Feature - Pain Pain Go Away

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Pain, Pain, Go Away!

Many people suffer from chronic pain or fatigue in the absence of any physical injury, making diagnoses, treatments and cures at the least difficult, at the most nearly impossible.

Most treatments for Chronic Fatigue Syndrome (CFS), fibromyalgia (FM) and chronic muscle pain (CMP) include medications, but Asst. Professor Dane Cook is going for a more natural solution that involves learning more about the psychobiology of pain.

“Drugs aren’t the only, or necessarily, the best answer for these patients – our bodies have a natural ability to control pain” said Cook, who came to UW-Madison from the Department of Veterans Affairs in New Jersey. “The idea is that if we can find out if the whole system is broken, or partially broken, we can help them regulate and have control over their pain.”

Cook (top right in photo) has received three national grants totaling more than $2.1 million for the purpose of solving this neurobiological mystery.

One of Cook’s research teams has nearly completed a 4-year NIH grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases that compares healthy adults with adults who suffer from arthritis (explained pain) and fibromyalgia (unexplained pain).

He also recently received a 4-year, $1 million Merit Review Award from Veterans Affairs and a 2009 $125,000 from Chronic Fatigue and Immune Dysfunction Syndrome Association of America.

Cook, with the help of his current research team and new graduate research assistant Jacob Meyer, hopes to shed some light on the causes of these conditions by comparing the neurology of pain and fatigue in healthy adults, Gulf War veterans with CMP, and patients with CFS, FM or both.

Cook’s research teams are using exercise and brain imaging techniques to find out how the brain regulates pain, how physical and mental exertion affects these subjects, and how exercise influences pain and fatigue.

There is some good evidence that exercise can help in treatment, but researchers don’t yet know how, Cook said.

“We have something within us that we need to tap… cognitive modulation of pain,” he said. “There are so many great questions to ask but I don’t have a lifetime to find out.”

Cook’s mentee and research assistant, Jacob Meyer, is excited at the prospect of taking part in each stage of Cook’s exercise and brain imaging research. The neurology behind exercise science “makes a lot of sense to me,” he said.

Meyer, who begins graduate school this fall, has already started working for Cook to get acclimated to the exercise psychology lab, brain-imaging facilities and the programs needed for data analysis. He spent the summer studying brain scans and how water molecules in the brain diffuse (their movement and what dictates it).

Meyer’s first exposure to exercise and chronic pain and fatigue was to review data on healthy adults, adults with just CFS and adults with both CFS and fibromyalgia.

He compared how those three groups respond to different intensities of exercise, how well they are able to perform neurological tasks during exercise and if they faint from standing up afterwards. Meyers explained that previous studies haven’t differentiated patients with both conditions from patients who only experience CFS.

Meyer helped prepare a presentation on the results for the entire research group that recently met in Madison. The presentation provided the groundwork to submit the results for publishing, and pointed out the complexity of the research process.

Meyer will be spending the coming semester studying the effects of acute exercise on symptoms of CFS, determining weather bacteria in the digestive system play a role in what is termed "post-exertional malaise," or a worsening of symptoms after exercise.

From forming a hypothesis, to getting human subjects approval, to analyzing brain scans, to publishing a paper, “I’m getting used to idea of how research really works,” said Meyer, who plans to continue through for a doctorate in exercise science, neurology and motor learning. “It’s not as straightforward as I thought it might be.”

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