How Neurons Multi Task

Today's post from news-medical.net (see link below) talks about the multi-tasking abilities of one of the neurons (nerve cells) responsible for the sort of neurological functions that people with neuropathy are very well aware of. Human beings have billions of neurons but discovering that some of them can perform more than one function and studying these may reveal some of the complexities which lead to nerve damage and its results. It all seems very far removed from the painful, tingling symptoms that you may suffer from but it shows how detailed modern research is and may lead to a breakthrough in understanding of how neurons work. That knowledge eventually leads to breakthroughs in treatment.

U-M researchers show how neurons perform multiple functions
Published on November 6, 2014 

Researchers at the University of Michigan have shown how a single neuron can perform multiple functions in a model organism, illuminating for the first time this fundamental biological mechanism and shedding light on the human brain.

Investigators in the lab of Shawn Xu at the Life Sciences Institute found that a neuron in C. elegans, a tiny worm with a simple nervous system used as a model for studying sensation, movement and other neurological function, regulates both the speed and direction in which the worm moves. The individual neurons can route information through multiple downstream neural circuits, with each circuit controlling a specific behavioral output.

The findings are scheduled for online publication in the journal Cell on Nov. 6. The research is also featured on the cover.

"Understanding how the nervous system and genes lead to behavior is a fundamental question in neuroscience, and we wanted to figure out how C. elegans are able to perform a wide range of complex behaviors with their small nervous systems," Xu said.

The C. elegans nervous system contains 302 neurons.

"Scientists think that even though humans have billions of neurons, some perform multiple functions. Seeing the mechanism in worms will help to understand the human brain," Xu said.

The model neuron studied, AIY, regulates at least two distinct motor outputs: locomotion speed and direction-switch. AIY interacts with two circuits, one that is inhibitory and controls changes in the direction of the worm's movement, and a second that is excitatory and controls speed.

"It's important to note that these two circuits have connections with other neurons and may cross-talk with each other," Xu said. "Neuronal control of behavior is very complex."

Source:
University of Michigan

http://www.news-medical.net/news/20141106/U-M-researchers-show-how-neurons-perform-multiple-functions.aspx

How To Turn Neuropathy Lemons Into Lemonade!

Today's short post from tellingknots.com (see link below) comes from a blog written by a lady living in Jerusalem, Israel and is a humorous look at an incident in her daily life with neuropathy. If only more of us could be able to bring a smile to other people's faces in such a way, living with neuropathy may not be such a daily grind.

Lemonade: A neuropathy kitchen ballet in one act 
Telling Knots 30th July 2014

Hot day in July, time to make lemonade. Sugar, lemon juice and a little hot water are already mixed up in the bottle. All that remains is to pour the cold water through the funnel and fill the bottle. Pouring from a Brita water-filter pitcher into the funnel. Left hand somehow loses grip on the funnel. Right hand somehow flips off the top of the Brita pitcher. Water, water of blessing, water of life, cold wet water flows over the kitchen counter, over me, onto the floor, onto the other counter, onto the floor of the next room.

I had no idea how much area a liter of water can actually cover.

Then comes the cleaning up part. My balance isn’t great today, but I need to make a choice: toss the floor cloth down and sort of skate around on it to sop up the water? Get down on my hands and knees (which means getting up again) to clean it up?

I start with the skating method, lose my balance (not a huge surprise) and fall over into the water. Nice and refreshing on this hot summer’s day. Since I’m down there anyway, I stay down and finish the clean up. Finally I crawl over to the bed and use it to hoist myself back up.

Cool – I did floor exercises today.
(This post appeared in almost identical form on my Facebook page. It made people smile, so I decided to post it here, too.)

http://www.tellingknots.com/archives/3490

Just How Effective Are Opioids In Neuropathy Treatment

Today's post from medpagetoday.com (see link below) is an interesting review of a large-scale study of the effects of opioid treatment on people with neuropathy. It concludes that opioid use has its limitations but there is no evidence that it is either, over-prescribed by doctors, or abused by patients. This removes it immediately from the current hysteria concerning opioid medication and recognises that people with severe neuropathy have very few options. As a result, it calls for new medication development, not to remove the 'evils' of opioids but to provide a better alternative for patients in chronic pain. Definitely worth a read though maybe a little disheartening for people who rely on opioids to dampen their symptoms, having already exhausted all other options.

