Chronic pain causes epigenetic changes in the brain and immune system

This 2015 Canadian rodent study by McGill researchers found:

“The critical involvement of DNA methylation in chronic pain. We show that in the PFC [prefrontal cortex], a brain region strongly implicated in chronic pain, a stunning number of promoters [control gene expression] are differentially methylated 9 months after injury. These changes are distant both in time and space from the original injury.

The changes in DNA methylation are highly organized in functional pathways that have been implicated in pain such as dysregulation of dopaminergic, glutamatergic, opioid and serotoninergic systems and important signaling and inflammatory pathways.

Genome-wide DNA methylation modifications of T cells [circulating white blood cells that control immune response] are also associated with nerve injury.

Most of the promoters (72%) identified as differentially methylated in T cells after nerve injury were also affected in the brain. While the methylation profiles in some of these modules were affected in the same direction in the brain and the T cells, others went in opposite direction. This is consistent with the idea that the brain and the immune system play different roles in chronic pain.

These data suggest that:

  • Persistent pain is associated with broad and highly organized organism-wide changes in DNA methylation, including two critical biological systems: the central nervous and immune systems.
  • This work also provides a possible mechanistic explanation for commonly observed comorbidities observed in chronic pain (i.e anxiety, depression).
  • Finally, the sheer magnitude of the impact of chronic pain, particularly in the prefrontal cortex, illustrates the profound impact that living with chronic pain exerts on an individual.”

The news coverage focused on how the study’s findings may lead to non-invasive DNA methylation measurements of chronic pain as well as treatments of the effects. I’d argue that the researchers’ concluding statement of the Discussion section deserved the most focus:

“Beyond the example of chronic pain, the robust and highly organized DNA methylation changes seen here in response to nerve injury provides some of the strongest evidence to date that experience effects DNA methylation landscapes at large distances in time and space.”

The study provided “some of the strongest evidence to date” that experiences caused widespread, long-lasting epigenetic changes. Given experiences’ etiologic functions, research with working hypotheses that experiences may also reverse epigenetic changes should be green-lighted.

“DNA methylation landscapes at large distances in time and space” warrant systematic examination of how experiential epigenetic changes during early life may be reversed by experiential therapies later in life. In the current year, there’s sufficient evidence for modifying research goals to primarily address causes, not just effects. “Overlapping signatures of chronic pain in the DNA methylation landscape of prefrontal cortex and peripheral T cells”

Outward expressions of inner truth

“Truth needs no defense except when that truth is more than the system can integrate; then it requires defenses.

Our merciful brain has found back-up ways to protect us. It keeps the truth from us even when we go on searching for the truth.

After patients have deep feelings they come up with many truths about their lives. It is buried and defended along with the pain. Thus no one has to give anyone insights; they are already there just waiting for the exit.” “The Act-out and More”

Epigenetics research that was designed to fall one step short of wonderful

This 2015 Edinburgh rodent study found:

“In utero exposure of rats to the analgesics indomethacin or acetaminophen, both of which target PG [prostaglandin] pathways, alters fetal germ cell number and development in both male and female fetuses. This results in modest but detrimental effects on F1 [children] female, but not F1 male, fertility in adulthood.

Fetal (F1) exposure of rats to either analgesic resulted in an effect in the second generation (F2 grand-daughters) that manifested as reduced ovarian size and markedly reduced follicle number in females but with evidence of increased follicle activation. The impact on F2 fertility (which was not studied) is unclear.

Our analgesic exposure regimen coincided with the period of chromatin/epigenetic remodelling of the (F1) fetal germ cells in both sexes, events which also occur in the human in the first trimester of pregnancy. The analgesic effects on F2 ovaries were transmitted via both paternal and maternal F1 lines.”

The limitations section showed that the rodents’ acetaminophen dosage was equivalent to a human overdose:

“We administered only a single dose of analgesics. The dose of acetaminophen which we used, resulted in blood levels of acetaminophen 2.5- to 8-fold higher than the levels reported in humans after normal therapeutic dosing (~60 mg/kg/day, divided into 4 doses) during pregnancy.”

I’m puzzled that the researchers didn’t take one more step, and design a great study. They knew what the additional effort would be, per statements such as:

“The impact on F2 fertility (which was not studied) is unclear.

