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Adrienne Dellwo

Could Discovery "Erase" Fibromyalgia Pain?

By March 16, 2012

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Imagine being able to erase fibromyalgia pain from you brain, making it just go away. It sounds like a dream, but - someday - scientists may actually be able to make that happen.

A team of researchers has made an important discovery about how the memory of pain is stored in the brain. Why is that important? Because the memory of pain intensifies future pain. That's something scientists have know for a long time. Every broken arm, every burn, every toothache, every surgery ... they've all formed trace memories that change how your brain responds to pain. In some of us, that leads to pain hypersensitivity.

Now researchers are saying they've found the substance responsible for forming those memories, and by blocking it, they may be able to erase pain memories and reduce hypersensitivity.

Manipulating Memories of Pain

The enzyme researchers are targeting is called PKMzeta. They say it deals with long-term memory storage in several regions of the brain and also affects how pain is processed by specialized nerves (nociceptors) in an area called the spinal cord dorsal horn (SCDH.) PMKzeta helps for connections between neurons, building pathways that activate when you experience new pain.

By blocking PKMzeta in rats, scientists were able to reverse both the pain-processing abnormality in the SCDH and hypersensitivity to movement across the skin (called mechanical allodynia, which is common in fibromyalgia.)

They concluded that PKMzeta is responsible for maintaining persistent pain and could be lead to a new type of drug for chronic pain. If so, this could finally be a drug that treats the cause of pain instead of merely covering it up.

Relevance to Fibromyalgia

This study was about chronic pain in general, not fibromyalgia specifically. However, many of the things they looked at are known to be involved in fibromyalgia, including:

  • SCDH nociceptors
  • Hypersensitivity to pain
  • Allodynia (pain from typically non-painful stimuli)
  • Pain from ischemia (impaired blood flow)

Nociceptors are specialized cells that can cause fast reactions to pain without having to first send signals to the brain and receive information back. They're what makes your hand flinch away just before you burn your fingers on the stove. If they had to communicate with the brain, they wouldn't be able to stop you.

In fibromyalgia, nociceptors can become chronically activated, which means they keep sending pain signals even when they pain should be gone. Those persistent itching, tingling, burning, stabbing pains that aren't tied to any current problem? They come from nociceptors.

"Hypersensitivity to pain" pretty much describes fibromyalgia. Something that would cause mild pain in someone else can cause moderate or severe pain in us. We're always going to be a few notches higher on the pain scale. That's due to a lowered pain threshold, which is the point at which sensation becomes painful.

Allodynia is one of those symptoms that really lets you know you have fibromyalgia. It's the pain from a loose waistband, a breeze against your skin, or a gentle touch. It's what makes your body scream when shower spray hits it or when you scratch an itch. Allodynia is a rare symptom, only showing up in a handful of conditions, most of which involve nerve damage (which fibromyalgia doesn't.) It's believed to originate in the nociceptors.

Ischemia is the medical term for a body part "falling asleep" due to restricted blood flow. Some research suggests that blood-flow problems in fibromyalgia lead to ischemia, which then becomes painful when the blood returns to the area and "wakes it up." With most people, it only happens in the feet and hands. With us, it can happen anywhere in the body.

First Steps in a Long Process

Sadly, science moves at a slow pace.† This study was done on rats, which means they still need to test the hypothesis on humans. Even if someone was working on a PKMzeta-blocking drug right now, it wouldn't likely be on the market for at least 5 years. However, someone may discover that an existing drug blocks this enzyme, or maybe that a particular supplement does. That could give us treatment options a lot sooner.

At the very least, it's good to know that work like this is being done and further validates fibromyalgia as a very real, physiological illness.

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Comments
March 16, 2012 at 10:18 am
(1) Rachael says:

“Every broken arm, every burn, every toothache, every surgery … they’ve all formed trace memories that change how your brain responds to pain. In some of us, that leads to pain hypersensitivity.”
***********************
And why is that? Every stress in your life (physical or mental) depletes natural dopamine stores and creates a ripple effect on nearby endorphins. Endorphins are necessary to prevent pain and maintain good mood. When dopamine and the endorphins malfunction, minor injuries can become major obstacles and experiences of both pain and misery are heightened.

http://www.livestrong.com/article/366013-dopamine-and-stress-response/

“Sadly, science moves at a slow pace.”
************************
That’s for sure!

March 16, 2012 at 10:32 am
(2) Rachael says:

It is now widely accepted in biology that within species there are two clear types of individuals, representing two survival strategies. This is not a dimension with most in the middle, but two types. One type you call highly sensitive, and the other NOT.

http://www.hsperson.com/pages/1Aug07.htm

Combine that biologically highly sensitive person with repeated stressors both physical and mental and you have a recipe for dopamine/endorphin depletion. That is why, when they want to keep treating everyone like we are all “one and the same” it truly baffles me. In their minds we are all in need of constant stimulation via vaccinations, exercise etc, which is just wrong.

