Striatal grey matter increase in patients suffering from fibromyalgia – A voxel-based morphometry study

Abstract

Fibromyalgia (FM), among other chronic pain syndromes, such as chronic tension type headache and atypical face pain, is classified as a so-called dysfunctional pain syndrome. Patients with fibromyalgia suffer from widespread, "deep" muscle pain and often report concomitant depressive episodes, fatigue and cognitive deficits. Clear evidence for structural abnormalities within the muscles or soft tissue of fibromyalgia patients is lacking. There is growing evidence that clinical pain in fibromyalgia has to be understood in terms of pathological activity of central structures involved in nociception. We applied MR-imaging and voxel-based morphometry, to determine whether fibromyalgia is associated with altered local brain morphology. We investigated 20 patients with the diagnosis of primary fibromyalgia and 22 healthy controls. VBM revealed a conspicuous pattern of altered brain morphology in the right superior temporal gyrus (decrease in grey matter), the left posterior thalamus (decrease in grey matter), in the left orbitofrontal cortex (increase in grey matter), left cerebellum (increase in grey matter) and in the striatum bilaterally (increase in grey matter). Our data suggest that fibromyalgia is associated with structural changes in the CNS of patients suffering from this chronic pain disorder. They might reflect either a consequence of chronic nociceptive input or they might be causative to the pathogenesis of fibromyalgia. The affected areas are known to be both, part of the somatosensory system and part of the motor system.

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.…”

Different Pain, Different Brain: Thalamic Anatomy in Neuropathic and Non-Neuropathic Chronic Pain Syndromes

“…Although most chronic pain investigations have focused on peripheral targets such as nociceptors and their terminations, there is evidence that changes within higher brain centers may also be important for the maintenance and/or development of some chronic pain conditions. For example, many chronic pain conditions are associated with gray matter losses in a number of brain regions associated with acute pain processing, i.e., primary and secondary somatic areas, insula, thalamus, and cingulate cortex (Apkarian et al, 2004;Kuchinad et al, 2007;Schmidt-Wilcke et al, 2007;Buckalew et al, 2008;DaSilva et al, 2008;Kim et al, 2008;Schweinhardt et al, 2008;Burgmer et al, 2009;Gustin et al, 2010;Younger et al, 2010). Despite numerous investigations reporting brain anatomy changes associated with chronic pain, it remains unknown what these gray matter changes represent and whether these changes are uniformly expressed in all chronic pain conditions regardless of their etiology.…”

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.…”