How does your brain respond to pain? - Karen D. Davis

Summary

This script explores the subjective nature of pain, explaining it as an emotional and sensory experience linked to tissue damage. It delves into the neurological processes involving nociceptors, neurons, and brain pathways that create individual pain experiences. The variability in pain sensitivity is highlighted, affecting how people cope and respond to treatments. The narrative emphasizes the importance of personalized medicine in pain management, with advancements in targeting specific brain networks for tailored treatments.

Takeaways

• 🕒 Pain can affect task performance differently; some people are distracted and perform worse, while others may focus better and faster when in pain.
• 🤔 Pain is subjective and varies from person to person, affecting how they experience and cope with it.
• 🔍 Pain is defined as an unpleasant sensory and emotional experience linked with actual or potential tissue damage.
• 📊 Pain can be measured by intensity on a scale from zero to ten, and also has a character such as sharp, dull, burning, or aching.
• ⚡️ Nociceptors are specialized nerve cells that detect tissue damage and send signals to the brain via the spinal cord.
• 🌐 The brain processes pain signals through a complex network of neurons and glia, involving both grey and white matter.
• 🔍 The salience network in the brain determines what to focus on, and pain signals immediately activate this network.
• 🏋️‍♂️ Motor pathways activated by pain can lead to immediate reactions, like pulling your hand off a hot stove.
• 🧘‍♀️ Modulation networks release chemicals like endorphins and enkephalins that help regulate and reduce pain, contributing to phenomena like 'runner's high'.
• 🧬 Individual differences in pain sensitivity and brain circuit efficacy can lead to varied responses to pain and treatment outcomes.
• 🛠️ Pain treatments are diverse, targeting different systems and can include medications, distraction techniques, and therapies like cognitive behavioral therapy.
• 🔬 Personalized medicine in pain treatment involves understanding individual brain responses to pain, potentially using imaging tools to tailor treatments.

Q & A

How does pain affect the time it takes to solve a puzzle?

Pain can either increase or decrease the time it takes to solve a puzzle, depending on an individual's response to pain. Some people are distracted by pain and take longer, while others use the task as a distraction and perform better under pain.

What is the definition of pain according to the script?

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

How is pain measured?

Pain is measured by its intensity, which can be described on a scale from zero (no pain) to ten (the most pain imaginable), and by its character, such as sharp, dull, burning, or aching.

What are nociceptors and what role do they play in pain perception?

Nociceptors are special tissue damage-sensing nerve cells that fire and send signals to the spinal cord and then up to the brain when you get hurt, initiating the pain perception process.

What are the components of the brain involved in processing pain signals?

The components involved in processing pain signals include neurons and glia in the grey matter, and the white matter that carries information as electrical impulses from one area to another.

What is the function of the salience network in relation to pain?

The salience network is a system of interconnected brain cells that decides what to pay attention to. It is activated by pain signals, causing the individual to focus on the pain.

How do motor pathways respond to pain?

Motor pathways are activated in response to pain to initiate actions that prevent further tissue damage, such as removing your hand from a hot stove.

What are endorphins and enkephalins, and how do they relate to pain?

Endorphins and enkephalins are chemicals released during pain or extreme exercise that help regulate and reduce pain, contributing to the phenomenon known as the runner's high.

Why is there variability in how different people experience pain?

Variability in pain experience is due to differences in the sensitivity and efficacy of the brain circuits involved in pain perception and modulation, which can result in some people having greater pain than others or developing chronic pain.

What is personalized medicine in the context of pain treatment?

Personalized medicine in pain treatment refers to the development of new treatments that can be tailored to individual patients based on their unique brain responses to pain, using tools like magnetic resonance imaging to map brain pathways.

How can cognitive behavioral therapy help in coping with pain?

Cognitive behavioral therapy can help in coping with pain by teaching individuals strategies to manage their responses to pain, potentially reducing its impact on their daily life.

