Abnormal functional activity of the central nervous system in fibromyalgia (FM) syndrome

The evaluation of pain is one of the major problems facing

general practitioners and specialists in medicine. Although

the source of pain can be usually be traced to specific

abnormalities in a given organ system, some patients present

with generalized pain syndromes, such as fibromyalgia, for

which no specific source can be found. Some researchers have

begun to consider that although there may be a somatic source

of such pain at its initiation, over time the pain may be

maintained or exacerbated by functional alterations in

critical regions of the brain and spinal cord that are

involved in pain processing or pain inhibition. This article

describes the techniques currently used to measure regional

cerebral blood flow (rCBF) in the brain by single photon

emission computed tomography (SPECT) imaging, and reviews the

SPECT and positron emission tomography literature concerning

alterations in functional brain activity associated with pain

in healthy individuals and in patients with chronic pain,

including those with fibromyalgia. The article concludes by

describing the implications of current knowledge about pain

and abnormal functional brain activity in the understanding of

the pathophysiology of fibromyalgia and in the development of

therapeutic strategies to manage patients with this disorder.

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