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

Abstract

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.

Gray matter abnormalities associated with fibromyalgia: A meta-analysis of voxel-based morphometric studies

“…The elements of this network may be engaged in emotional processing, executive and cognitive functions [54][55][56], and pain perception [57,58]. Previous resting state fMRI studies have demonstrated aberrant DMN connectivity in patients with fibromyalgia [59][60][61][62]. Moreover, Napadow and colleagues have provided preliminary evidence that intrinsic DMN connectivity can be used as an objective marker in fibromyalgia for tracking intra-subject changes in spontaneous chronic pain [60].…”

Fibromyalgia Syndrome in Need of Effective Treatments

“…A number of studies have provided further evidence of dysfunctional connectivity of the pain network in FMS (Jensen et al, 2012;Flodin et al, 2014). One study found that FMS patients exhibited higher sensitivity to pain provocation than controls and that they required less pressure to evoke equal pain, but they failed to respond to pain provocation in the primary link in the descending pain-regulating system (the rostral anterior cingulate cortex) (Flodin et al, 2014).…”

“…One study found that FMS patients exhibited higher sensitivity to pain provocation than controls and that they required less pressure to evoke equal pain, but they failed to respond to pain provocation in the primary link in the descending pain-regulating system (the rostral anterior cingulate cortex) (Flodin et al, 2014). Another study comparing the functional connectivity of the descending pain inhibitory network in age-matched FMS patients and healthy controls found that patients displayed less connectivity within the brain's pain inhibitory network during calibrated pressure pain compared with healthy controls (Jensen et al, 2012).…”

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“…Consequently muscle weakness can be linked to peripheral and central mechanisms [23]. Several studies found no correlation in muscle histopathologically and muscle metabolism in FMS etiopathogenesis [24,25].…”