Fibromyalgia IS In the Head After All Fibromyalgia IS In the Head After All

Fibromyalgia affects about two per cent of the population, women more so than men. The disease involves the enhancement of pain impulses, leaving sufferers highly sensitive to pain, which is both chronic and diffuse. Previously, the causes of the disease were unknown, and there were no objective measurements of the way the CNS processes pain. _SD

Of all the pain syndromes, Fibromyalgia can be one of the most frustrating. The patients often seem to be depressed, anxious, and personally ineffectual. Treatment with antidepressants -- traditionally tricyclic antidepressants such as amitriptyline -- has been useful for managing the problem. But is it possible that the depression, anxiety, and helplessness are the result of the chronic pain, and not the cause? Swedish researchers have taken a deep look into the brain, at the foundations of Fibromyalgia.

In one of the studies presented in the thesis, subjects had both thumbs pressed hard enough for them to feel the same degree of mild pain as healthy controls. Using functional magnetic resonance imaging (fMRI), researchers could show that the subjects had the same level of activity in the parts of the brain that deal with emotions as well assensory information from the thumb, regardless of which group they belonged to. However, the subjects with fibromyalgia had lower activity in a brain area that inhibits the experience of pain.


According to the team, treatment with drugs that work on the central nervous system (CNS), such as SNRI antidepressants, are effective against fibromyalgia. But this is not a question of treating depression but of other properties of these drugs.


"The patients who had had their pain symptoms for the shortest amount of time were those that responded best to the drug treatments tested," says Karin B Jensen. "This shows how important it is that fibromyalgia is detected and taken seriously as early in its development as possible."


Her thesis also confirms the existence of a relationship between genetics and pain regulation. Studies of healthy people revealed a relationship between a specific genetic variant and the effect of a morphine-like drug on repeated pain stimulation. The results suggest that the gene under study only affects the body's pain regulating system in the presence of greater psychological stress. This knowledge, say the researchers, could one day make possible the development of customised medical treatments and thus better and more effective pain relief. _SD

There may be many more than trillions of ways that humans experience the world differently, due to the combinatorial explosion of genetic and epigenetic mechanisms involved in turning biochemistry into conscious reality. Fibromyalgia is a relatively common -- and frequently disabling -- manifestation of human biodiversity via genetic and / or epigentic variability. How many uncounted other ways do we experience reality differently from each other, due to the quirks of our genes?

A Duel To The Pain

To the pain means the first thing you will lose will be your feet below the ankles. Then your hands at the wrists. Next your nose....The next thing you will lose will be your left eye followed by your right....Your ears you keep and I'll tell you why. So that every shriek of every child at seeing your hideousness will be yours to cherish. Every babe that weeps at your approach, every woman who cries out, "Dear God! What is that thing," will echo in your perfect ears. That is what to the pain means. It means I leave you in anguish, wallowing in freakish misery forever. _PrincessBride

The US Justice Department has its own ideas of what "to the pain" might mean. In order to use pain as a non-lethal weapon against crime, the US DOJ research labs are developing a "pain beam" weapon for use by its agents of the law.

The research arm of the US Department of Justice is working on two portable non-lethal weapons that inflict pain from a distance using beams of laser light or microwaves, with the intention of putting them into the hands of police to subdue suspects.

The two devices under development by the civilian National Institute of Justice both build on knowledge gained from the Pentagon's controversial Active Denial System (ADS) - first demonstrated in public last year, which uses a 2-metre beam of short microwaves to heat up the outer layer of a person's skin and cause pain.
'Reduced injuries'

Like the ADS, the new portable devices will also heat the skin, but will have beams only a few centimetres across. They are designed to elicit what the Pentagon calls a "repel response" - a strong urge to escape from the beam.