Long-Term Opioids May Not Help in Polyneuropathy
by Kristin Jenkins Contributing Writer, MedPage Today May 23, 2017 Reviewed by Henry A. Solomon, MD, FACP, FACC Clinical Associate Professor, Weill Cornell Medical College and Dorothy Caputo, MA, BSN, RN, Nurse Planner last updated 05.23.2017
 
Action Points

Long-term opioid therapy among patients with polyneuropathy appears to increase the risk of adverse outcomes without benefiting functional status, according to a retrospective population-based study.
Note the data agree with prior studies showing opioid use disorders are more prevalent among those receiving long-term opioid therapy, but did not indicate that long-term opioid therapy significantly increases mortality among patients with polyneuropathy as it does among broader populations of patients reported elsewhere.


Long-term opioid therapy in patients with polyneuropathy appears to increase the risk of adverse outcomes without benefiting functional status, researchers said.

Data from a retrospective, population-based cohort study showed that 18.8% of 2,892 patients with polyneuropathy received opioids continuously for at least 90 days compared to 5.4% of 14,435 controls. They were also more likely to rely on gait aids and have difficulty climbing stairs (adjusted HR 1.7) and experience depression (adjusted HR 1.53), opioid dependence (aHR 2.85), and opioid overdose (aHR 5.12) compared to controls, Christopher J. Klein, MD, of the Mayo Clinic in Rochester, Minn, and colleagues reported online in JAMA Neurology.

"By showing that polyneuropathy increases the risk of long-term opioid therapy and that long-term opioid therapy is not associated with improved functional status but is associated with adverse outcomes, this study provides useful information to counsel patients with polyneuropathy who are considering or are already receiving opioid therapy," the researchers said. "Furthermore, it provides evidence that could influence treatment guidelines and health policy."

The researchers also reported that a diagnosis of opioid abuse among patients with polyneuropathy who were taking opioids for any length of time was observed in less than 2% of patients and that there was no significant association with overall mortality. However, there was a 7.2% rate of opioid dependence and a 2.6% rate of opioid overdose, they pointed out, adding that this "underscores that abuse and dependence are not synonymous."

"Thus, our results agree with those of prior studies citing that opioid use disorders are more prevalent among those receiving long-term opioid therapy, but we did not find that long-term opioid therapy significantly increases mortality among patients with polyneuropathy as it does among broader populations of patients reported elsewhere.

Importantly, the study also showed that neurologists and pain physicians were only prescribing long-term opioid therapy in a small percentage of patients, a finding consistent with national trends, the researchers noted. "Therefore, it is likely that discussing potential benefits, as well as adverse outcomes, of long-term opioid therapy will fall to the primary care clinician," Klein and colleagues said.

For the study, the Rochester Epidemiology Project (REP) database was searched for prescriptions given to patients with polyneuropathy and for those given to controls in ambulatory practice. All data came from participants who resided in Olmsted County from Jan. 1, 2006, to Dec. 31, 2010 and were reported previously. The latest follow-up ended Nov. 25, 2016.

Patients with polyneuropathy receiving 90 days or more of opioid therapy were more likely to be female (57%) than those receiving short-term opioid therapy (P<0 .001="" 46="" 69="" age="" also="" although="" between="" br="" common="" commonly="" differences="" documented="" for="" groups="" in="" indication="" long-term="" median="" most="" musculoskeletal="" no="" of="" opioid="" oxycodone="" p="0.13)." pain="" patients="" polyneuropathy="" prescribed="" prescribing="" significant="" similar="" starting="" the="" therapy.="" there="" trends="" two="" versus="" were="" with="" xycontin="" years="">
Although rates of lower limb complications were comparable between the two groups, patients with polyneuropathy used non-opioid analgesics more often than controls.

