Fibromyalgia pain reflected in patients' brain activity

Monitoring brain activity could offer a new way to manage and diagnose pain in patients with fibromyalgia.  A recent study used to MRI scans to link changes in the brain with changes in clincial pain score in patients with fibromyalgia. Researchers believe their approach could provide a much-needed objective measurement of pain for fibromyalgia patients.

The research involved 17 women with fibromyalgia who underwent pain treatment. The treatment was found to reduce resting connectivity within the brain and reduce clinical pain scores. The diminished pain correlated with the reduced connectivity between the default mode network and the anterior insula. The study results suggest that MRI imaging can be used to assess fibromyalgia pain and treatment success.

Previous research has used similar brain scans to predict whether patients will develop chronic back pain. In a recent study, brain scans conducted soon after the onset of pain were used to predict whether the pain would become chronic with 85% accuracy. Neuroscientist Vania Apkarian told Science Now that the study represents the first time scientists can predict which of two patients with similar injuries will develop chronic pain.

The brain scans of patients with persistent pain showed altered activity in the insula and the nucleus accumbens, which are parts of the brain involved in learning and emotional responses. This suggests that the interactions between these brain regions may contribute to chronic pain. The research could have important implications for the prevention of chronic pain; if doctors can determine who is at risk, they could alter treatment accordingly. However, more research is needed before brain scans can be routinely used for diagnosing or evaluating pain.

References

Baliki M, Petre B, Torbey S, et al. Corticostriatal functional connectivity predicts transition to chronic back pain. Nature Neuroscience 2012; doi:10.1038/nn.3153.

Napadow V, et al. "Decreased intrinsic brain connectivity is associated with reduced clinical pain in fibromyalgia." Arthritis Rheumatism 2012; 64: 2398-2403.