A spokesperson for the National Institute for Justice likens the effect of the new devices to that of "blunt trauma" weapons such as rubber bullets, "But unlike blunt trauma devices, the injury should not be present. This research is looking to reduce the injuries to suspects," they say. _NewScientist

Only two cases of second-degree burns have been recorded from thousands of experimental uses of the pain beam. I have had worse from an afternoon in the sun, as have many of my readers, no doubt.

We all know, however, that such weapons always find their way outside of official channels, in the hands of well to do criminals who have a flair for organisation and bribery. Thieves and rapists are already using Tasers to bring their victims to submission. What sort of uses will criminals find for pain beam devices?

Sure, you may see this new P-beamer as a torture weapon, in line for use at Abu Ghraib or Guantanamo, or perhaps for the secret dungeons under the White House. But what about using it as a proper dueling weapon, for the satisfaction of matters of honour? Is it possible that the fear of pain might encourage better manners among the teeming and worthless generations of psychological neotenates and the academically lobotomised? Could such P-beam devices find a use in today's high schools and universities, as a way of encouraging learning and discouraging delinquency and boorishness? Perhaps, perhaps, and thanks for suggesting it.

Because here at the top secret government labs, we are just the same as all branches of government. We're here to help you. And the bigger and more powerful we grow, the better equipped we will be to provide assistance. Don't worry. Just be good, and we will make sure you are happy. Or, we will at least not beam you.

Peel Scalp, Open Skull, Apply Electrodes

Medical indications for the placement of brain electrodes are multiplying. Parkinson's, paralysis, pain control, epilepsy, depression, deafness, blindness, and many more. It is good that the techniques for brain electrode implantation are growing more sophisticated.

1. Electrodes on the scalp can only detect electrical waves that have passed through the skull, producing a weak signal susceptible to interference from mains electricity and other sources.
2. Electrodes implanted directly into the brain produce much clearer signals, but are not well tolerated by the body. "The brain tries to get rid of [the electrodes] by covering them with a sheet of tissue," explains Schalk. "The signal degrades over time."
3. Schalk and colleagues at Albany Medical College, Washington University in St Louis, University of Washington, Seattle, and the University of Wisconsin at Madison, all US, think a third approach will face fewer hurdles...They cover part of the brain's surface with a polymer sheet containing a grid of electrodes 2 millimetres in diameter and spaced 10 mm apart, a method called electrocorticography (ECOG). Such electrode grids are often placed in people with severe epilepsy to identify the focus of seizures within the brain.

"These grids are thin like a sheet of paper," says Schalk. "The electrodes record signals similar to those recorded by electrodes on the scalp, but with much greater fidelity."___ NewScientist

So far, the new approach looks good for long-term electrode array implantation. As the electrode arrays become more sophisticated, so do the possibilities for communication between the brain and electronic machines.

'When we turn the current on, the patients report the emptiness suddenly disappears'...By inserting electrodes into the brain while the patient is conscious (so that the surgeon knows if they have hit the right spot), Dr Mayberg found remarkable results. When she published her work, she said: "In the operating room, when we first turn the current on and get into the right location, the patients report that the heaviness or emptiness suddenly disappears. If they had a sense of a black cloud, they report it physically lifting."

The moment the electrodes were turned off, some of the positive effects vanished, but the overall results - four out of six patients were lifted from depression for six months - were encouraging.___Source

Wireheading is the science fiction concept of being able to connect the brain directly to an external electronic signal--for either "electronic bliss" or for purposes of high level communication with sophisticated computing devices (or with other wireheads).

The more sophisticated the brain electrode arrays, the more sophisticated the possible mind-machine or mind-mind interactions. "Brain chips" are already learning how to transfer neural signals across a "brain necrotic divide," as from a stroke. Such chips are slowly growing beyond mere relay stations, to learning to decode simple neural signals. As such experience grows, neurochips will learn even better neural communications skills.