In an accompanying editorial, Nora Volkow, MD, of the National Institute on Drug Abuse, and Walter Koroshetz, MD, of the National Institute of Neurologic Disorders and Stroke, noted that opioids in this study were prescribed more often for treatment of non-neuropathic indications. However, this finding doesn't change the evidence behind current guidelines advising against opioids as first-line treatment in most cases of neuropathic pain because of long-term safety concerns, they said.

The study also highlights the limited alternatives for managing chronic pain, and the urgent need to develop new medications, the editorialists said. Recent work in animal models demonstrate that innovative opioid peptides and biased opioid agonists may provide equivalent pain relief with less tolerance and fewer adverse effects while success with biologics for inhibiting pain at the its source may shift the focus to prevention, they said.

"In the meantime, structural changes in the healthcare system, including training of physicians in the screening and management of pain, as well as coverage by insurance of comprehensive pain management programs, are needed to ensure that patients receive the most effective treatments for their chronic pain conditions," Volkow and Koroshetz said.

Limitations of the study include the fact that it was based on prescription data without confirmation that prescriptions were filled or taken as intended.


This study was funded by the Mayo Foundation for Medical Education and Research, Mayo Clinic Center for Individualized Medicine, and the National Institutes of Health (NIH). The study authors disclosed no conflicts of interest. The editorialists disclosed no funding or conflicts of interest.

https://www.medpagetoday.com/neurology/painmanagement/65497

How To Change Your Lifestyle To Help Neuropathy Pain

Today's post from neuropathydr.com (see link below) is a 'self help' post designed to make you re-evaluate any daily habits you might have that may influence the amount of pain and discomfort you may have. Now nobody is suggesting that your pain isn't real and that your neuropathy symptoms can be cured by simply changing your attitude towards them. If there is any gain to be made by following the suggestions in this article, it's that you may be able to reduce the strength of the symptoms by adjusting certain habits you have and equally adjusting your lifestyle to make choices that will benefit you. Reading the article will probably make you wonder if, indeed, there are a few things that you could do better. Must be worth a try!

Lifestyle Change for Chronic Pain: How Do You Do It?
Posted by Editor on October 16, 2014

Knowing the Benefits Isn’t Enough to Elicit Lifestyle Change for Chronic Pain… So What Is?
By Carol Jeffrey

The World Health Organization (WHO) has defined “health” as not merely the absence of disease but as a “state of complete physical, mental, and social well-being.” That’s a rather rigid utopian view, however; an increasing amount of research is showing that patients fare much better when a multifactorial treatment approach is used to combat disease. In sharing my experience, I will expound on the physical, mental and social factors associated with making a healthy lifestyle change for chronic pain in our mindset and diets.

REFRAMING

Whenever I heard the word “diet” my thoughts went directly to lack of comfort food, deprivation and fear of failure, but these were misguided thoughts. This reminded me of a study which showed that one’s mindset could alter a person’s visual acuity. “Because the letters get progressively smaller on successive lines, participants expected only to be able to read the first few lines on a traditional eye chart. When the participants viewed a shifted and reversed chart, they were able to see letters in which they previously couldn’t identify. This showed that mindset manipulation can counteract physiological limits imposed on vision.” (Believing Is Seeing…, Langer E, Dept. of Psych, Harvard.) Shifting my view allowed me to see not only the gains of feeling better from eating a well balanced diet, but the losses that I had incurred from making poor nutritional choices. I used this information to reframe the word “diet” into new thoughts of nutrition, health, and well-being. The success of healthy eating depends not only on our mindset, but understanding how the mind-body connection affects our eating habits.

MIND-BODY CONNECTION

Let me briefly explain what the mind-body connection is about. It’s important to “be present to one’s self” in a way that fosters self-awareness and acceptance…this allows us to change. I used to work in a physician’s office, and I usually scarfed down my lunch between patients and phone calls. This ended up being a mindless task of squelching my hunger pains with food devoid of nutritional value, leaving me lethargic by the end of the day. Often, after the long commute home I would be too tired to cook, so I’d stop for fast food, only to ingest more food devoid of nourishment. My mindlessness carried on into the late evening when I would find myself absent mindedly munching on snacks as I relaxed. My poor eating habits extended Into my weekend, not due to lack of time but due to the social pressures of eating out with friends…where healthy food choices were limited. I was not psychologically present while eating nor mindful of my food choices.

