Thursday, February 21, 2013

Traits and continuums

Trying to gather a few thoughts together into some kind of bundle..

1. Recent blogpost from Fred Wolfe on Fibromyalgia Perplex,  Fibromyalgia as a Trait (and a Continuum) Disorder

Delicious post: 
Fibromyalgia is a symptom based disorder, not a sign based (therefore categorical) "disease." And may never become one. Certainly Fred Wolfe, himself, backed away from his original  attempts to do just that. (See this link, in this post.)
"Pain, fatigue and sleep problems affect all people at some time, and some people are afflicted more than others. Fibromyalgia can be diagnosed by criteria when all of these symptoms are continuous (chronic) and bothersome (severe)."
 "When people with fibromyalgia were followed for an average of 4 years, it was found that patients switched between criteria-positive and criteria-negative states frequently, with 44.0% failing to meet criteria at least once during follow-up." 
 So, people can fade in and out of "having" it, and some who may "have" it, don't even know it. 

Definition of "trait: 
"Applied to fibromyalgia, trait means the tendency of those with fibromyalgia to respond to physical or mental stress in a stereotyped way—by increasing pain, fatigue and the other symptoms of fibromyalgia."
OK, sounds like their brains have learned to respond that way. 
The way brains learn to deal with all sorts of things in life. 
Which brings me to the next thought I want to bundle in, somehow:

2. A poster on SomaSimple, MaxG, picked up on the notion of Trait and continuum:
"Last year I read Oliver Sacks great book on migraines (called, well, "Migraine").In some parts, he takes an almost philosophical look at migraine headache as a sort of forced withdrawal response of an organism to a stressor. 
Sacks incorporates migraines into several "frames" in the book:
1.) in a continuum of allied "neurological disorders" (epilepsy, narcolepsy, vagal attacks, catatonic reactions, etc.), where the differentiato between each "disease" is the duration of symptoms and the "Jacksonian level" (functional level of neural integration).2.) in a "disease cycle" where the sufferer alternates between bouts of, say, migraines, ulcers and psoriasis as a response to particular stressors, being symptom free of one while suffering from the other, etc.3.) migraines as a continuum itself; where it is implied that amny people suffer from subclinical bouts of migraines (with or without aura, with or without vagal symptoms, with or without headaches) and the clinical cases simply represent one "extreme" of this continuum.
I hope I'm not the only one seeing a similar line of thinking in the above quoted article on FM.
I find this concept of exaggerated stress responses fascinating.Viewing the human organism as a "complex dynamical system" that is hardly in a simple equilibrium but more in a state of constant "circling" around one "chaotic attractor" (maybe a "normal" state") and thinking of "diseases" like migraines or FM as a jump to a different "chaotic attractor"; this makes a lot of sense, in my opinion of "spectrum" disorders like FM and migraines."
3. Then he posted a wonderful image that looks a bit like this, but not this exact one: 
Loenz attractor image from
Here is the one he shared:

4. His picture reminded me of this blogpost from the Dana foundation:  Unlocking the Mystery of Consciousness,  by Lauren Ware:
..... "Information doesn't just flow through a brain like cars down a highway," says Brown. "It creates all kinds of loops, some excitatory, some inhibitory, some that amplify, down-regulate or modify other circuits."

5. His post reminded me of a couple items (see REFERENCES) discussed in the March issue of Nature Reviews Neuroscience, blogged about here: Moving your mind instead of your body. 

6. Anyway.. here's to rostral control of descending modulation of all manner of afferent input, sensory-discriminative exteroceptive and afferent-motivational interoceptive input, be it nociceptive or non-nociceptive. The only way to know if it is or isn't nociceptive, for real, is to examine it, and decide. If it vanishes, great - you managed to help your own brain descendingly modulate it favourably. If it didn't vanish, you might want to hire a careful human primate social groomer to add a bit or even more than just a bit of exteroceptive contact, so your brain has a chance to get a better fix on it, then try again. But realize this: only you will be able to change it, from the inside, by building pathways, so, best get started. 

1. Artur Luczak,  Peter Bartho,  and Kenneth D. Harris;  Gating of Sensory Input by Spontaneous Cortical Activity. The Journal of Neuroscience, 23 January 2013, 33(4): 1684-1695

2. Kenneth D. Harris & Alexander Thiele; Cortical state and attention. Nature Reviews Neuroscience 12, 509-523 (September 2011)

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