~Source: The CFS Research Foundation
The CFS Research Foundation, based in Hertfordshire, England, has agreed to fund an ambitious, cutting edge study into why so many Chronic Fatigue Syndrome/ME sufferers experience heightened pain. The three-year study will be conducted by a team of UK scientists and clinicians at Bart’s and the London Medical School, Imperial College and Imanova, a centre of excellence for imaging sciences.
Entitled “The neurophysiology of pain in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)”, the study will seek to discover the physiological and chemical abnormalities underlying pain in CFS/ME patients. A large majority of people with CFS/ME suffer from a number of painful symptoms including muscle and joint pain, headaches, sore throat and lymph node pain. Many endure chronic widespread pain which can become unbearable. An additional problem for these sufferers is that normal pain killers do little to ease their pain.
Scientists and doctors know very little about why pain is such a problem but there is some evidence to suggest that the way the brain handles pain signals in CFS/ME patients is different from that in healthy people. There are two potential reasons: spinal sensitisation, in which non-painful sensations are felt as painful because nerves that are not specialised in detecting pain tell the spinal cord that what is being felt is hurting us, (called allodynia) while mildly painful sensations are felt as unbearable because the brain’s natural defences don’t fire and central augmentation in which the brain’s pain matrix becomes overly sensitive, reacting faster than normal to the possibility of pain which it then interprets as being more painful and unpleasant. Together these are referred to as Central Sensitisation. This condition is not specific to CFS/ME but the particular biological and biomedical mechanisms which cause it in CFS/ME sufferers is unknown.
The research team will attack the problem on four fronts. Firstly, they will measure pain thresholds to a number of potentially painful stimuli (e.g. pressure and heat) and assess whether there is spinal cord sensitivity to pain (spinal sensitisation). Secondly, they will use cutting edge fMRI (functional Magnetic Resonance Imaging) to scan the brains of CFS/ME patients, to examine the pain matrix (pain pathways), and see how they differ from healthy controls. Thirdly, they will use two medications that block two of the brain’s pain chemical transmitters (dopamine and the opioids) in combination with fMRI to see how they are involved in the pain pathways and the response to pain. Finally, the team will see whether the differences in pain levels, central sensitisation and activity of the pain matrix are related to differences in a particular gene in CFS/ME patients.
The research will lead to a better understanding of how the brain is involved in pain symptoms in CFS/ME patients, how certain brain chemicals and the gene involved in their metabolism, are involved and thus provide a way forward to consider more effective treatments.
The CFS Research Foundation’s Honorary Director, Anne Faulkner said: “The Foundation maintains its belief that it is essential that the basis of CFS/ME must continue to be at the top of its agenda. We must understand the causes of the disease before we can find a cure. While our long term research continues, we decided it was time to widen our research by trying to obtain a deeper understanding of how one particular organ might be involved in causing a particularly distressing symptom endured by many people with CFS/ME – namely pain. To find therapies to relieve pain could change lives.”
You can find out more about the CFS Research Foundation and its work by visiting its website