BEING MINDFUL

Unfortunately, prolonged psychological stress, years of detrimental lifestyle, and poor eating habits had greatly contributed to my poor health. This eventually led to physical disability, unemployment, and the inability to do many of the things that I once loved. I was finally ready to break this cycle, and needed to become aware of the circumstances which led to my poor lifestyle choices and eating habits. I began paying attention to my internal dialogue (i.e., I don’t want to let them down, I’m expected to “…” I know I should choose the salad but I’ve had a difficult day so I deserve to eat what I want. I’m feeling anxious…Ice cream is always soothing. I’m not overweight so it isn’t like I’m pigging out). When I quit accepting my excuses, I became more mindful of my thoughts and choices, and discovered that I had much more control over my health than I had previously realized.

MISGUIDED DEPENDENCE

By this time I had reframed my thoughts about diet, understood the mind-body connection, was mindful of my choices, realized I had control over many aspects of my health. Yet, I was still depending upon my physician to heal me, or at least make me feel better with pharmaceuticals. Which leads me to the next issue I needed to address.

ENCULTURED

I had been encultured into believing that it was my physician’s job to heal, and the pharmaceutical company’s job to relieve my pain. If I failed to get better, it wasn’t my fault, or was it? “In 2012, the pharmaceutical industry spent more than $24 billion on marketing to influence physicians, and over $3 billion in advertising to consumers.” (Cegedim Strategic Data) Traditionally, very few non-M.D. or non-D.O. practitioner appointments or treatments have been covered by insurance. These practices enculture and direct us into accepting the limitations that Western medicine on its own has to offer. It also moves us further away from more natural treatments and the means of self-healing. The strategies used by insurance and BigPharm are contrary to obtaining optimal health, since integrative medicine has shown to be most effective in managing disease. Now that I understood why I was so dependent on my physician, what could I do about it?

SELF-HEALING BEHAVIOR

Fabrega Horacio, Jr. wrote an interesting article (Sickness and Healing and the Evolutionary Foundations of Mind and Minding) which shows how non-human primates (i.e., chimpanzees) are reliant on self-healing behaviors that not only remedy illness but prevent many illnesses, through social functions and diet. I had been relying on my doctors to heal me and a pill to ease my pain, instead of taking personal responsibility, and using preventive and self-healing behaviors…like the chimps. I understood that eating a healthy diet along with living a well balanced life was essential for pain reduction, but I still wasn’t motivated to change.

MOTIVATION

Pain is fundamentally unpleasant, and is designed to protect by promoting motivation and learning. I was now enlightened to the fact that my lifestyle and poor diet were fueling the raging fire within my damaged nerves. However, like many others, I have an aversion to change and even though the reward of pain relief should have provided enough motivation to elicit change…it wasn’t. It is said that most people are motivated by one of two things, “inspiration” or (in my situation) “desperation.” My chronic pain was extremely difficult to handle, but it was the lack of being able to engage in life that made me desperate enough to make changes. My attitude and desire toward change had evolved from I wish, I want, to I must. My reason to change had now been clarified and my need for change had transformed from I should, I intend, to “I am” making a lifestyle change for chronic pain. However, what would keep me motivated? This is where goal setting came into play.