The analgesic-induced reduction in fetal ovarian germ cell number was of particular concern, as the lifetime complement of oocytes is formed in utero at/around the time of birth in women and rodents.”

F3 great-grandchildren were needed to demonstrate “the impact on F2 fertility.” Testing of F3 great-grandchildren may have also provided evidence for or against transgenerational epigenetic inheritance, because those subjects’ cells would have had no direct exposure effects from analgesics.

Weren’t the researchers at the MRC Centre for Reproductive Health, The Queen’s Medical Research Institute University of Edinburgh, interested in understanding whether or not a pregnant woman who overdosed during her fetus’ early development on an analgesic available to billions of people, could potentially adversely affect not only her (F0) and her children’s (F1) and grandchildren’s (F2) reproductive health, but also her F3 great-grandchildren?

Weren’t the researchers interested in being a part of a great study, one that may have advanced science, one that may have shown whether or not epigenetic information was transmitted between generations in the absence of continued analgesic exposure? “Analgesic exposure in pregnant rats affects fetal germ cell development with inter-generational reproductive consequences”

Epigenetic memories of stress as therapeutic targets

This 2015 Swedish rodent study found:

Histone modifications induced by glucose are associated with activation of TXNIP gene [a proinflammatory gene involved in diabetic kidney disease] transcription.

Glucose-stimulated TXNIP gene expression can be

  • reversed by inhibition of histone acetyltransferase (HAT), or
  • enhanced by inhibition of histone deacetylase (HDAC).”

A 2016 Japanese commentary expounded on the study:

“Epigenetic changes accumulate as cell memory, and this epigenetic memory plays a crucial role in the long-term consequences of adult-onset diseases and aging.

The first stimulus, which might be high glucose levels or hypoxia, changes the condition of histone modification or chromosomal conformations. The changes are then memorized as epigenetic memory in the cells, which could help to maintain epigenetic status in response to the first stimulus.

Consequently, when a second stimulus occurs, cells with epigenetic memory respond to the stimulus promptly by the upregulation of downstream genes through binding transcriptional factors. The cells without epigenetic memory take longer to upregulate the expression of downstream target genes.

High glucose levels that are sustained for long periods appear to change histone modification, resulting in the prompt response of TXNIP gene upregulation. Considering that TXNIP is an important proinflammatory gene, this prompt response increases the likelihood of diabetic complications. TXNIP is reported to be augmented by high glucose levels and to promote oxidative stress.”

The study and commentary provided specific examples of the wide-ranging forms of physiological memory induced by stress. “Epigenetic regulation of the thioredoxin-interacting protein (TXNIP) gene by hyperglycemia in kidney”

Confusion may be misinterpreted as altruism and prosocial behavior

This 2015 Oxford human study of altruism found:

“Division of people into distinct social types relies on the assumption that an individual’s decisions in public-goods games can be used to accurately measure their social preferences. Specifically, that greater contributions to the cooperative project in the game reflect a greater valuing of the welfare of others, termed “prosociality.”

Individuals behave in the same way, irrespective of whether they are playing computers or humans, even when controlling for beliefs. Therefore, the previously observed differences in human behavior do not need to be explained by variation in the extent to which individuals care about fairness or the welfare of others.

Conditional cooperators, who approximately match the contributions of their groupmates, misunderstand the game. Answering the standard control questions correctly does not guarantee understanding.

We find no evidence that there is a subpopulation of players that understand the game and have prosocial motives toward human players.

These results cast doubt on certain experimental methods and demonstrate that a common assumption in behavioral economics experiments, that choices reveal motivations, will not necessarily hold.

When attempting to measure social behaviors, it is not sufficient to merely record decisions with behavioral consequences and then infer social preferences. One also needs to manipulate these consequences to test whether this affects the behavior.”

The researchers are evolutionary biologists who had made similar points in previous studies. They addressed possible confounders in the study and supporting information, and provided complete details in the appendix. For example, regarding reciprocity:

“Communication was forbidden, and we provided no feedback on earnings or the behavior of groupmates. This design prevents signaling, reciprocity, and learning and therefore minimizes any order effects.