In the brain, it is all about the connections, the timing, the amplitudes, and the frequencies. The smart approach to learning our way around brain signaling would be to implant smart arrays of electrodes that merely sit, watch, wait, correlate, analyse, theorise, and test theories. It goes without saying that such experiments with passive brain electrode arrays would also contribute to machine cognition research. Conversely, better machine cognition based upon brain emulation, would provide neuro-researchers with better models for testing theories and hypotheses.

Just getting started? No, just starting to get started.

Safer Nerve Blocks--A Promising Combination Local Anesthetic

I have a great deal of experience in this area of medicine--providing spinal blocks, epidurals, regional nerve blocks etc. Most persons in the profession of anesthesia or pain treatment have wanted a local anesthetic with the properties claimed for this experimental combination drug:

“We’ve introduced a local anesthetic selectively into specific populations of neurons,” explains Harvard Medical School Professor Bruce Bean, an author on the paper, which appears in Nature on Oct. 4. “Now we can block the activity of pain-sensing neurons without disrupting other kinds of neurons that control movements or non-painful sensations.”

“We’re optimistic that this method will eventually be applied to humans and change our experience during procedures ranging from knee surgery to tooth extractions,” adds Professor Clifford Woolf of Massachusetts General Hospital, who is senior author on the study.

Despite enormous investments by industry, surgical pain management has changed little since the first successful demonstration of ether general anesthesia at MGH in 1846. General and local anesthetics work by interfering with the excitability of all neurons, not just pain-sensing ones. Thus, these drugs produce dramatic side effects, such as loss of consciousness in the case of general anesthetics or temporary paralysis for local anesthetics.

“We’re offering a targeted approach to pain management that avoids these problems,” says Woolf.

...The new method exploits a membrane-spanning protein called TRPV1, which is unique to pain-sensing neurons. TRPV1 forms a large channel, where molecules can enter and exit the cell. But a “gate” typically blocks this opening. The gate opens when cells are exposed to heat or the chili-pepper ingredient capsaicin. Thus, bathing pain-sensing neurons in capsaicin leaves these channels open, but non-pain sensing neurons are unaffected because they do not possess TRPV1.

The new method then takes advantage of a special property of the lidocaine derivative QX-314. Unlike most local anesthetics, QX-314 can’t penetrate cell membranes to block the excitability of the cell, so it typically lingers outside neurons where it can’t affect them. For this reason it is not used clinically.

When pain-sensing neurons are exposed to capsaicin, however, and the gates guarding the TRPV1 channels disappear, QX-314 can enter the cells and shut them down. But the drug remains outside other types of neurons that do not contain these channels. As a result, these cells fully retain their ability to send and receive signals.

...The team must overcome several hurdles before this method can be applied to humans. They must figure out how to open the TRPV1 channels without producing even a transient burning pain before QX-314 enters and blocks the neurons, and they must tinker with the formulation to prolong the effects of the drugs. Both Bean and Woolf are confident they’ll succeed.

“Eventually this method could completely transform surgical and post-surgical analgesia, allowing patients to remain fully alert without experiencing pain or paralysis,” says Woolf. “In fact, the possibilities seem endless. I could even imagine using this method to treat itch, as itch-sensitive neurons fall into the same group as pain-sensing ones.”

Source

I am looking forward to such an anesthetic becoming available.

Reaching Into The Brain With Electromagnetic Fingers

I have been excited about the potential for electromagnetic treatments of the brain for almost two decades. Both electrical stimulation (CES) and magnetic stimulation (TMS) hold promise for treating depression and migraines--while TMS may eventually also treat Alzheimer's and help in stroke rehab. Neurofeedback is a third electronics-dependent modality of treatment that appears extremely promising.
Here is some recent news about an improved TMS system from Brainsway Ltd.:

Standard TMS coils are limited to activation of only cortical brain regions, up to a depth of about 1.5 cm. Hence when treating depression with a standard TMS system, the limbic system, which is related to mood regulation and is generally deeper than 1.5 cm, is only indirectly affected, through secondary processes involving cortical structures, which are directly activated by TMS and then affect the deeper limbic system structures.