GOAL SETTING

“Remember the word ‘SMART.’ Successful goals are Specific, Measurable, Achievable, Realistic and Timely.” This is based on research conducted by Dr. Edwin A. Lock of the University of Maryland.
Specific: I asked myself what my life was currently missing and what I wanted in my life. Connecting life goals to specific health-related goals clarified the reason I wished to be well and what I would do once my health improved. Thereby answering the questions what, where and why.
Measurable: I then determined how I would accomplish and measure my success. (i.e. Add three new organic, non processed foods to my grocery cart each week. Actively work with my doctor on natural pain relief techniques at each visit. Exercise as tolerated but do it two times a week. Do one thing each day to prepare me for a less stressful career.)
Achievable: I then asked myself if I had the skill, tools, and resources needed. (i.e. I researched YouTube, and I borrowed books from the library to learn about natural pain relief techniques, meditation, healthy diet, etc., and sought out physicians who practiced integrative medicine.)
Realistic: To avoid frustration, I focused on honest goals that I believed were obtainable. There was plenty of evidence to show that changing my lifestyle and eating a healthy diet would decrease my pain and improve my quality of life. It was realistic to train for a less stressful career. Total health and no pain was impossible; however, controlling diet, decreasing narcotic use and learning healthier ways of dealing with pain were within my control.
Timely: I gave myself one year to turn my health around and begin a new career. This goal challenged me but it was possible. I set daily, weekly and monthly goals which were frequently reviewed and revised as necessary.

There aren’t any shortcuts to change, including a lifestyle change for chronic pain. I had to reframe my negative thoughts, become more self-aware and mindful of my decisions, accept personal responsibility for my health, incorporate self-healing behavior, determine what would motivate me, set and commit to my goals.

The rewards of an improved quality of life came by default as I achieved my goals. I have not yet reached the utopia of health that the WHO refers to, but I have significantly decreased my pain level and again live an active and meaningful life. This article reflects my journey, but more importantly, I hope it encourages and guides you to make your own changes so that you too may live life to its fullest.

What is your experience with lifestyle change for chronic pain? Talk with us at our Facebook page.

http://neuropathydr.com/lifestyle-change-for-chronic-pain/

How Can Marijuana Help Neuropathy Sufferers

Depending on the laws and cultural attitudes within your own area, today's video about the usefulness of marijuana for pain problems (especially neuropathy) may or may not be relevant for you. Unfortunately, reactions to marijuana as a medical tool range from the hysterical and mistrusting to being totally convinced of its efficacy; much of the former is based on preconceptions stemming from various governments' wars on drugs as a whole. Many neuropathy sufferers already benefit from the use of medical marijuana but if you're a non-smoker, or an ex-smoker, you may find it much more difficult. The video suggests using vapourised marijuana, to avoid the worst lung problems but this does add to the expense, as well as being somewhat tricky to use. You also have to be able to accept getting high, which contrary to popular myth is not for everyone! Nevertheless, this video is a useful explanation of how marijuana works medically.

How Good Is Carbamazepine For Neuropathic Pain

Today's post comes from summaries.cochrane.org (see link below) and is part of the Cochrane Collaboration: Cochrane Medical Summaries data banks. In this study, they look at Carbamazepine to see how effective it is as a neuropathic pain treatment and the conclusions may alarm some people because in their view, there's very little evidence to support the hype over Carbamazepine (Tegretol, Equetro). It is an anti-convulsant (anti epilepsy) drug that is more and more frequently used to treat severe neuropathic pain but the results are anything but conclusive. This article goes on to explain why the Cochrane people are equally doubtful as to its efficiency in controlling nerve pain.

Carbamazepine for chronic neuropathic pain and fibromyalgia in adults  Wiffen PJ, Derry S, Moore R, Kalso EA
Published Online:10 April 2014
Neuropathic pain is pain coming from damaged nerves. It is different from pain messages carried along healthy nerves from damaged tissue (a fall, or cut, or arthritic knee). Neuropathic pain is treated by different medicines than pain from damaged tissue. Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people. Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is lacking, but fibromyalgia can respond to the same medicines as neuropathic pain.

Carbamazepine was developed to treat epilepsy, but it is now used to treat various forms of chronic pain. We performed searches (up to February 2014) to look for clinical trials where carbamazepine was used to treat neuropathic pain or fibromyalgia. We found 10 studies involving 418 people involved in testing carbamazepine. Studies were not generally of very good quality. Most were very small, as well as of short duration. Studies lasting only one or two weeks are unhelpful when pain can last for years.

There was not enough good quality evidence to say how well carbamazepine worked in any neuropathic pain condition. Pooling four small studies showed that it was better than placebo, but the result cannot be relied upon. There was not enough information from these studies to make any reliable comment on adverse events or harm.

