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Hypersensitivity to Non-Painful Events May be Part of Pathology in Fibromyalgia

  [ 18 votes ]   [ 4 Comments ]
www.ProHealth.com • September 15, 2014


Hypersensitivity to Non-Painful Events May be Part of Pathology in Fibromyalgia. Image by Victor Habbick courtesy of FreeDigitalPhotos.net
Image by Victor Habbick courtesy of FreeDigitalPhotos.net
New research shows that patients with fibromyalgia have hypersensitivity to non-painful events based on images of the patients' brains, which show reduced activation in primary sensory regions and increased activation in sensory integration areas. Findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR), suggest that brain abnormalities in response to non-painful sensory stimulation may cause the increased unpleasantness that patients experience in response to daily visual, auditory and tactile stimulation.

Fibromyalgia is a chronic, musculoskeletal syndrome characterized by widespread pain, affecting roughly two percent of the world population, say experts. According to the ACR, five million people in the U.S. have fibromyalgia, which is more prevalent among women. In previous studies fibromyalgia patients report reduced tolerance to normal sensory (auditory, visual, olfactory, and tactile) stimulation in addition to greater sensitivity to pain.

For the present study, researchers used functional magnetic resonance imaging (fMRI) to assess brain response to sensory stimulation in 35 women with fibromyalgia and 25 healthy, age-matched controls. Patients had an average disease duration of 7 years and a mean age of 47.

According to the study, patients reported increased unpleasantness in response to multisensory stimulation in daily life activities. Furthermore, fMRI displayed reduced activation of both the primary and secondary visual and auditory areas of the brain, and increased activation in sensory integration regions. These brain abnormalities mediated the increased unpleasantness to visual, auditory and tactile stimulation that patients reported to experience in daily life.

Lead study author, Dr. Marina López-Solà from the Institute of Cognitive Science, University of Colorado Boulder said, "Our study provides new evidence that fibromyalgia patients display altered central processing in response to multisensory stimulation, which are linked to core fibromyalgia symptoms and may be part of the disease pathology. The finding of reduced cortical activation in the visual and auditory brain areas that were associated with patient pain complaints may offer novel targets for neurostimulation treatments in fibromyalgia patients."

Abstract:

Altered fMRI responses to non-painful sensory stimulation in fibromyalgia patients

By Marina López-Solà, et al.

Objective: Fibromyalgia (FM) is a disorder characterized by chronic pain and enhanced responses to acute noxious events. However, the sensory systems affected in FM may extend beyond pain itself, as FM patients show reduced tolerance to non-nociceptive sensory stimulation. Characterizing the neural substrates of multisensory hypersensitivity in fibromyalgia may thus provide important clues about the underlying pathophysiology of the disorder. The aim of this study was to characterize brain responses to non-nociceptive sensory stimulation in FM patients and its relationship to subjective sensory sensitivity and clinical pain severity.

Methods: Functional magnetic resonance imaging (fMRI) was used to assess brain response to auditory, visual and tactile-motor stimulation in 35 women with FM and 25 matched controls. Correlation and mediation analyses were performed to establish the relationship between brain responses and three types of outcomes: subjective hyper-sensitivity to daily sensory stimulation, spontaneous pain, and functional disability.

Results: Patients reported increased subjective sensitivity (increased unpleasantness) in response to multisensory stimulation in daily life. FMRI revealed that patients showed reduced task-evoked activation in primary/secondary visual and auditory areas and augmented responses in the insula and anterior lingual gyrus. Reduced responses in visual and auditory areas were correlated with subjective sensory hyper-sensitivity and clinical severity measures.

Conclusion: FM patients showed strong attenuation of brain responses to non-painful events in early sensory cortices, accompanied by an amplified response at later stages of sensory integration in the insula. These abnormalities are associated with core fibromyalgia symptoms, suggesting that they may be part of the pathophysiology of the disease. © 2014 American College of Rheumatology.