It might also be argued that people playing with computers cannot help behaving as if they were playing with humans. Such ingraining of behavior would suggest a major problem for the way in which economic games have been used to measure social preferences. In particular, behavior would reflect everyday expectations from the real world, such as reputation concerns or the possibility of reciprocity, rather than the setup of the game and the true consequences of choices.”

Some of the news coverage missed the lead point of how:

“Economic experiments are often used to study if humans altruistically value the welfare of others.

These results cast doubt on certain experimental methods and demonstrate that a common assumption in behavioral economics experiments, that choices reveal motivations, will not necessarily hold.”

Here are several expressions of beliefs in one news coverage article where the author attempted to flip the discussion to cast doubt on the study. It was along the lines of “There’s something wrong with this study (that I haven’t thoroughly read) because [insert aspersion about sample size, etc.]” What motivates such reflexive behavior?

This study should inform social behavior studies that draw conclusions from flawed experimental designs. For example, both:

based their findings on a video game of popping balloons. Neither study properly interpreted their subjects’ decisions per the current study’s recommendation:

“When attempting to measure social behaviors, it is not sufficient to merely record decisions with behavioral consequences and then infer social preferences. One also needs to manipulate these consequences to test whether this affects the behavior.” “Conditional cooperation and confusion in public-goods experiments”

This post has somehow become a target for spammers, and I’ve disabled comments. Readers can comment on other posts and indicate that they want their comment to apply here, and I’ll re-enable comments.

Lifelong effects of stress

A 2016 commentary A trilogy of glucocorticoid receptor actions that included two 2015 French rodent studies started out:

Glucocorticoids (GCs) belong to a class of endogenous, stress-stimulated steroid hormones. They have wide ranging physiologic effects capable of impacting metabolism, immunity, development, stress, cognition, and arousal.

GCs exert their cellular effects by binding to the GC receptor (GR), one of a 48-member (in humans) nuclear receptor superfamily of ligand-activated transcription factors.”

The French studies were exceedingly technical. The first GR SUMOylation and formation of an SUMO-SMRT/NCoR1-HDAC3 repressing complex is mandatory for GC-induced IR nGRE-mediated transrepression:

“GCs acting through binding to the GR are peripheral effectors of circadian and stress-related homeostatic functions fundamental for survival.

Unveils, at the molecular level, the mechanisms that underlie the GC-induced GR direct transrepression function mediated by the evolutionary conserved inverted repeated negative response element. This knowledge paves the way to the elucidation of the functions of the GR at the submolecular levels and to the future educated design and screening of drugs, which could be devoid of undesirable debilitating effects on prolonged GC therapy.”

The companion study Glucocorticoid-induced tethered transrepression requires SUMOylation of GR and formation of a SUMO-SMRT/NCoR1-HDAC3 repressing complex stated:

“GCs have been widely used to combat inflammatory and allergic disorders. However, multiple severe undesirable side effects associated with long-term GC treatments, as well as induction of glucocorticoid resistance associated with such treatments, limit their therapeutic usefulness.”

Even when researchers study causes, they often justify their efforts in terms of outcomes that address effects. Is an etiologic advancement in science somehow unsatisfactory in and of itself?

Once in a while I get a series of personal revelations while reading scientific publications. Paradoxically, understanding aspects of myself has seldom been sufficient to address historical problems.

Thoughts are only where some of the effects of problems show up, and clarifying my understanding can – at most – tamp down these effects. The causes are elsewhere, and addressing them at the source is what ultimately needs to happen.

A few glucocorticoid-related items to ponder:

  • How has stress impacted my life? When and where did it start?
  • Why do I feel wonderful after taking prednisone or other anti-inflammatories? What may be the originating causes of such effects?
  • Why have prolonged periods of my life been characterized by muted responses to stress? How did I get that way?
  • Have I really understood why I’ve reflexively put myself into stressful situations? What will break me out of that habit?
  • Why do the feelings I experience while under stressful situations feel familiar? Does my unconsciousness of their origins have something to do with “homeostatic functions fundamental for survival?”
  • Why haven’t I noticed that symptoms of stress keep showing up in my life? There are “physiologic effects capable of impacting metabolism, immunity,” etc. but I don’t do something about it?
  • How else may stress impact my biology? Brain functioning? Ideas and beliefs? Behavior?

