Gray matter abnormalities associated with fibromyalgia: A meta-analysis of voxel-based morphometric studies.

Editor’s Note:  Watch for Cort Johnson’s upcoming article reviewing this study and proposing that ultimately researchers and doctors should be able to identify subsets and target treatments for fibromyalgia using this and other brain imaging studies.
 
ABSTRACT
 
OBJECTIVES
 
Studies employing voxel-based morphometry (VBM) have reported inconsistent findings on the association of gray matter (GM) abnormalities with fibromyalgia. The aim of the present study is to identify the most prominent and replicable GM areas that are involved in fibromyalgia.
 
METHODS
 
A systematic search of the PubMed database from January 2000 to September 2015 was performed to identify eligible whole-brain VBM studies. Comprehensive meta-analyses to investigate regional GM abnormalities in fibromyalgia were conducted with the Seed-based Mapping software package.
 
RESULTS
 
Seven studies, reporting nine comparisons and including a grand total of 180 fibromyalgia patients and 126 healthy controls, were included in the meta-analyses. In fibromyalgia patients compared with healthy controls, regional GM decreases were consistently found in the bilateral anterior cingulate / paracingulate cortex/medial prefrontal cortex, the bilateral posterior cingulate/paracingulate cortex, the left parahippocampal gyrus/fusiform cortex, and the right parahippocampal gyrus/hippocampus. Regional GM increases were consistently found in the left cerebellum. Meta-regression demonstrated that age was correlated with GM anomalies in fibromyalgia patients.
 
CONCLUSIONS
 
The current meta-analysis identified a characteristic pattern of GM alterations within the medial pain system, default mode network, and cerebro-cerebellar circuits, which further supports the concept that fibromyalgia is a symptom complex involving brain areas beyond those implicated in chronic pain.
 
Shi H, Yuan C, Dai Z, Ma H, Sheng L. Gray matter abnormalities associated with fibromyalgia: A meta-analysis of voxel-based morphometric studies. Semin Arthritis Rheum. 2016 Dec; 46(3):330-337. doi: 10.1016/j.semarthrit.2016.06.002. Epub 2016 Jun 8.

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