Outlines

00:00

🔬 The Impact of Pain on Task Performance

This paragraph explores the relationship between pain and task performance. It begins by posing a scenario where the discomfort of electric shocks might prolong the time taken to solve a puzzle. However, it challenges this assumption by suggesting that some individuals might actually perform tasks more efficiently when in pain, using the activity as a distraction. The paragraph delves into the nature of pain itself, defining it as an unpleasant sensory and emotional experience linked to tissue damage. It introduces the concept of pain intensity and character, and explains the physiological process involving nociceptors, neurons, and glia that lead to the perception of pain. The role of the brain's salience network in focusing attention on pain signals is also highlighted, along with the activation of motor and modulation networks that help in coping with pain by releasing endorphins and enkephalins.

Keywords

💡Pain

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is central to the video's theme as it explores how different individuals perceive and cope with pain. The script uses the example of a puzzle to illustrate how pain can either distract or focus an individual, affecting their performance on tasks.

💡Nociceptors

Nociceptors are specialized nerve cells that detect tissue damage and send signals to the spinal cord and brain. They are integral to the pain experience as described in the video, acting as the initial sensors that trigger the pain response when one gets hurt.

💡Salience Network

The salience network is a system of interconnected brain cells that determines what to pay attention to. In the context of pain, this network is immediately activated, focusing the individual's attention on the pain signal, as mentioned in the script.

💡Pain Signal

A pain signal refers to the electrical impulses that carry information about pain from the nociceptors through the spinal cord to the brain. The video explains how the brain processes these signals through various pathways, affecting the individual's perception and reaction to pain.

💡Cortex

The cortex, specifically mentioned as the part of the brain that decides what to do with the pain signal, plays a crucial role in the video's discussion on pain processing. It is where the brain interprets the pain information received from the sensing pathway.

💡Motor Pathways

Motor pathways are activated in response to pain to initiate actions such as removing one's hand from a hot stove. The script highlights their role in the immediate physical response to pain.

💡Modulation Networks

Modulation networks are activated to regulate and reduce pain by delivering chemicals like endorphins and enkephalins. The video describes these networks as part of the brain's coping mechanism during pain, creating phenomena like the runner's high.

💡Pain Intensity

Pain intensity is described on a scale from zero to ten in the script, with zero being no pain and ten being the most pain imaginable. This concept is used to quantify and compare the level of pain experienced by individuals.

💡Pain Character

The character of pain refers to its quality, such as sharp, dull, burning, or aching. The script mentions this to illustrate the diverse nature of pain perceptions, which can influence how it is experienced and described by individuals.

💡Chronic Pain

Chronic pain is defined in the script as pain that persists months after an injury should have healed. It is a significant topic in the video as it discusses the challenges of treating pain that does not respond to regular treatments.

💡Personalized Medicine

Personalized medicine is the concept of tailoring treatments to individual patients based on their unique brain responses to pain. The video emphasizes this approach as key to finding the best treatment for each person, moving away from one-size-fits-all treatments.

Highlights

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Pain intensity can be measured on a scale from zero to ten, the most pain imaginable.

Pain also has a character, such as sharp, dull, burning, or aching.

Nociceptors are special nerve cells that sense tissue damage and send signals to the brain.

Pain signals are processed by neurons and glia in the brain's grey matter.

The brain's white matter carries pain information as electrical impulses through interconnected pathways.

The cortex decides what to do with the pain signal, while the salience network decides what to pay attention to.

Pain signals immediately activate the salience network, drawing attention to the pain.

Motor pathways are activated in response to pain to prevent further tissue damage, such as pulling your hand off a hot stove.

Modulation networks are activated to deliver endorphins and enkephalins, which help regulate and reduce pain.

Individual brain circuit sensitivity and efficacy determine how much pain is felt and coped with.

Variability in pain sensitivities is similar to variability in responses to other stimuli, such as roller coasters causing motion sickness in some.

Understanding individual brain responses to pain is key to finding the best treatment for each person.

There are many treatments for pain, targeting different systems, from non-prescription medications to stronger pain medicines and anesthetics.