The purpose of many epigenetic processes is to control virus-like material

This 2016 Swiss human review’s subject was:

“Transposable elements (TEs) may account for up to two-thirds of the human genome, and as genomic threats they are subjected to epigenetic control mechanisms engaged from the earliest stages of embryonic development.

TEs are present in all organisms from bacteria to humans, and they constitute essential motors of evolution. TEs are phylogenetically and biologically related to viruses.

TEs can disrupt genes, provide novel coding activities, exert a wide range of transcriptional influences, and, because of their repetitive nature, create grounds for recombination events leading to genomic deletions and duplications, yet only a very small minority of TEs present in the human genome are still transposition-competent, accounting for one new germline integrant in 20 to 50 human births, and none is capable of horizontal transfer.

A vast majority of these DNA-binding proteins, including many of those expressed in human differentiated cells, primarily recognize sequences contained within TEs..controlling the transcriptional potential of their TE targets well beyond the early embryonic period..modulating the transcriptional impact of TE-residing sequences that are co-opted to regulate the expression of cellular genes.

A large fraction of the recognizable mobile elements in our genome are unique to humans or close relatives. The impact of this phenomenon on speciation might be particularly pronounced in organs subjected to environmental constraints that are not overly coercive, such as the brain..the central nervous system.”

The author presented evidence that the purpose of many ongoing epigenetic processes is to silence or otherwise “tame” TEs “to regulate the expression of cellular genes.” The author contrasted his view with the view that:

“Beyond this early embryonic period, TEs become permanently silenced, and that the evolutionary selection of TE controllers is the result of a simple evolutionary arms race between the host and these genetics invaders.” “Transposable Elements, Polydactyl Proteins, and the Genesis of Human-Specific Transcription Networks”

State-dependent brain functions and adrenaline

This 2015 German/Italian rodent study investigated:

“How a specific neuromodulatory input may influence the information content and the readout of cortical information representations of sensory stimuli.

The locus coeruleus (LC) is a brainstem neuromodulatory nucleus that likely plays a prominent role in shaping cortical states via a highly distributed noradrenaline release in the forebrain. In particular, the LC:

  • Contributes to regulation of arousal and sleep;
  • Is involved in cognitive functions such as vigilance, attention, and selective sensory processing; and
  • Modulates cortical sensory responses and cortical excitability.

An important addition of our work to previous models of state dependence was the inclusion of the contribution of an important neuromodulator – the noradrenergic system. Our results support the hypothesis that the temporal structure of LC firing causally influences cortical dynamics.

Our work highlights the importance of timing of LC burst: suitably timed LC burst (for example, triggered by an alerting stimulus) can very rapidly trigger transitions into excitable cortical states, which in turn decrease the threshold for cortical responses and thus dynamically facilitate the processing of salient or attended events.

State dependence may either:

  • Force neurons to transmit information only using codes that are robust to state fluctuations (e.g., relative firing rates), or may
  • Force downstream neurons to gain information about the state of the networks sending the sensory messages and then to use the knowledge of state to properly interpret neural responses.

Our results suggest that the latter information transmission scheme is feasible, because detecting state by either monitoring the dynamics of cortical ongoing activity alone or by also monitoring the dynamics of noradrenergic modulation substantially increased the amount of information about sensory stimuli in the late response components relevant for behavior.”

The study added to the evidence that state dependencies can’t be overlooked in explanations of brain function and resultant physical and mental activity. Locus coeruleus neural activity “can very rapidly trigger transitions into excitable cortical states..and thus dynamically facilitate the processing of salient or attended events.”

Adrenaline from the locus coeruleus produced a state of arousal in multiple brain and body areas tied into the subjects’ sympathetic nervous systems. Such internal state changes may be accompanied by state-dependent memories, following the findings of What can cause memories that are accessible only when returning to the original brain state?

The study highlighted the capability of a lower brain structure to influence other brain areas. Its findings should inform researchers in attention and behavior studies, especially when investigating causes of attention and behavior difficulties. “Modeling the effect of locus coeruleus firing on cortical state dynamics and single-trial sensory processing”

Treating prenatal stress-related disorders with an oxytocin receptor agonist

This 2015 French/Italian rodent study found:

“Chronic systemic treatment with carbetocin [unavailable in the US] in PRS [prenatally restraint stressed] rats corrected:

  • the defect in glutamate release,
  • anxiety– and depressive-like behavior,

and abnormalities:

  • in social behavior,
  • in the HPA response to stress, and
  • in the expression of stress-related genes in the hippocampus and amygdala.