Source: Arthritis & Rheumatology, September 15, 2014. By Marina López-Solà, Jesus Pujol, Tor D. Wager, Alba Garcia-Fontanals, Laura Blanco-Hinojo, Susana Garcia-Blanco, Violant Poca-Dias, Ben J. Harrison, Oren Contreras-Rodríguez, Jordi Monfort, Ferran Garcia-Fructuoso and Joan Deus. Department of Psychology and Neuroscience, Muenzinger D158, 345 UCB, Boulder, Colorado, 80309-0345. E-mail: marina.lopezsola@colorado.edu



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Article Comments Post a Comment

Understanding
Posted by: ydavison
Sep 17, 2014
I have been dealing with fibromyalgia for many many many years and I still dont understand it or how it affects me sometimes or if in fact it is because of the fibromyalgia that I react like I do.
I use to feel like superwoman, I could multi-task and carry on with a smile not only on my face but in my heart as well.
Today I am not only unable to multi-task, but I feel broken. My heart, my soul, and my body. And then I have a turn and I accomplish all my backlog and I feel like getting out there. But without knowing why or what something will knock me down and it is tremendously hard to deal with it. Its hard to deal with not feeling well without puking or physical symptoms that represent illness.
I suffer in silence, and my soul is screaming for someone, anyone, to reach out and give me a hug. It sucks to be alone when you are too grown up to cry.
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Non-painful stimuli and fibromyalgia
Posted by: ronnie12
Sep 17, 2014
I read the article on hypersensitivity to non-painful events..I am a male, 66 years of age, and have CFS/FM..For 7 years I have had these awful siseases or syndromes or whatever the crrect term is.. Not sure how the people that did this study did this or how they came up with the conclusion that sound, light, odors, etc can cause severe reactions to people with Fibromyalgia..Before I had FM, sound did not other me..Now I have to have everything turned down very low, no loud TV or radios or any loud sounds..I can even hear a clock ticking at night and never get to sleep until I remove the clock..In my conversations with other people with FM, a lot have stated the same thing..Now, what I want to know is was this study done to find this out, because I could have told then the terrible feeling that comes over my body when a loud noise happens..It almost sends me into a nervous breakdown and makes my brain send horrible shock waves throughout my body...Or, was this study done to come up with some useful conclusions that is helpful in finding ways to help the awful symptoms of FM. I was just wandering and maybe I will get an answer..Sound and light will drive a very high percentage of FM sufferers crazy or make you crawl up in a ball and hit the floor..I don't think the sound-reaction occurance cause FM, but I do believe FM causes the sound-reaction occurance...Just one of many symptoms that CFS/FM absolutely rips your soul out of you and removes all hope for any future..I have doctors and I have faith..Just wish I had a cure and something to help these symptoms..Trust me, it is no fun being home bound and bed ridden for weeks at the time...Hey, is there a doctor out there that would give me a shout out and lets talk..I ama college grad, a 35 year manager in corporate America, owned my own business for 15 years, and have done a lot of studying on all the protocols and "cures" for Fibromyalgia..Would like to talk to someone..No snake oil vendors, please.
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To ydavison
Posted by: ProHealth-Editor
Sep 19, 2014
I want to reassure you that you are not alone. Here at ProHealth we have a wonderful community of people with fibromyalgia who understand and are experiencing many of the same difficulties and frustrations as you. You might want to visit our forums and connect with some of them. Just click on the "Forums" link at the top of the page.

I understand only too well what you mean when you talk about trying to catch up when you have a good day, only to feel worse again. That's something most of us have a hard time with. After feeling bad for so long, it's hard not to overdo when we finally have a day where we feel better. But it really is important to try to learn to pace ourselves so we don't use up all of our energy in one burst of accomplishing things.

Dr. Bruce Campbell has written several excellent articles on pacing and learning to use our "energy envelope." You can read some of his articles here: http://www.prohealth.com/fibromyalgia/fibromyalgia-pacing.cfm

I hope that helps at least a little. And I hope you'll continue to be part of our fibromyalgia community here at ProHealth. – Karen
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neural feedback
Posted by: azoe
Sep 25, 2014
I would like to know whether there is research on neural feedback to quell the brain's over-reaction to pain and non-painful stimuli? I understand that the brain is retrainable and plastic...meditation also re-trains the brain. It would be wonderful if all fibro patients need to do is to re-train the brain....
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