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According to the CDC in 2016 11% to 40% of the US population suffered from chronic pain. This pain may be related to a pathology like cancer, joint or muscle problems, migraines, etc. It is called chronic if it lasts more than three months. When the pain becomes chronic it is no longer a symptom but rather a disease in itself. In the long term, this suffering can obviously have an impact on daily life – both personal and professional – and can have negative psychological consequences. A recent study published in the European Journal of Pain confirms this: researchers found that chronic pain and depression are related because prolonged suffering alters the chemical functioning of a part of the brain related to mood.
GABA: essential neurotransmitters for brain signaling
Chronic pain is more than just a horrible feeling,” explains Sylvia Gustin, a neuroscientist and psychologist at the University of New South Wales and the NeuRA Neurological Research Institute, a neuroscience research institute in Australia, and one of the study’s co-authors. It can affect how we feel, what we believe, and who we are.
The aim of this study was to better understand the relationship between the physical aspect of pain and its psychological consequences. To do this, the researchers analyzed the brain scans of 48 volunteers with and without chronic pain. They wanted to monitor the levels of gamma-aminobutyric acid (GABA) in each individual. GABA is an inhibitory type of neurotransmitter that regulates the activity of nerve cells in the nervous system. Therefore, its role is crucial for proper brain signaling.
Without GABA we cannot control our thoughts or emotions
When GABA levels are equal to those of glutamate, a stimulating neurotransmitter, a person’s emotions are positive. Researchers already knew that glutamate levels decrease when someone suffers chronic pain. At the same time, the individual may also experience emotional distress due to the decrease in GABA levels.
The breakthrough of the study was that it showed that chronic pain is associated with a decrease in GABA levels. In other words, pain leads to anxiety and depression because GABA levels decrease. The brain scans analyzed showed that GABA levels were indeed very different in chronic pain. More worryingly, the researchers believe that chronic pain – that is, pain that lasts a long time – can have a lasting effect on our brain’s processing of emotions by reducing inhibitory measures. Thus, without GABA, our emotional reactions and thoughts would be out of control.
“For the first time, we have shown in humans that chronic pain is associated with a decrease in GABA, an inhibitory neurotransmitter in the medial prefrontal cortex. In other words, a real pathological change is taking place,” explains Sylvia Gustin. In the long term, this study could allow researchers to better understand the brain, ideally to improve the treatment of people with chronic pain-related depression.
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