Head, Neck, & ShouldersPain in the Brain

Pain in the Brain

Abnormal Brain Activity Linked to Psychological Illness

by Margaret Jaworski

“It’s all in your head.” The comment, usually meant as a dismissal of unexplained physical symptoms, turns out to be accurate –in a reassuring way. Researchers at the University of Cambridge and University College London found abnormalities in the brains of people suffering from a psychogenic disease that differed significantly from those with the organic form of the disease .The study was published in the journal, Brain.

According to neurologist James Rowe, MD, University of Cambridge, one of the researchers, while psychogenic diseases may look very similar to illnesses caused by a genetic defect or by physical damage to nerves, muscles or the brain, these medically unexplained physical symptoms are “poorly understood, complex and variable which makes them difficult to diagnose and even more difficult to treat,” said Dr. Rowe. (Read more at Poorly Understood.) Consequently, sufferers find themselves in treatment limbo.

In the study, the researchers looked at people with either psychogenic or organic dystonia of the leg, as well as healthy people with no dystonia. Dystonia is a movement disorder that causes involuntary, often painful and disabling muscle contractions. The patients with organic disease had a specific gene mutation that caused their dystonia. The psychogenic patients had the same manifestations of the disease – ranging from painful contracture to paralysis – the researchers could not identify any physical explanation, even after extensive investigations.

The scientists performed PET brain scans on the volunteers to measure the blood flow and brain activity of the participants while holding various foot positions. In addition, electrical activity of the leg muscles was measured at the same time to determine which muscles were engaged during the scans.

The researchers identified abnormal brain function in the psychogenic patients that differed significantly from the abnormal brain function of individuals with the organic disease. The findings “opens up a way for researchers to learn how psychological factors can, by changing brain function, lead to physical problems,” said researcher, Anette Schrag, MD, University College London.

Research into psychogenic or medically unexplained illness is extremely important. Says Dr. Schrag, one in six patients that see a neurologist [in the U.K.] has a psychogenic illness. Numbers in the U.S. are similar. “These patients are as ill as someone with organic disease, but with a different cause and different treatment needs. Understanding these disorders, diagnosing them early and finding the right treatment are all clearly very important. We are hopeful that these results might help doctors and patients understand the mechanism leading to this disorder, and guide better treatments.”

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