

Pain and depression associated with cancer - symptoms often unrecognized and undertreated - can be significantly reduced through centralized telephone-based care management coupled with automated symptom monitoring, according ...

Early relationships influence teen pain and depression

Nov 25, 2009

Angst could be more than a rite of passage for insecure teenagers, according to a study published in the Journal of Pain. Researchers from the Université de Montréal, Sainte-Justine University Hospital Center ...

Recommended for you

Ebola in mind, US colleges screen some students

11 hours ago

University students from West Africa may be subject to extra health checks when they arrive to study in the United States as administrators try to insulate their campuses from the worst Ebola outbreak in ...

WHO: More Ebola cases in past week than any other

13 hours ago

The past week has seen the highest increase of Ebola cases since the outbreak in West Africa began, the World Health Organization said Friday, offering more evidence that the crisis is worsening.

User comments : 0