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Intrinsic Brain Connectivity in Fibromyalgia is Associated with Chronic Pain Intensity – Source: Arthritis and Rheumatism, Apr 6, 2010

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By Vitaly Napadow, Richard E Harris, et al. • www.ProHealth.com • June 2, 2010


Objective: Fibromyalgia (FM) is considered to be the prototypical central chronic pain syndrome and is associated with widespread pain that fluctuates spontaneously. Multiple studies have demonstrated altered brain activity in these patients.

Our objective was to investigate:

• The degree of connectivity between multiple brain networks in FM,

• As well as how activity in these networks correlates with spontaneous pain.

Methods: Resting functional magnetic resonance imaging (fMRI) data in FM patients (n=18) and age-matched healthy controls (HC, n=18) were analyzed using dual regression independent component analysis (ICA) - a data driven approach used to identify independent brain networks.

We evaluated intrinsic, or resting, connectivity 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.

Spontaneous pain levels were also covaried with intrinsic connectivity.

Results: We found that:

• FM patients had greater connectivity within the DMN and right EAN (rEAN; p<0.05, corrected), and greater connectivity between the DMN and the insular cortex - a brain region known to process evoked pain.

• Furthermore, greater spontaneous pain at the time of the scan correlated with greater intrinsic connectivity between the insula and both the DMN and rEAN (p<0.05, corrected).

Conclusion:

• Our findings indicate that resting brain activity within multiple networks is associated with spontaneous clinical pain in FM.

• These findings may also have broader implications for how subjective experiences such as pain arise from a complex interplay amongst multiple brain networks.

Source: Arthritis and Rheumatism, Apr 6, 2010. PMID: 20506181, by Napadow V, Lacount L, Park K, As-Sanie S, Clauw DJ, Harris RE. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Radiology, Logan College of Chiropractic, Chesterfield Missouri; Department of Biomedical Engineering, Kyunghee University, Yongin, Korea;  Obstetrics and Gynecology Department,  and  Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan. [Email:  vitaly@nmr.mgh.harvard.edu]





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