Poorly Understood Brain Region Linked to Chronic Pain & Pain Perception

Summary: Understanding chronic pain is challenging, as, unlike acute pain that occurs due to stimulation of peripheral pain receptors, pathological changes in the brain play a vital role in chronic debilitating pain. A new study has identified a region deep inside the brain called the claustrum, which appears to play a vital role in chronic pain development. Damage to this brain region is known to cause cognitive decline, seizure, and disruption in the sleep-wake cycle. However, this is the first study to find an association between chronic pain and claustrum.

Chronic head pain differs significantly from acute pain, something that occurs due to injury. Even pain due to chronic diseases is different from the pain caused by acute trauma. Pain caused by acute trauma occurs due to stimulation of local pain receptors, and the signal from these receptors travels to the brain, resulting in pain sensation.

However, if someone is living with chronic pain, this pain signal keeps reaching the brain. This causes significant changes in the brain at the receiving end of the signal, which is different brain centers. As a result, the brain might become more sensitive to pain. Additionally, reaction to pain may cause distress, anxiety, mood issues, increased stress responses, and other changes. 

But things are even more complicated. Chronic pain may often outlast the event that initiated the pain. Thus, for example, a person may have some disease condition causing pain. Doctors may be able to treat that disease, but a person continues to experience pain. It occurs due to some changes in the brain. Hence, it is vital to understand the role of various brain centers in chronic head pain. 

New research suggests that one poorly understood brain region called claustrum may cause pain of central origin. If this brain region is damaged due to some reasons, a person may experience chronic pain and at times cluster headaches.

The present study was done by a research group at Oxford University. In the study, researchers reviewed the clinical data of patients known to be living with claustrum lesions. As expected, these individuals display cognitive impairment and seizures. However, what amazed researchers is that these patients also suffered from chronic pain. Moreover, claustrum damage appears to cause debilitating pain1.

Researchers say that they have known the role of claustrum in many pathologies, like its damage causes reduced cognition and seizures and may even disrupt the sleep-wake cycle. However, this is the first study to identify a link between claustrum and chronic debilitating pain.

Investigators say that there are many reasons why the role of claustrum in pain remains poorly understood. This small brain structure resides deep inside the brain, and damage to this brain area is rare. Additionally, science has still not fully understood the role of this brain area in various health conditions. Even worse, claustrum damage is associated with a broad range of symptoms.

It appears that claustrum might be playing a broader role in pain perception than thought earlier. In addition, it appears to play a vital role in the development of severe chronic pain. Thus, researchers say that the next step must be finding ways to reduce the symptoms caused by damaged claustrum. They think that therapies targeting this brain region may help in chronic pain treatment in many cases.

The present research is important in many ways, as it is the first study identifying the claustrum’s role in chronic pain. In addition, it means that future studies can now focus on modulating the activity of this brain region to overcome chronic pain.

Researchers have identified many ways in which this particular part of the brain might be damaged, like certain infections, autoimmune conditions, and more. Many such conditions cause cognitive decline along with chronic pain syndrome. 

Of course, these are the early days, and science must fully understand the claustrum’s role in pain perception. Nonetheless, it is a step forward in understanding chronic pain and its treatment.

Padda Institute of Pain Management offers dedicated cluster headache specialists. The interventional pain management services help to get relief from cluster headaches with non-surgical and minimally invasive techniques. 

By Gurpreet Singh Padda, MD, MBA