March 16, 2012 at 3:09 pm
(3) Thomas says:

PKMzeta serves some rather important functions; tinkering with it may lead to many unwanted effects as well. See the article below.

http://blogs.discovermagazine.com/notrocketscience/2011/03/03/todd-sacktor-talks-about-the-memory-engine/#more-3965

March 16, 2012 at 7:59 pm
(4) JennyG says:

I’ve NEVER heard my pain explained so clearly. I think my particular brand of fibro is very much related to PKMzeta, which I had never heard of before today. I feel understood and hopeful, and I’ll be watching for more info on this breakthrough.

Thank, you, Adrienne!

March 17, 2012 at 2:55 am
(5) PAT MCKINNEY says:

AFTER HAVING BRAIN STEM SURGERY AND REMOVAL OF MY CRERBALLUM TONSILS AND A TUMOR I WAS LEFT WITH SEIZURES AND MY FIBRO HAS BEEN FULL BLOWN SINCE.ALSO I CAN NEVER BE HUGGED AND IF SOMEONE DOES THAT IS NOT AWARE I GET STARS IN SIGHT.IT IS TERRIBLLE.I SURE WISH THINGS COULD CHANGE.THIS HAS BEEN 10 YRS SINCE SURGERY.

March 17, 2012 at 3:58 am
(6) Armando Abrero says:

For a sufferer of what is as yet an incurable illness, any news such as this is welcome.
I work for Ben’s Friends (bensfriends.org) an organization that supports communities helping people with rare diseases such as Fibromyalgia. I feel no hesitation on sharing this on the site http://www.livingwithfibro.org as am sure the members will truly appreciate it.
May I just take this opportunity to also invite fibromyalgia sufferers to see the site and join the community Living With Fibro.
Thank you.

March 17, 2012 at 9:30 am
(7) Margo says:

This does sound promising and I hope they refine their work more.

My concern is that if this enzyme is involved with long term memory storage in several areas of the brain, are they affecting ALL of these areas of the brain?

Maybe for some people these types of pain are bad enough that they are willing to take the risk of losing other types of memory too, but whether or not the researchers were asl to target only the spinal cord dorsal horn ro the study, if they’re going to get to studying on humans – with pain mangement in mind – they’ll have to find a way to limit the blocking of the enzyme to just they spinal cord dorsal horn, I think.

This is a good step, but I don’t want big swaths of my memory wiped out all for the sake of pain management, although my pain of the sorts that would probably be helped by control of this enzyme is also not great. Someone with excruciating pain of these sorts might out of desparation be willing to sell their very soul just for a little relief. I’m not there. (I do have enough other problems though, just not these ones.)

March 17, 2012 at 11:45 am
(8) Eva says:

Oh how I wish science didn’t move so slowly. What a blessing it would be to erase the pain memories. I’m really have a difficult time with this stupid ‘syndrome.’

March 17, 2012 at 12:37 pm
(9) demonica says:

Why cant the tests be done on humans instead of animals, id hate to be cured just on the basis of the drug been tried upon rats.

I understand that it is to do with the pain receptors ets but there is sooo many questions i would want answering from those scientists , like why all of a sudden does it come on? why does it take so long to be treated properly ? and is there any link between fibro and atheritis ?

March 17, 2012 at 3:31 pm
(10) barb quester says:

it took me about 50 years to figure out that i am a highly sensitive person (HSP) in all senses of the term. if i would have know that when i was dating someone at 18 and when he rubbed my arm in a loving fashion i pulled away, which probably gave him the sense that i wasn’t interested. being HSP has changed every aspect of my life. allodynia is a strange symptom. when i go to bed and the dog licks my arm it drives me crazy! or when the cat’s cold nose hits my hand, etc, same thing. crowds make me nuts, i have always had to make sure i was wearing clothing that i was comfortable in. i can’t hold a relationship for all these reasons and more. but God let me be this way for some reason — to be HSP and to have CFS and FM. i don’t know why, but i take it one day at a time. i wish now that i could go back to that boy and explain why i was the way i was, but i can’t. God knows and that’s what matters.

March 18, 2012 at 1:31 am
(11) Delere says:

Rachael’s comments made me wonder if introverts have a higher incidence of fibro and perhaps other pain disorders. Over the last hundred years or so there has been increased pressure to be more ‘outgoing’, increased stimulus to the senses to process causing stress. Here is a TED talk that speaks of this pressure to conform in an increasingly face paced world that has lost sight of the need for down time, seclusion and retrospection.

http://www.ted.com/talks/susan_cain_the_power_of_introverts.html

March 18, 2012 at 10:11 am
(12) Rachael says:

Delere said: “Rachaelís comments made me wonder if introverts have a higher incidence of fibro and perhaps other pain disorders.”
********************

I’m sure they do. There is evidence introverts are born with a highly, reactive immune systems making them more sensitive to their environment. Introversion does not mean you are necessarily shy, but it does mean you have a lower baseline for arousal. Because of this introverts have a “biological” need for quiet time to recharge their batteries. This biological difference can be seen on PET scans of the brain as more frontal lobe activity.

