Overlapping Structural and Functional Brain Changes in Patients With Long‐Term Exposure to Fibromyalgia Pain

Abstract

Objective There is vast evidence for brain aberrations in patients with fibromyalgia (FM) and it is possible that central plasticity is critical for the transition from acute to chronic pain. However, the relationship between brain structure and function is poorly investigated. Methods The present study, including 26 FM patients and 13 age- and gender-matched healthy controls, investigated the differences between patients and controls regarding functional connectivity during intermittent pressure pain and measures of brain structure. Magnetic resonance imaging (MRI) was used to obtain high-resolution anatomical images and functional MRI scans for measures of pain-evoked brain activity. Results FM patients displayed a distinct overlap between decreased cortical thickness, brain volumes and measures of functional regional coherence in the rostral anterior cingulate cortex. The morphometric changes were more pronounced with longer exposure to FM pain. In addition, we found associations between structural and functional changes in the mesolimbic areas of the brain and comorbid depressive symptoms in FM patients. Conclusion The combined integration of structural and functional measures allowed for a unique characterization of the impact of FM pain on the brain. Our data may lead to the identification of early structural and functional brain alterations in response to pain, which could be used to develop markers to predict the development of FM and other pain disorders.

Structural Brain Alterations in Community Dwelling Individuals with Chronic Joint Pain

“…In total, 15 studies that assessed the relationship between brain structures and chronic pain were included in this review. 9,11,14,17,[33][34][35][36][37][38][39][40][41][42][43] All brain regions previously reported to be significantly associated with chronic pain are shown in the On-line Table, together with the direction of the effect. We decided to include the brain regions that were reported to be associated with musculoskeletal pain at least twice.…”

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

“…For example, the volume of gray matter (GM) or the thickness of the thalamus, hippocampus, amygdala, and the insular, somatosensory, prefrontal, and anterior cingulate cortex, except for the striatum, were reported to be decreased (6,(11)(12)(13)(14)(15), indicating that prolonged nociception may have a negative effect on regional integrity in pain processing regions of the brain.…”

Neuroimagen de la fibromialgia: una enfermedad del cerebro

“…No obstante, son varios los estudios que observan la combinación de un incremento y decremento del VSG en regiones cerebrales específicas (33,36,72). El incremento del VSG se objetiva en la COF izquierda (73,74), CCA dorsal (48), INS (48), SII (48,71,75), cerebelo (73,74,76) y estriado bilateralmente (48,73).…”

“…Contrariamente, se constata una reducción del VSG en la circunvolución temporal superior (71,73), INS (71,77,78), COF lateral (72) y medial (71,74,76,79,80), CCA rostral (61,72,76,77,79), CCP (71,76,80), precuneus izquierdo (71,75,76), TAL (48,73), amígdala (48,61), circunvolución parahipocámpica (61,76,79), putamen (48) y SGP (48,75). Es de especial relevancia el decremento del VSG y grosor de la corteza en la CCA en su porción rostral, así como una reducción significativa del VSB en la CCA rostral izquierda y en la COF lateral izquierda (72), puesto que ello conlleva a una desregulación de los mecanismos inhibitorios endógenos en la FM (33,69,72,75,78).…”

“…(2009) encontraron una reducción del VSG solo en la INS anterior izquierda en pacientes con FM y un trastorno afectivo comórbido. Asimismo, la reducción del VSG y grosor cortical en la CCA derecha rostral es más pronunciada en pacientes con mayor cronicidad del dolor y se constata una relación positiva entre las alteraciones funcionales y estructurales en regiones mesolímbicas en comorbilidad con la severidad del estado afectivo de pacientes con FM (72). En esta misma línea, Díaz-Piedra y cols.…”