Thursday, July 1, 2010

Gray matter atrophy?

I've been bothered a lot by my cognitive changes over the last 10 years, which seem to get worse daily. I'm almost 40 so I shouldn't be having much, if any issues with memory, etc. However, those of us with EDS (and people with Fibromyalgia) know that it is all too common to lose thoughts, feel foggy, forget everything, and generally feel stupid. It is very frustrating to me that I cannot remember things that were once very important to me - for instance, I hear something interesting on the news (NPR) and then can't bring it into a conversation later that day. The only condition in which my memory doesn't seem to fail me as much is when there is a visual cue attached to it, which is very helpful especially when I need to find something I misplaced! At this point, how much of what I feel is from the pain, from the meds, or from EDS?

Anyway, because of where I work and my general interest in reading scientific literature, I've heard a lot about gray matter atrophy and chronic pain lately. Basically, the outer part (gray matter) of the brain shrinks and loses volume - it ages prematurely. In depression, treatment with anti-depressants can reverse some of the damage/shrinkage in the hippocampus. Is there anything that can help with pain-related damage to the gray matter? One of the articles below seems to suggest that pain management might be helpful.

I wish I understood this topic better and hope there is someone out there who can alleviate my fears of losing my cognitive skills/function at too early of an age. Maybe there will be someone at the EDNF conference this month who can address this issue? Without hope, there is nothing. 

"The function of gray matter is to route sensory or motor stimulus to interneurons of the CNS in order to create a response to the stimulus through chemical synapse activity. Grey matter structures (cortex, deep nuclei) process information originating in the sensory organs or in other gray matter regions. This information is conveyed via specialized nerve cell extensions (long axons), which form the bulk of the cerebral, cerebellar, and spinal white matter." Wikipedia

"As gray matter decrease is at least partly reversible when pain is successfully treated, we suggest that the gray matter abnormalities found in chronic pain do not reflect brain damage but rather are a reversible consequence of chronic nociceptive transmission, which normalizes when the pain is adequately treated." J Neurosci. 2009 Nov 4;29(44):13746-50. 

"Local morphologic alterations of the brain in areas ascribable to the transmission of pain were recently detected in patients suffering from phantom pain, chronic back pain, irritable bowl syndrome, fibromyalgia and frequent headaches. These alterations were different for each pain syndrome, but overlapped in the cingulate cortex, the orbit frontal cortex, the insula and dorsal pons. As it seems that chronic pain patients have a common "brain signature" in areas known to be involved in pain regulation, the question arises whether these changes are the cause or the consequence of chronic pain. The in vivo demonstration of a loss of brain gray matter in patients suffering from chronic pain compared to age and sex-matched healthy controls could represent the heavily discussed neuroanatomical substrate for pain memory." Schmerz. 2009 Dec;23(6):569-75.[in German]