Coping strategies like distraction, relaxation, meditation, and yoga can help manage pain.

Cognitive behavioral therapy can be taught as a strategy to cope with pain.

For severe chronic pain that doesn't respond to regular treatments, new treatments are being developed to stimulate or block specific pain networks.

Personalized medicine involves tailoring treatments to individual patients using tools like MRI to map brain pathways.

Transcripts

Translator: Jessica Ruby Reviewer: Caroline Cristal

Let's say that it would take you ten minutes to solve this puzzle.

How long would it take

if you received constant electric shocks to your hands?

Longer, right?

Because the pain would distract you from the task.

Well, maybe not;

it depends on how you handle pain.

Some people are distracted by pain.

It takes them longer to complete a task, and they do it less well.

Other people use tasks to distract themselves from pain,

and those people actually do the task

faster and better when they're in pain

than when they're not.

Some people can just send their mind wandering

to distract themselves from pain.

How can different people

be subjected to the exact same painful stimulus

and yet experience the pain so differently?

And why does this matter?

First of all, what is pain?

Pain is an unpleasant sensory and emotional experience,

associated with actual or potential tissue damage.

Pain is something we experience,

so it's best measured by what you say it is.

Pain has an intensity;

you can describe it on a scale

from zero, no pain, to ten, the most pain imaginable.

But pain also has a character,

like sharp, dull, burning, or aching.

What exactly creates these perceptions of pain?

Well, when you get hurt,

special tissue damage-sensing nerve cells,

called nociceptors, fire and send signals

to the spinal cord and then up to the brain.

Processing work gets done by cells called neurons and glia.

This is your Grey matter.

And brain superhighways carry information as electrical impulses

from one area to another.

This is your white matter.

The superhighway that carries pain information

from the spinal cord to the brain

is our sensing pathway

that ends in the cortex,

a part of the brain that decides what to do

with the pain signal.

Another system of interconnected brain cells

called the salience network

decides what to pay attention to.

Since pain can have serious consequences,

the pain signal immediately activates the salience network.

Now, you're paying attention.

The brain also responds to the pain

and has to cope with these pain signals.

So, motor pathways are activated

to take your hand off a hot stove, for example.

But modulation networks are also activated

that deliver endorphins and enkephalins,

chemicals released when you're in pain or during extreme exercise,

creating the runner's high.

These chemical systems help regulate and reduce pain.

All these networks and pathways work together

to create your pain experience,

to prevent further tissue damage,

and help you to cope with pain.

This system is similar for everyone,

but the sensitivity and efficacy of these brain circuits

determines how much you feel and cope with pain.

This is why some people have greater pain than others

and why some develop chronic pain

that does not respond to treatment,

while others respond well.

Variability in pain sensitivities

is not so different than all kinds of variability

in responses to other stimuli.

Like how some people love roller coasters,

but other people suffer from terrible motion sickness.

Why does it matter that there is variability

in our pain brain circuits?

Well, there are many treatments for pain,

targeting different systems.

For mild pain, non-prescription medications

can act on cells where the pain signals start.

Other stronger pain medicines and anesthetics

work by reducing the activity in pain-sensing circuits

or boosting our coping system, or endorphins.

Some people can cope with pain using methods that involve

distraction, relaxation, meditation, yoga,

or strategies that can be taught, like cognitive behavioral therapy.

For some people who suffer from severe chronic pain,

that is pain that doesn't go away

months after their injury should have healed,

none of the regular treatments work.

Traditionally, medical science has been about

testing treatments on large groups

to determine what would help a majority of patients.

But this has usually left out

some who didn't benefit from the treatment

or experienced side effects.

Now, new treatments that directly stimulate or block

certain pain-sensing attention or modulation networks

are being developed,

along with ways to tailor them to individual patients,

using tools like magnetic resonance imaging

to map brain pathways.

Figuring out how your brain responds to pain

is the key to finding the best treatment for you.

That's true personalized medicine.