TBI and Chronic Allostatic Overload or Stress Increase Pain

Newswise — Traumatic brain injury (TBI) is a leading cause of death and disability. Post-injury distress is common, with many individuals experiencing chronic anxiety and depressive symptoms as well as chronic pain. In this collection of articles in the journal NeuroRehabilitation, experts report on findings that shed light on the relationship between stress and pain following a TBI and implications for rehabilitation.

"The brain, in concert with the body's systems, orchestrates the response to stress, the goal being to reduce uncertainty and ensure existence," explained guest editor Gary Goldberg, BASc, MD, Department of Physical Medicine and Rehabilitation, Medical College of Virginia / Virginia Commonwealth University Healthcare System, Richmond, VA. "This adaptive response to stress is called 'allostasis.' A brain injury increases the likelihood of chronic allostatic overload, or chronic stress, in some patients, making them more prone to a variety of stress-related physical ailments, including chronic pain and posttraumatic stress syndrome."

"As illustrated by these two studies, the whole question of how best to treat persisting symptoms associated with TBI may well have less to do with the specific details of the physical injury itself, and more to do with multiple other environmental and intrinsic factors influencing how the injured person is coping with the overall experiential impact and stress precipitated by the injury and its complex real-life repercussions," noted Dr. Goldberg. "Research into assisting individuals in the development of resilience and the capacity for 'letting go' of maladaptive beliefs may lead to significant improvements in clinical outcomes in individuals who struggle with the negative impact of chronic stress."

"What is required is an optimal integration of insights obtained through conventional functional neuroscience--for example, with respect to neuropsychopharmacology and the operation of functional brain networks--and insights obtained through a relational, whole-person perspective that recognizes and fully honors and engages the subjective being, personality, and social context of the person whose existential struggles we as healthcare professionals are obligated and entrusted to help mitigate," he concluded.

 

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Other Categories:

• depression

• traumatic brain injury