Nociceptive pain and its emotional component can result in the development of a “chronic pain memory”. This report describes two patients who had long histories of chronic pain and opioid dependence. Both patients experienced sudden memory loss that was followed by significant pain reduction and an eradication of their need for opioid management. Neural centers involved in sensory pain, its affective component, opioid dependence, and memory overlap in the brain and share common pathways. The anterior cingulate cortex, the insular cortex, and the amygdala are examples of regions implicated in both pain and memory. One of the patients in the report experienced multiple seizure episodes, which may have contributed to memory loss and pain relief. The role of electroconvulsive therapy as it relates to amnesia and pain is reviewed. Questions are raised regarding whether therapies that address the memory component of pain may have a role in the treatment of long-term chronic pain patients.
aDepartment of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA
bSchool of Social Work, Columbia University, New York, NY, USA
cDepartment of Anesthesiology College of Physician and Surgeons, Columbia University Medical Center, New York, NY, USA
dPain Management Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 850 Boylston Street, Chestnut Hill, MA 02467, USA
*Corresponding author. Tel.: +1 617 732 9057; Fax: +1 617 732 9050.
Submitted October 7, 2006; received in revised form June 5, 2007; accepted June 20, 2007.
☆An earlier version of this report was presented at the ASRA 2005 Spring Meeting in Toronto, Canada.