Altered brain activity during pain processing in fibromyalgia

Burgmer, Markus; Pogatzki-Zahn, Esther; Gaubitz, M.; Wessoleck, Erik; Heuft, Gereon; Pfleiderer, Bettina

doi:10.1016/j.neuroimage.2008.09.008

Cited by 141 publications

(105 citation statements)

References 54 publications

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“…On examination of the patient medical charts, three patients were excluded; past early-onset alcoholism in 2 patients and a possible diagnosis of fibromyalgia in one patient. Indeed, alcoholism with onset in adolescence might have modified brain structure , and fibromyalgia has been reported to alter brain activity in frontocingulate areas (Burgmer et al, 2009).…”

Section: Participantsmentioning

confidence: 99%

Baseline Brain Metabolism in Resistant Depression and Response to Transcranial Magnetic Stimulation

Martinot

Ringuenet

et al. 2011

Neuropsychopharmacol

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Neuroimaging studies of patients with treatment-resistant depression (TRD) have reported abnormalities in the frontal and temporal regions. We sought to determine whether metabolism in these regions might be related to response to repetitive transcranial magnetic stimulation (TMS) in patients with TRD. Magnetic resonance images and baseline resting-state cerebral glucose uptake index (gluMI) obtained using 18 F-fluorodeoxyglucose positron emission tomography were analyzed in TRD patients who had participated in a doubleblind, randomized, sham-controlled trial of prefrontal 10 Hz TMS. Among the patients randomized to active TMS, 17 responders, defined as having 50% depression score decrease, and 14 nonresponders were investigated for prestimulation glucose metabolism and compared with 39 healthy subjects using a voxel-based analysis. In nonresponders relative to responders, gluMI was lower in left lateral orbitofrontal cortex (OFC), and higher in left amygdala and uncinate fasciculus. OFC and amygdala gluMI negatively correlated in nonresponders, positively correlated in responders, and did not correlate in healthy subjects. Relative to healthy subjects, both responders and nonresponders displayed lower gluMI in right dorsolateral prefrontal (DLPFC), right anterior cingulate (ACC), and left ventrolateral prefrontal cortices. Additionally, nonresponders had lower gluMI in left DLPFC, ACC, left and right insula, and higher gluMI in left amygdala and uncus. Hypometabolisms were partly explained by gray matter reductions, whereas hypermetabolisms were unrelated to structural changes. The findings suggest that different patterns of frontal-temporal-limbic abnormalities may distinguish responders and nonresponders to prefrontal magnetic stimulation. Both preserved OFC volume and amygdala metabolism might precondition response to TMS.

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Section: Participantsmentioning

confidence: 99%

Baseline Brain Metabolism in Resistant Depression and Response to Transcranial Magnetic Stimulation

Martinot

Ringuenet

et al. 2011

Neuropsychopharmacol

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“…5 The emotional areas of the brain were activated before, during and after the application of a painful stimulus. 6 Central mechanisms of pain processing in the frontal cortex and the cingulate cortex were shown to play an important role in individuals with fibromyalgia. 7 Symptoms of depression in this group were correlated with the magnitude of pain-evoked activation in the brain regions associated with affective pain processing.…”

Section: Scientific Basis For Fibromyalgia As a Psychiatric Conditionmentioning

confidence: 99%

Fibromyalgia: psychiatrists should now be picking up the baton

Neal

2011

Psychiatrist

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SummaryRecent functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scan studies have demonstrated the importance of the modulation of pain perception by the emotional regions of the brain in fibromyalgia. In the absence of any other objective biological abnormality, is it time to review the respective roles of primary care, psychiatry and rheumatology in the classification, diagnosis and management of fibromyalgia?

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“…In a recent review, Cagnie and colleagues (2014) points out several reoccurring findings of central sensitization in FM as revealed by brain imaging: There is moderate evidence for gray matter reductions in anterior cingulate cortex (ACC) and prefrontal regions (reported by, e.g., Burgmer et al, 2009;Jensen et al, 2013), while overall gray matter volume is unaffected. There also exists moderate evidence for spatially similar but stronger response in pain-related regions (including primary (S1) and secondary (S2) somatosensory cortex, cerebellum, insula, posterior cingulate cortex (PCC), and ACC to experimentally induced pain in patients diagnosed with FM relative to controls.…”

Section: Introductionmentioning

confidence: 99%

Fibromyalgia Is Associated with Decreased Connectivity Between Pain- and Sensorimotor Brain Areas

et al. 2014

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Fibromyalgia (FM) is a syndrome characterized by chronic pain without known peripheral causes. Previously, we have reported dysfunctional pain inhibitory mechanisms for FM patients during pain administration. In this study we employed a seed correlation analysis, independent component analysis (ICA), and an analysis of fractional amplitude of low frequency fluctuations (fALFF) to study differences between a cohort of female FM patients and an age-and sex-matched healthy control group during a resting-state condition. FM patients showed decreased connectivity between thalamus and premotor areas, between the right insula and primary sensorimotor areas, and between supramarginal and prefrontal areas. Individual sensitivity to painful pressure was associated with increased connectivity between pain-related regions (e.g., insula and thalamus) and midline regions of the default mode network (including posterior cingulate cortex and medial prefrontal cortex) among patients and controls. However, neither ICA nor fALFF revealed any group differences. Our findings suggest that abnormal connectivity patterns between pain-related regions and the remaining brain during rest reflect an impaired central mechanism of pain modulation in FM. Weaker coupling between pain regions and prefrontal-and sensorimotor areas might indicate a less efficient system level control of pain circuits. Moreover, our results show that multiple, complementary analytical approaches are valuable for obtaining a more comprehensive characterization of deviant resting-state activity. In conclusion, our findings show that FM primarily is associated with decreased connectivity, for example, between several pain-related areas and sensorimotor regions, which could reflect a deficiency in pain regulation.

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Altered brain activity during pain processing in fibromyalgia

Cited by 141 publications

References 54 publications

Baseline Brain Metabolism in Resistant Depression and Response to Transcranial Magnetic Stimulation

Baseline Brain Metabolism in Resistant Depression and Response to Transcranial Magnetic Stimulation

Fibromyalgia: psychiatrists should now be picking up the baton

Fibromyalgia Is Associated with Decreased Connectivity Between Pain- and Sensorimotor Brain Areas

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