The unique technology of Brainsway Deep TMS System enables direct non-invasive activation of deep brain structures.

Deep TMS is a breakthrough in the search for a non-invasive approach for treating common brain disorders.

Source.

Here is some information about CES from GNIF Brain Blogger:

Researchers don’t fully understand mechanisms involved, but theorize that CES electrical current helps reestablish optimal brain chemistry and improves efficiency of neural connections. [10] One example of research supporting this theory involves electrical engineering simulations conducted by researchers at the University of Texas, Austin. Their brain mapping techniques suggested that minute amounts of current traveled to the brain’s thalamus, enough to enable release of neurotransmitters. [11] Other research conducted by North Dakota State University utilized EEG techniques to quantify changes during administration of CES versus sham treatment. The research showed frequency distribution shifts suggestive of beneficial changes. [12]

Based on current and ongoing research, neuroscientist Dr. James Giordano postulates that CES microcurrent travels to the base of the brain (the brainstem), activating clusters of nerve cells which make the brain chemicals serotonin and acetylcholine. Serotonin is linked to relaxation [13] while acetylcholine is linked to body processes not under conscious control while at rest. [14] Released by nerve cells at the synapse, these neurotransmitters influence pathways within the brain and spinal cord that inhibit arousal and agitation. The resulting “fine tuning” helps the nervous system to restore homeostatic balance and possibly creates brain patterns known as alpha rhythms. Measurable via brain wave recordings (called EEG); scientists often associate alpha states with enhanced mental focus and relaxation. Neurological processes linked to alpha states seem to reduce stress, stabilize mood, and exert control over certain types of pain.

Source.

When I was in medical school, I was very impressed by neuropharmacology. Although I necessarily use neuropharmacology routinely on patients, I am always looking for effective non-pharmacological treatments. Perhaps I am hoping to find a profitable use for my electrical engineering training? Probably not. I simply don't like the potential drug side effects.

Brain Implants for Parkinson's, Epilepsy, Depression: We Are All Cyborgs Now

In a recent New York Times article, patients and doctors discuss the new neuro-implant technology called neuromodulation. Used as treatment for disorders from Parkinson's disease, depression, and epilepsy, to chronic pain disorders and tremors. But that is just the beginning. In this industry, the sky is the limit. Read on:

Don Falk stretched his right arm over his head, past the faint marks where a surgeon sank two wires deep in his brain, to show how uncontrollable tremors in his hand used to slap him awake in the morning.

It was just one of many difficulties he suffered as his Parkinson's disease advanced. Falk had trouble shaving and walking, and his medications caused his head to twitch awkwardly, making him self-conscious in church.

''It's the day-to-day living that is so hard with Parkinson's,'' he said.

In May, Falk, 52, started to get better with the help of an emerging class of implantable medical devices called neuromodulators -- tiny machines that stimulate the central nervous system to treat a host of disorders. Analysts say they could be the next big thing for some of the market's hottest medical technology companies.

....Neuromodulators are technological cousins of implantable heart defibrillators, a $5.5 billion market that's growing at nearly 20 percent a year.

The devices do have some hurdles. While they've been shown to be safe and effective at treating some disorders, they're generally recommended only after drugs and other less invasive treatments fail.

The surgical procedure can be complex, and the devices themselves are expensive, about $50,000 for the deep brain stimulator, less for other devices in the class. And that doesn't include the costs of surgery.

The results are impressive, but ''it's not a big moneymaker,'' said Dr. Richard Veyna, Falk's neurosurgeon at Methodist Hospital in this Minneapolis suburb. Not enough doctors know about the technology, and at current insurance reimbursement rates simpler procedures are more profitable, Veyna said.

Perhaps surprisingly, the risks of brain surgery rarely dissuade patients, maybe because they are tired of living with Parkinson's symptoms and have seen other treatments fail, he said.

