Resting brain activity associated with spontaneous fibromyalgia pain

July 29, 2010, Wiley

A recent study from researchers at Massachusetts General Hospital and University of Michigan provides the first direct evidence of linkage between elevated intrinsic (resting-state) brain connectivity and spontaneous pain intensity in patients with fibromyalgia (FM). This research shows an interaction of multiple brain networks, offering greater understanding of how pain arises. Details of the study appear online and in the August issue of Arthritis & Rheumatism.

Chronic pain syndromes such as FM can cause widespread pain that varies in intensity and fluctuates over time. In addition to pain, FM patients may experience other symptoms such as fatigue, sleep disturbances, memory problems, and temperature sensitivity. The National Institute of and Musculoskeletal and Skin Diseases estimates that FM affects 5 million American 18 years of age or older, occurring more often in women (80%-90%).

In the current study, Vitaly Napadow, Ph.D. and colleagues enrolled 36 female subjects —18 FM patients and 18 healthy control subjects with a mean age of 38.9 and 36.1 years of age, respectively. FM study subjects had a disease-duration of at least 1 year, self-reported pain for more than 50% of each day, and were willing to limit introduction of new medications or treatment strategies to control FM symptoms.

As a part of the study, 6 minutes of resting-state functional magnetic resonance imaging (FMRI) data from study subjects were collected. Data were analyzed using dual-regression independent components analysis—a data-driven approach for the identification of independent brain networks. Intrinsic connectivity was evaluated in multiple brain networks: the default mode network (DMN), the executive attention network (EAN), and the medial visual network (MVN), with the MVN serving as a negative control.

Prior to undergoing the MRI scan, participants were asked to rate the intensity of their FM pain on a scale of 0󈝶, where 0 is equivalent to "no pain present" and 10 is equivalent to "the worst pain they could imagine." The pain scores ranged widely, from 0 to 8.1.

"Our results clearly show that individuals with FM have greater connectivity between multiple and the insular cortex, which is a brain region previously linked with evoked pain processing and hyperexcitability in FM," said Dr. Napadow. The research team found that patients with FM had greater intrinsic connectivity within the right EAN, and between the DMN and the insular cortex—a brain region linked to evoked pain processing. "In patients with FM, our findings strongly implicate the insular cortex as being a key node in the elevated intrinsic connectivity," added Dr. Napadow. "Patients demonstrated greater DMN connectivity to the left anterior, middle, and posterior insula." In the right EAN, FM patients demonstrated greater intra-network connectivity within the right intraparietal sulcus (iPS). Researchers found no differences between the FM and healthy control groups for the left EAN or the MVN.

The current findings provide better understanding of the underlying brain mechanisms of clinical pain in FM and may potentially lead to markers of disease progression. Broader implications for explaining how subjective experiences such as pain arise from a complex interplay among multiple networks can also be derived from this study. "Our approach represents a novel step forward in finding the neural correlates of spontaneous clinical pain," concluded Dr. Napadow. "However, our results were derived strictly from patients with FM and may not be generalized to other chronic pain states, an area we are currently evaluating for further research."

More information: "Intrinsic Brain Connectivity in Fibromyalgia Is Associated With Chronic Pain Intensity." Vitaly Napadow, Lauren LaCount, Kyungmo Park, Suzie As-Sanie, Daniel J. Clauw, and Richard E. Harris. Arthritis & Rheumatism; Published Online: April 6, 2010 (DOI: 10.1002/art.27497); Print Issue Date: August 2010.

Related Stories

Recommended for you

DNA gets away: Scientists catch the rogue molecule that can trigger autoimmunity

February 22, 2018
A research team has discovered the process - and filmed the actual moment - that can change the body's response to a dying cell. Importantly, what they call the 'Great Escape' moment may one day prove to be the crucial trigger ...

Low-calorie diet enhances intestinal regeneration after injury

February 22, 2018
Dramatic calorie restriction, diets reduced by 40 percent of a normal calorie total, have long been known to extend health span, the duration of disease-free aging, in animal studies, and even to extend life span in most ...

Fertility breakthrough: New research could extend egg health with age

February 22, 2018
Women have been told for years that if they don't have children before their mid-30s, they may not be able to. But a new study from Princeton University's Coleen Murphy has identified a drug that extends egg viability in ...

Artificial intelligence quickly and accurately diagnoses eye diseases and pneumonia

February 22, 2018
Using artificial intelligence and machine learning techniques, researchers at Shiley Eye Institute at UC San Diego Health and University of California San Diego School of Medicine, with colleagues in China, Germany and Texas, ...

Gut microbes protect against sepsis—mouse study

February 22, 2018
Sepsis occurs when the body's response to the spread of bacteria or toxins to the bloodstream damages tissues and organs. The fight against sepsis could get a helping hand from a surprising source: gut bacteria. Researchers ...

Breakthrough could lead to better drugs to tackle diabetes and obesity

February 22, 2018
Breakthrough research at Monash University has shown how different areas of major diabetes and obesity drug targets can be 'activated', guiding future drug development and better treatment of diseases.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

jerryd
not rated yet Aug 01, 2010

I'd bet a good number of FM patients were getting it from Lipitor and similar medicines. My mother was diagnosed with FM but it like was from Lipitor.

I later took Lipitor and got the same exact symptoms, bad muscle pains so bad I couldn't get out of bed. 3 weeks after I stopped taking it my symptoms were gone.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.