These findings disclose a novel function of oxytocin receptors in the hippocampus, and encourage the use of oxytocin receptor agonists in the treatment of stress-related psychiatric disorders in adult life.”


The adult male subjects were:

“PRS rats..the offspring of dams exposed to repeated episodes of restraint stress during pregnancy.

These rats display anxiety- and depressive-like behaviors and show an excessive glucocorticoid response to acute stress, which is indicative of a dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis caused by an impaired hippocampal glucocorticoid negative feedback.

PRS rats show a selective reduction in glutamate release in the ventral hippocampus.”

The researchers cited several other studies they have performed with the PRS phenotype. In the current study:

“Carbetocin treatment had no effect on these behavioral and neuroendocrine parameters in prenatally unstressed (control) rats, with the exception of a reduced expression of the oxytocin receptor gene in the amygdala.

Carbetocin displayed a robust therapeutic activity in PRS rats, but had no effect in unstressed rats, therefore discriminating between physiological and pathological conditions.”

The PRS phenotype showed the ease with which a child can be epigenetically changed – even before they’re born – to be less capable over their entire life. Just stress the pregnant mother-to-be. “Activation of presynaptic oxytocin receptors enhances glutamate release in the ventral hippocampus of prenatally restraint stressed rats” (not freely available) Thanks to coauthor Dr. Eleonora Gatta for providing the full study.

What was not, is not, and will never be

Neuroskeptic’s blog post Genetic Testing for Autism as an Existential Question related the story of “A Sister, a Father and a Son: Autism, Genetic Testing, and Impossible Decisions.”

“I decided to put the question to my sister, Maria. Although she is autistic, she is of high intelligence.

Maria was excited to be an aunt soon, and was willing to do what she could to help my baby – even if what she was helping with was to avoid her own condition.

She is high enough functioning to know some of what she’s missing in life, and has longed her entire life to be “normal.” If she could save her niece or nephew some of the pain and awkwardness her condition had caused her, she was willing to help.”

In the concluding paragraph:

“What struck me about this story is the way in which the prospect of the genetic test confronted Maria with a very personal decision: will you do something that might help prevent someone else becoming like you?

Isn’t this very close to the ultimate existential question: all things considered, would you wish to live your life over again?”

Aren’t the majority of humans also “high enough functioning to know some of what she’s missing in life?”

Aren’t our feelings of what we’re missing one of the impetuses for us to have also “longed her entire life to be normal?”

This feeling was aired in Dr. Arthur Janov’s blog post What a Waste:

“What it was, was the feeling of great loss, something missing that could never again be duplicated.

It was no love where it could have been the opposite if the parent’s gates could have been open. But it could not be because that would have meant terrible pain and suffering for them; and their whole neurologic system militated against any conscious-awareness.”

We long for what was and is impossible:

  • For many of us, the impossibilities of having normal lives started with prenatal epigenetic changes.
  • Our experiences of our postnatal environment prompted us into adapting to its people, places, and contents. These neurological, biological, and behavioral adaptations were sometimes long-lasting deviations from developmental norms.
  • Other genetic factors combined with the above to largely make us who we were and are.

Our longing for an impossible-to-reconstruct life doesn’t go away.

We often may not be aware of our longing for what “could not be” and of its extensive impacts. Such feelings impel us into many hundreds of ideas, hundreds of beliefs, and hundreds of behaviors, a sample of which were referred to above:

  • Behaviors to “do something that might help prevent someone else becoming like you;”
  • Ideas such as existential philosophy; and
  • Beliefs that manifest the “wish to live your life over again.”

Spending our time on these ideas, beliefs, and behaviors won’t ameliorate their motivating causes. Our efforts distance us from our truths, with real consequences: a wasted life.

What keeps us from understanding our reality? I invite readers to investigate Dr. Arthur Janov’s Primal Therapy for effective therapeutic approaches.