People often ask if there is a cross-over between children with autism and people with ME/CFS … well one of the near-universal characteristics of autism is introversion. In fact the “spectrum of autism” is based upon degrees of introversion. Perhaps, it is introverted children who are more vulnerable to damage from environmental stimuli ( vaccines, toxins etc) and this accounts for the autism explosion we have witnessed in the past few decades.

Take the AQ test:

http://www.wired.com/wired/archive/9.12/aqtest.html

March 19, 2012 at 1:50 pm
(13) Brian Portland says:

I do not wish to appear flippant or to offend anyone, but I would like to ask why would someone want to take a pill to ease “pain memory” or to change how the brain processes pain signals when medical marijuana can already do these things? Medical marijuana need not be smoked(typically the chief reason why people reject it as an option.), it can be consumed as a vapor from a vaporizer, it can be eaten in foods, and it can be made into tinctures and consumed as a liquid. Most importantly, given that many of us have busy lives with little time to waste, it can be consumed in a manner that alleviates pain and other symptoms without psychoactivity i.e. one can consume this herb for medicinal effects without “getting high.” Big Pharma always appears ready to sell new medicines without necessarily knowing the full consequences of those medications in advance. A simple herbal treatment with few negatives would seem an option. Of course, many of us don’t live in so-called “med-pot” states, but maybe we should.

March 20, 2012 at 3:30 am
(14) Andrew says:

It should be noted that this idea that this idea that memories of pain leads to pain hypersensitivity is still very much a hypothesis and not a theory since the specific mechanisms are not known.

Blocking PKMzeta is a very blunt way of showing that memory formation is involved and the drug likely has nonspecific effects that may explain the findings.

Blocking PKMzeta leads to reduced brain plasticity for memory formation – so unless patients are willing to tolerate amnesia, this is unlikely to be a specific target for chronic pain conditions.

All I can say is a lot more research is needed.

March 23, 2012 at 3:12 am
(15) Felicia Fibro says:

Wow! This is just one step into further understanding chronic pain, but I can imagine many possibilities with this new research. These are the types of findings I long to hear about – they give me such hope for a brighter, less painful future!

March 23, 2012 at 8:47 am
(16) Deborah Conant says:

If there is a study where they need to test it humans how would you find out? I have fibromyalgia, a severe case. I believe I have the nerve damage where alldonya is involved. I have chronic pain and am allergic to all the meds that you take for fibromyalgia so I have to take muscle relaxers, seizure meds, and 20mg oxycotin three times a day. It would be nice to not have to take all this, I have kidney failure now. I also have a rare blood disease called hyperhomocystinenmia.

March 23, 2012 at 2:58 pm
(17) Terence Coderre says:

As an author of the PKMzeta paper on which this article was about, I’d like, if I may, to make some corrections to the article, and to respond to some of the comments. Adrienne, your article was for the most part extremely accurate, but just a minor correction about nociceptors. Nociceptors are the neurons in the body which act as pain receptors. They start in tissues, like skin and extend to the spinal cord cord or the brain where they synapse on central nervous system (CNS) neurons in pain pathways. Both nociceptors and CNS neurons can be sensitized. We found that PKM-zeta was critical for the sensitization of CNS neurons in the spinal cord, but not for sensitization of peripheral nociceptors. As for the commentaries, it is important to note that the PKM-zeta inhibitor was given spinally at the lumbar spinal level where nociceptors from the rat hind paws synapse on CNS neurons. Therefore, the treatment did not affect brain neurons involved in cognitive memories. Our research was aimed not to cure chronic pain, but to understand how neural memories of pain are stored within CNS neurons, and lead to long-term amplification of pain responses. We showed that an inhibitor of PKM-zeta is able to erase neural pain memories and reverse the sensitization of spinal cord neurons and reduce pain hypersensitivity. Future research will be needed to determine how to target PKM-zeta specifcally in neurons of the pain pathways, and to determine whether these drugs can be safely used in humans. There are many drugs out there that can be used to fight pain, but we understand that most of them are either not very effective or produce unwanted side-effects. Our aim is to come up with new approaches to relieving pain, and eventually develop new medications that will supplement what is certainly available.

May 31, 2013 at 2:59 pm
(18) Patricia says:

If it would only erase pain memory, great.

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