Pain as the work of brain

Nick Rawlins, pro-vice-chancellor and professor of psychology at Oxford

By Yoon Ja-young

Prof. Nick Rawlins, of the University of Oxford, believes pain comes not only from the experience of the pain itself but also from the anticipation. The neuroscientist, who is also pro-vice-chancellor of the prestigious school, was speaking at a special lecture on pain as a mind-body interaction, for University of Oxford alumni in Seoul on Monday.

Rawlins, who has led research in the neural basis of memory, brain degeneration, pain, schizophrenia and anxiety, explained how researchers came to understand that the brain works in modules. He cited the case of Phineas Gage, a railroad construction foreman who suffered an accident involving dynamite in 1848 in which a steel rod was blown through his left cheek and into his skull. He miraculously survived and did not even lose consciousness. However, his personality showed changes after the event. Prior to the incident, he was known as a polite, reliable, capable, efficient, and shrewd person. After the accident, he became foul-mouthed, unreliable, capricious, obstinate, and disastrous at planning. The incident demonstrated the modularity of the brain, but had limitations as a sample case.

“The psychological changes were essentially anecdotal ... We can only guess the extent of his brain damage,” Rawlins said. “We don’t really know what was really going on in his brain.”

He cited another important incident in neuroscience in 1953 in which a young man who had suffered epilepsy and seizures after a bicycle accident at the age of nine had surgery to remove part of his brain. The epilepsy was controlled but, “Something had gone terribly wrong,” the professor said. The patient lost his ability to remember new facts, although he could remember his earlier life as a child. His doctor had to reintroduce himself to his patient each time they met.

With the later development of magnetic resonance imaging (MRI) and further research, it was discovered which part of the brain was responsible for memory loss. Neuroscientists now use MRIs to reveal more secrets of the brain, based on the realization that when a certain part of the brain is active, it needs more energy. When that happens, the professor said, the blood flow to that part of the brain increases.

The development of neuroscience is also revealing secrets of chronic pain. In addition to the pain itself, a constant fear of pain sometimes leads to depression and anxiety, worsening the condition, Rawlins said. As an extreme example of pain increasing with anxiety, he cited a man who experienced severe pain when he saw a 15-centimeter nail had penetrated his shoe. At the emergency department, however, doctors found the nail had passed between the man’s toes, without harming him.

Rawlins said that thanks to the development of imaging technologies, researchers have discovered a pain circuit in the brain where emotion, perception and learning are based. Their next focus is on developing new pharmacological or psychological treatments to cure chronic pain, which, he said, is the mind-body interaction.