Carbamazepine is probably helpful for some people with chronic neuropathic pain. It is not possible to know beforehand who will benefit and who will not. 


Abstract

Background:
This is an update of a Cochrane review entitled 'Carbamazepine for acute and chronic pain in adults' published in Issue 1, 2011. Some antiepileptic medicines have a place in the treatment of neuropathic pain (pain due to nerve damage). This updated review considers the treatment of chronic neuropathic pain and fibromyalgia only, and adds no new studies. The update uses higher standards of evidence than the earlier review, which results in the exclusion of five studies that were previously included.
Objectives:
To assess the analgesic efficacy of carbamazepine in the treatment of chronic neuropathic pain and fibromyalgia, and to evaluate adverse events reported in the studies.
Search strategy:
We searched for relevant studies in MEDLINE, EMBASE and CENTRAL up to February 2014. Additional studies were sought from clinical trials databases, and the reference list of retrieved articles and reviews.
Selection criteria:
Randomised, double blind, active or placebo controlled trials (RCTs) investigating the use of carbamazepine (any dose, by any route, and for at least two weeks' duration) for the treatment of chronic neuropathic pain or fibromyalgia, with at least 10 participants per treatment group. Participants were adults aged 18 and over.
Data collection and analysis:
Two study authors independently extracted data on efficacy, adverse events, and withdrawals, and examined issues of study quality. Numbers needed to treat for an additional beneficial effect (NNT) or harmful effect (NNH) with 95% confidence intervals (CIs) were calculated from dichotomous data.

We performed analysis using three tiers of evidence. First tier evidence derived from data meeting current best standards and subject to minimal risk of bias (outcome equivalent to substantial pain intensity reduction, intention-to-treat analysis without imputation for dropouts, at least 200 participants in the comparison, at least 8 weeks' duration, parallel design), second tier from data that failed to meet one or more of these criteria and were considered at some risk of bias but with adequate numbers in the comparison, and third tier from data involving small numbers of participants that was considered very likely to be biased or used outcomes of limited clinical utility, or both.
Main results:
Ten included studies (11 publications) enrolled 480 participants with trigeminal neuralgia, diabetic neuropathy, and post stroke pain. Nine studies used a cross-over design, and one a parallel group design. Most of the studies were of short duration, lasting four weeks or less.

No study provided first or second tier evidence for an efficacy outcome. Using third tier evidence, carbamazepine generally provided better pain relief than placebo in the three conditions studied, with some indication of pain improvement over mainly the short term, but with poorly defined outcomes, incomplete reporting, and in small numbers of participants. There were too few data in studies comparing carbamazepine with active comparators to draw any conclusions.

In four studies 65% (113/173) of participants experienced at least one adverse event with carbamazepine, and 27% (47/173) with placebo; for every five participants treated, two experienced an adverse event who would not have done so with placebo. In eight studies 3% (8/268) of participants withdrew due to adverse events with carbamazepine, and none (0/255) with placebo. Serious adverse events were not reported consistently; rashes were associated with carbamazepine. Four deaths occurred in patients on carbamazepine, with no obvious drug association.
Authors' conclusions:
Carbamazepine is probably effective in some people with chronic neuropathic pain, but with caveats. No trial was longer than four weeks, had good reporting quality, nor used outcomes equivalent to substantial clinical benefit. In these circumstances, caution is needed in interpretation, and meaningful comparison with other interventions is not possible.
This record should be cited as:
Wiffen PJ, Derry S, Moore R, Kalso EA. Carbamazepine for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD005451. DOI: 10.1002/14651858.CD005451.pub3
Assessed as up to date:
7 February 2014 - See more at: http://summaries.cochrane.org/CD005451/carbamazepine-for-chronic-neuropathic-pain-and-fibromyalgia-in-adults#sthash.HwZTAeUu.dpuf

http://summaries.cochrane.org/CD005451/carbamazepine-for-chronic-neuropathic-pain-and-fibromyalgia-in-adults

How Keeping Axons Alive May Benefit Neuropathy Patients

Today's post from futurity.org (see link below) tries to explain the new findings regarding the death of nerve cells and nerve axons and how this may eventually lead to significantly better treatments for neuropathy patients. Another post here a few days ago (scroll down to May 3rd) announced the results of this research but as with many articles like this, many people might have found it difficult to follow. This article takes care to explain the science in words we can all understand and for that reason deserves a gold star from this blog. Worth a read - they may be onto something here.

