Altered White Matter Integrity in the Corpus Callosum in Fibromyalgia Patients Identified by Tract‐Based Spatial Statistical Analysis

Abstract

Objective. Although recent imaging studies of fibromyalgia (FM) have converged on a dysfunction of central pain processing as the primary pathophysiologic cause of the disorder, microstructural changes of the white matter (WM) suggestive of abnormalities in the anatomic connectivity of the brain have not been extensively examined. The aim of this study was to investigate WM integrity and its possible relationship to pain symptoms in women with FM.Methods. Nineteen FM patients and 21 age-, sex-, and education-matched healthy control subjects were included in the study and underwent diffusion-weighted imaging. Group differences in WM integrity, which were assessed via fractional anisotropy (FA), was investigated by applying tract-based spatial statistics.Results. As compared with the healthy control group, the FM group showed a single cluster with lower FA in the left body of the corpus callosum, which was found to be connected to the bilateral sensorimotor cortices (P < 0.05, corrected for multiple comparisons). Furthermore, FA values in the cluster were negatively associated with sensory pain, as measured by the ShortForm McGill Pain Questionnaire, as well as with the relative magnitude of sensory pain versus affective pain (calculated by dividing the sensory score by the affective score).Conclusion. Findings of the current study demonstrated that patients with FM had disrupted WM microstructure in the body of the corpus callosum, which was associated with clinical pain intensity. Our results suggest that abnormal interhemispheric transfer might contribute to the heightened pain perception. Our findings further strengthen the hypothesis of centrally augmented pain processing in patients with FM.

Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature

“…Reduced FA in the thalamus was also reported in a third study (n=19) that correlated with pain reporting [70]. Recently, contrarian findings of reduced FA that correlated with increases in pain reporting were found in 19 patients in the portion of the corpus callosum that connects to S1 [71]. Age also appears to be an important factor in anisotropy in FM.…”

White Matter Microstructural Similarity and Diversity of Functional Constipation and Constipation-predominant Irritable Bowel Syndrome

“…The main interhemisphere commissure is required for many aspects of neural function, encompassing inhibition of cortical functions, integration of sensory information, regulation of cognition, processing of emotion, and interhemispheric exchange of information. 52,53 Multiple studies reported CC dysfunction in patients with chronic pain, such as fibromyalgia, 54 migraine, 55 and temporomandibular disorder, 56 supporting the indicative role of the CC in pain perception and pain control. 57 Therefore, we reasoned that aberrations in the WM integrity in the CC may cause the reduction of obstruction to water diffusion and reduced anisotropy, which can be responsible for the perceptional intensity of abdominal discomfort and pain in FC and IBS-C patients.…”

Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation?

“…Association fibers, namely (6) the cingulum cingulate gyrus (i.e., subgenual and retrosplenial part of the cingulum) and (7) the cingulum hippocampus (i.e., parahippocampal part of the cingulum) (Lieberman et al, ; Mori et al, ) and (8) fornix and stria terminalis (Borsook et al, ; Chen et al, ; Upadhyay et al, ). Finally, commissural fibers, that is (9) the tapetum of the corpus callosum (Kim et al, ; McAllister, ) and (10) the splenium of the corpus callosum (Lieberman et al, ). Acceleration–deceleration of the brain is believed to affect the superior cerebellar peduncles, and periventricular WM (McAllister, ), for example, tapetum of the corpus callosum (Kim et al, ; Sarikcioglu et al, ; Todd & Lempert, ).…”

“…Finally, commissural fibers, that is (9) the tapetum of the corpus callosum (Kim et al, ; McAllister, ) and (10) the splenium of the corpus callosum (Lieberman et al, ). Acceleration–deceleration of the brain is believed to affect the superior cerebellar peduncles, and periventricular WM (McAllister, ), for example, tapetum of the corpus callosum (Kim et al, ; Sarikcioglu et al, ; Todd & Lempert, ). For visualization purposes, masks of these ROIs are displayed on MD maps of the WM Mori atlas (Mori et al, ) in Figure .…”