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Four Questions: Chronic Pain and How It Affects the Brain

by Alexis Blue

hronic pain affects an estimated 100 basic task — pulling a designated lever to and others might notice that you’re sticking
Cmillion Americans, and its impact receive a food reward — at the same rate as to what you know. You’re not venturing out,
goes beyond physical discomfort. control groups. However, they were much you’re not trying new things, you’re not
Research led by University of Arizona slower than rats without pain to adapt when learning new information. You’re kind of on
psychologist Stephen Cowen illustrates conditions changed, and a new lever was autopilot.
how chronic pain may impact cognitive introduced that produced more food. So this might be an unforeseen
abilities, such as decision-making, as The findings provide insight into how consequence of chronic pain that we don’t
well. pain may hinder cognitive flexibility in study enough. In the past, we’ve focused
Cowen and UA professor of humans, Cowen says. more on the immediate effect of just the pain
pharmacology Frank Porreca, along with Q: What motivated you to look at chronic itself, which is very important, but some of
their collaborators at Eli Lilly, investigated pain as it relates to decision-making? the more detrimental consequences may be
how pain impacts cognitive flexibility, A: Traditionally, what we’re mostly in the poor decisions that are made.
or the ability of the brain to learn new concerned about with chronic pain is the With most of the therapies we test for
information. The study, published in the pain itself — the emotional component chronic pain, nobody looks at the effects on
journal Pain, revealed that the ability of the pain or the physical feeling of pain. treating the cognitive or learning deficits that
to adapt to changing situations may be Those are the things we usually focus on, perhaps are accompanying chronic pain. In
hindered in those with chronic pain. and rightly so, but there are also other our study, we found maybe we should start
“Cognitive flexibility is a broad term, consequences of having chronic pain looking at that.
but overall, it’s your ability to adapt to that affect your ability to learn and make Q: Why do we see the connection between
new information, being flexible with decisions, and that’s what we focused on chronic pain and cognitive flexibility, and
your learning,” says Cowen, an assistant with this study. We wanted to see what what are the next steps for this research?
professor in the UA Department of types of learning deficits or alterations in A: I study the frontal cortex, the
Psychology. “For example, you might your ability to adapt to new information frontal part of the brain that we think is so
initially learn one route to work, and you are affected by chronic pain, and that’s important for decision-making and cognitive
do that day after day, and then the next something that’s very rarely been looked at flexibility. The frontal cortex is really
two days in a row there’s construction. in the field. important for the ability to override our basic
You should be able to reroute yourself and Q: What are the implications of your instincts, in a sense, and to be more adaptive
not, out of habit alone, keep going down findings for people suffering chronic pain? to new information.
that path that always makes you late for A: If you’re suffering from chronic pain, When you have chronic pain, the
work.” your ability to make good decisions or adapt neuronal activity in the frontal cortex
In Cowen’s study, rats with to new information might be compromised. changes considerably. We thought that these
neuropathic pain were able to learn a You might not realize it, but your friends changes would result in an inability to adapt
to new information, and, sure enough, that’s
what we found.
We didn’t directly measure frontal
activity — we didn’t look at the neuroscience
— so that’s what we really would like to do
next, and that’s what my lab’s specialty is:
recording the activities of neurons in the
brain during decision-making and during
learning.
Q: What excites you most about this work?
A: If I can get a glimpse into how this
great machine of ours called the brain works
and understand how interactions between
groups of neurons lead to a memory, lead to
an action, lead to a decision — that’s the most
exciting thing. I really want to look under the
hood and get a glimpse of what the system is
doing. I’m very interested in the translational
component too: How do we take what we’re
doing and help patients?
Stephen Cowen / Chris Richards photo

20 ARIZONA ALUMNI MAGAZINE