In a first of a kind study, University of Michigan researchers used brain imaging procedures to track the clinical action of pregabalin, a drug known by the brand name Lyrica® that is prescribed to patients suffering from fibromyalgia and neuropathic pain.
Researchers performed three different brain imaging procedures – proton magnetic resonance spectroscopy, functional magnetic resonance imaging and functional connectivity magnetic resonance imaging – in 17 patients with fibromyalgia.
Fibromyalgia is a chronic pain disorder thought to result from a disturbance in the way the central nervous system processes pain.
It affects an estimated 10 million people in the United States and 3 to 6 percent of the world population.
Patients with fibromyalgia may spontaneously report pain throughout their bodies although there is no inflammatory or anatomical damage.
In addition to chronic pain, patients may also suffer from related mood disturbances, such as anxiety and depression.
Prior studies have suggested that fibromyalgia patients may have heightened neural activity in a region of the brain involved in processing pain and emotion called the insula, and that this excess activity may be related to elevated levels of the excitatory neurotransmitter glutamate.
Analysis of the brain imagery suggests that Lyrica® works in part by reducing the concentration of glutamate within the insula — a finding that supports observations in animal studies.
These reductions in glutamate were also accompanied by decreases in insula connectivity and reductions in clinical pain ratings.
Investigators believe the use of brain imaging to monitor brain activity associated with administration of pain medications may help in the development of new medicines and personalized chronic pain treatment.
“The significance of this study is that it demonstrates that pharmacologic therapies for chronic pain can be studied with brain imaging,” said lead study author Richard Harris, Ph.D., assistant professor of anesthesiology at the University of Michigan.
“The results could point to a future in which more targeted brain imaging approaches can be used during pharmacological treatment of chronic widespread pain, rather than the current trial-and-error approach.”
Source: University of Michigan