Can saving axons keep nerves alive?
Washington University in St. Louis rightOriginal Study Posted by Caroline Arbanas-WUSTL on May 5, 2015

You are free to share this article under the Attribution 4.0 International license.

New research highlights how nerves—whether harmed by disease or traumatic injury—start to die.

The discovery unveils new targets for developing drugs to slow or halt peripheral neuropathies and devastating neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS).

Peripheral neuropathy damages nerves in the body’s extremities and can cause unrelenting pain, stinging, burning, itching, and sensitivity to touch. The condition is commonly associated with diabetes or develops as a side effect of chemotherapy.

Nerve cells talk to each other by transmitting signals along communication cables called axons. Such signals underlie vital activities, such as thinking and memory, movement, and language.

As part of a study published in Science, the researchers showed they could prevent axons from dying, a finding that suggests therapies could be developed to counteract the withering away of nerve axons.

“We have uncovered new details that let us piece together a major pathway involved in axon degeneration,” says senior author Jeffrey Milbrandt, professor in, and head of, the genetics department at Washington University School of Medicine in St. Louis.

“This is an important step forward and helps to identify new therapeutic targets. That we were able to block axon degeneration in the lab also gives us hope that drugs could be developed to treat patients suffering from a variety of neurological conditions.” 

Energy supply

A common thread among many neurological disorders and traumatic nerve injuries is the degeneration of axons, which interrupts nerve signaling and prevents nerves from communicating with one another. Axon degeneration is thought to be an initiating event in many of these disorders. In fact, an unhealthy axon is known to trigger its own death, and researchers are keenly interested in understanding how this happens.

Working in cell cultures, fruit flies, and mice, Milbrandt and coauthor Aaron DiAntonio, professor of developmental biology, and their colleagues showed that a protein already known to be involved in axon degeneration acts like a switch to trigger axon degeneration after an injury.

Moreover, they found that this protein, once unleashed, causes a rapid decline in the energy supply within axons. Within minutes after the protein—called SARM1—is activated in neurons, a massive loss of nicotinamide adenine dinucleotide (NAD), a chemical central to a cell’s energy production, occurs within the axon.

“When a nerve is diseased or injured, SARM1 becomes more active, initiating a series of events that quickly causes an energetic catastrophe within the axon, and the axon undergoes self-destruction,” says first author Josiah Gerdts, an MD/PhD student in Milbrandt’s laboratory.
Keeping axons alive

Working in neurons in which SARM1 was activated, the researchers showed they could completely block axon degeneration and neuron cell death by supplementing the cells with a precursor to NAD, a chemical called nicotinamide riboside. The neurons were able to use nicotinamide riboside to keep the axons energized and healthy.

Nicotinamide riboside has been linked in animal studies to good health and longevity, but its benefits have not been shown in people. The researchers say much more research is needed to know whether the chemical could slow or halt axon degeneration in the body.

“We are encouraged by the findings and think that identifying a class of drugs that block SARM1 activity has therapeutic potential in neurological disorders,” Milbrandt says. “The molecular details this pathway provides give us a number of therapeutic avenues to attack.”

The National Institutes of Health (NIH) and Vertex Pharmaceuticals supported the work.

Source: Washington University in St. Louis 

http://www.futurity.org/nerves-neuropathy-axons-914382/

How To Make Your Daily Nerve Pain More Bearable

Today's post from mnn.com (see link below) is another 'self-help' post designed to reduce the impact of your symptoms on your daily life and you may find it interesting, depending on the level of cynicism you're feeling today. At least it doesn't resort to clichés based on mindfulness, or yoga, or meditation (all of which may be useful for many people) and any list of self-improvement tasks that includes, swearing and sex, gets my vote. Give some a try - you never know and it may reduce your dependence on chemical pill treatments.