Falk said he didn't hesitate about brain surgery. ''My tremor was so bad I just wanted it done,'' he said. His adult children didn't think twice either: ''They did not like me just sitting there, shaking and stuff.''

Falk touts his procedure to other Parkinson's patients, telling them that his medication has been cut by two-thirds and his insurance covered the procedure.

Competition, higher volume and technological advances drove down the costs of implantable cardiac devices, and could do the same for the neuromodulators. Only a small number of people who might benefit from the devices -- people who suffer from Parkinson's, tremors, epilepsy, chronic depression or chronic pain -- are now getting them, Wald said.

''Neurostimulation to me, in fact the whole neurological space, is what cardiology was 10 years ago,'' Wald said. ''The opportunity is just vast.''

....Dr. Todd Sitzman, an anesthesiologist in Hattiesburg, Miss., has used them in hundreds of patients with chronic pain over the last decade.

''Does it work from the patient's perspective? Without question,'' said Sitzman, who sits on the National Pain Foundation's board of directors. ''It is a therapy that gives them some relief and some semblance of a life.''

Companies are already pushing to develop new applications for the devices. They see potential uses in treating diseases including depression, obsessive-compulsive disorder, erectile dysfunction, traumatic brain injuries, obesity, angina, incontinence and ringing in the ears.

Read the entire article here.

Hat tips to Singularity News (Multipolarity News) and The Speculist.

Personally, it seems to me that these companies are thinking too small. If implants can help the blind to see, there is no reason they cannot do much more than the planned uses listed in the NYT article. I prefer correcting damage and defects biologically, but there will definitely be a period of time when the hardware will be able to accomplish things the wetware is not capable of. Think of it as the need to use crutches, temporarily. Eventually, you put them aside and walk on your own.

Hydrogel Drug Implants Deliver the Goods

Medgadget has an interesting post about a new medical implant technology developed by New Jersey company Valera.

Valera's Hydron implant technology is a:
subcutaneous drug delivery reservoir, the Hydron Implant has been designed for in-office physician insertion into the patient's upper arm using local anesthesia. The hydrogel polymer compositions possess soft, flexible tissue-like characteristics, providing excellent biocompatibility and patient comfort.

Employing micropores for drug diffusion, the implants are non-biodegradable and are capable of long-term (one year or more), continuous, near zero order release rates determined primarily by specific polymer blends, implant wall attributes and drug solubility.
Because Valera® has the ability to manufacture Hydron Implants to exacting chemical and geometric specifications, the technology is applicable to a broad spectrum of drugs, representing significant prospects for meeting therapeutic needs not addressed by current oral administration, depot injection, short duration implants, and transdermal patch delivery systems.

Here is the story about the human testing of the implant. It was used to suppress premature puberty in young girls.

According to Spitz, the results of the implant testing for puberty were encouraging. Puberty hormones remained suppressed at nine months after implant insertion in all 11 girls, and up to 15 months in six girls who were followed for more than one year after the original implant was inserted. All the girls reported less pain and discomfort, and less interference with school activity and work with the implant than with standard monthly injections, the investigators reported.

According to the Pediatrics report, there was no menstrual bleeding during the implant treatment, and mean breast development regressed somewhat during treatment. The acceleration in bone maturation that would signal an end to growth in height decreased during treatment, as did growth velocity, the report indicated.

"Our results showed there were no half measures. Each and every child experienced complete and full suppression. It was even more effective than monthly injections," said Spitz.

"The advantage of the implant is that it's simple to insert under local anesthesia and causes the complete suppression of the hormones for one year," said Spitz. "It obviates the need for children to come in every month for an injection. With injections, kids who have an overactive pituitary gland sometimes even need to come in two or three times a month. And sometimes, these injections are very painful.
"

A lot of medical treatments are given over a period of several months or years. Some are even potentially permanent treatments. An implant keeps working, even when the patient forgets all about the medicine or the medical condition. Implant techology improves along with technology for drug, biotech, and nanotech treatments for stubborn and deadly diseases.