10 everyday activities that can reduce pain, according to science
Starre Vartan December 2, 2015,

Most of us have pain some of the time; some of us have pain most of the time. Whether your pain is temporary or chronic, it doesn't matter: Pain is the worst. Not only is it physically uncomfortable, it's overwhelming, taking over other feelings, interests or desires. Strong pain is debilitating, and for some of us, it prevents basic activities either directly or secondarily. For example, nausea frequently accompanies pain, making meals impossible. (I know when I have a bad headache or aching ankle, I can't eat).

Of course, there are a raft of pharmaceutical options for temporary pain and medical procedures for chronic pain, but some are safer than others and some of us like to avoid taking pills as much as possible. Wherever you are on the pain spectrum, doing any of the things below definitely can't hurt and may very well get you some relief — and we have the science to back up that claim.

Swear: Letting a few choice words fly can reduce feelings of pain in most people, according to a 2009 study. Researchers from Keele University in the U.K. found: "Swearing increased pain tolerance, increased heart rate and decreased perceived pain compared with not swearing. However, swearing did not increase pain tolerance in males with a tendency to catastrophise. The observed pain-lessening (hypoalgesic) effect may occur because swearing inducesa fight-or-flight response and nullifies the link between fear of pain and pain perception."

Hug yourself: An interesting 2011 study in the journal Pain found that in 20 subjects who were given painful electric shocks, pain was reduced when arms were crossed in front of the body. Like studies that have helped patients with phantom limb pain who use mirrors to confuse or reorient the brain's understanding of the body in space, arm crossing "...impairs this ability to localize tactile stimuli," according to the study, meaning that pain is lessened due to the brain's becoming confused about its origins.

Listen to music: A number of studies have shown that music reduces pain after surgery of various kinds, from gynecologic to major abdominal. And it's even been found to be effective for terminally ill patients with pain.

Sing: Feel free to sing along if you are already listening to music. In a study that compared those who sang versus those who just listened to music and relaxed, those who belted out a few reported better moods and less pain.

Get a hug: Since hugging has been proven to lower cortisol (the stress hormone) and relax the body, it can have some temporary mitigation for pain — as can gentle stroking or other affectionate touch between two people who are both comfortable with the action. A good hug should last 20 seconds for best effect (again, as long as both parties are comfortable with that).

Rub the area around the injury: This floods the brain with stimuli from the area that has been hurt, reducing the brain's ability to focus on the pain's origin area. (This works particularly well for bumped shins and is my go-to move!)

Dance: Dancing in time with others releases endorphins, which can up one's pain tolerance, as found by testing Brazilian dancers who engaged in synchronized and non-synchronized dancing. Those who danced with others released more endorphins, probably due to the social bonding aspect of dancing with others — though you get some positive effect from moving to music too. "Both synchronisation and exertion had independent effects on these measures, so moving energetically or moving in synchrony can both make you feel closer to others when you are dancing," Bronwyn Tarr told Phys.org. "But combining high energy and synchrony had the greatest effects – which might explain why people love to Flashmob!"

Sex: Sex can be mighty distracting, which can help with pain, but it also gets endorphins flowing around the body, making it better for reducing some aches (like migraines) than painkillers. According to researchers: "Sex can abort migraine and cluster headache attacks, and sexual activity is used by some patients as acute headache treatment." Don't have a partner? No worries; the same effects in pain relief can be achieved by reaching climax solo.

Laugh at a comedy show: Watching silly movies and laughing can genuinely make you feel better if you are experiencing pain. According to one study from the 1980s: "Movies were viewed by two groups (humor and non-humor) and differences between groups were noted on measures of perceived pain and affect. Humor is shown to provide significant benefits." And more recent studies back up those older findings.

Pain can ruin your day. But the alternative is a feeling-free life (some people are born without pain receptors) — which is a dangerous, life-threatening condition. So it's worth keeping in mind that pain is part of being human.

http://www.mnn.com/health/fitness-well-being/blogs/everyday-activities-can-reduce-pain-according-science