MGH Researchers Make a Key Discovery for Diagnosing Fibromyalgia Patients

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Fibromyalgia patients often hear the words “You look so good. How can you be ill?” Or maybe the insensitive words “fibromyalgia is all in your head”. Ongoing and recent research; however, validates the reality of this invisible illness. This information allows individuals with fibromyalgia and other similar invisible illnesses to press on beyond doubt and find validation for their complex illnesses. Even more important, understanding recent research helps provide direction and identifies natural choices for healthy pain management with fibromyalgia.

Written by Marco Loggia, PhD
Investigator, Martinos Center for Biomedical Imaging, Massachusetts General Hospital
Assistant Professor of Radiology, Harvard Medical School

Fibromyalgia can be a difficult disease to clearly diagnose, as the symptoms can often change and coexist with symptoms of other diseases. Researchers at Mass General and colleagues from Switzerland recently identified a distinct pattern of brain inflammation in fibromyalgia patients that could be the key to diagnosing the elusive disorder.

Fibromyalgia has been a medical mystery for quite some time. Unlike other chronic medical conditions, there is no test or scan that can detect it. Doctors can only make a diagnosis based on a patient’s reported symptoms and by excluding other possible causes.

However, a team of researchers at Mass General, in collaboration with a team form the Karolinska Institutet in Sweden, recently identified a pattern of inflammation in the brains of fibromyalgia patients that could be the key to diagnosing the elusive disorder. Their insights could also provide much needed validation for fibromyalgia patients, who have often encountered skepticism about the legitimacy of their symptoms.

Patients with fibromyalgia often describe feeling pain throughout the body, fatigue, mood swings, and difficulties with sleep (click here to read what sleeping is like in fibro) and memory. These symptoms are said to come and go, as well as coexist with symptoms of other diseases, making a clear diagnosis difficult. (Click here to read 15 comorbids conditions in  fibro).

What is inflammation?

Inflammation is part of the body’s healing process. Without inflammation, infections and wounds would not heal. But inflammation can also be potentially harmful. There are two types of inflammation, acute and chronic. Acute inflammation comes on suddenly from an injury or infection. It presents classic symptoms such as swelling, redness and pain.

Acute inflammation is momentary, lasting from a few days to a couple of weeks, depending on the origin of the inflammation. Chronic inflammation is long-term inflammation that lasts for months and years. It comes about slowly and sets the stage for chronic diseases. Heart disease, autoimmune diseases, neurological diseases, diabetes, cancer, Alzheimer’s, arthritis and many other conditions are linked to chronic inflammation.

Targeting Brain Inflammation

Using a strategy that had previously been successful in identifying brain inflammation associated with chronic back pain, the team—led by Marco Loggia, PhD—used PET brain imaging technology to measure the activity levels of a key protein in astrocytes and microglia, two types of brain cells known as glial cells.

By comparing the imaging results of fibromyalgia patients to healthy controls, they found that fibromyalgia patients had increased inflammatory activity in several regions of the brain. Researchers suspect that this widespread inflammation could explain the complexity of fibromyalgia symptoms. There also appears to be a correlation between inflammatory activity and the severity of fibromyalgia symptoms. The higher the reported fatigue, the higher the levels of inflammation the researchers found.

The researchers believe that this inflammation may increase the sensitivity of receptors related to pain and fatigue. The discovery could also give researchers a way to measure the effectiveness of new therapies by measuring how inflammation levels change in response to treatment.

“Demonstrating inflammation in the brain of patients suffering from fibromyalgia has two implications,” says Loggia.

“First, by showing that objective neurochemical changes can be observed, we provide validation to these patients that their condition is real, a claim that is often met with skepticism and stigma by society and even some clinicians. Second, our results identify in neuroinflammation a novel therapeutic target, paving the way for novel treatments for this poorly-understood and difficult-to-treat condition.” Reference: Mass General

 

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Research teams find widespread inflammation in the brains of fibromyalgia patients

PET imaging studies reveal elevated glial activation, correlation with fatigue levels. A study has documented for the first time widespread inflammation in the brains of patients with the poorly understood condition called fibromyalgia.

A study by Massachusetts General Hospital (MGH) researchers — collaborating with a team at the Karolinska Institutet in Sweden — has documented for the first time widespread inflammation in the brains of patients with the poorly understood condition called fibromyalgia. Their report has been published online in the journal Brain, Behavior and Immunity.

“We don’t have good treatment options for fibromyalgia, so identifying a potential treatment target could lead to the development of innovative, more effective therapies,” says Marco Loggia, PhD, of the MGH-based Martinos Center for Biomedical Imaging, co-senior author of the report. “And finding objective neurochemical changes in the brains of patients with fibromyalgia should help reduce the persistent stigma that many patients face, often being told their symptoms are imaginary and there’s nothing really wrong with them.”

The current study provides evidence of elevated TSPO binding, as measured with CPBR28 PET, in patients with fibromyalgia (FM) compared to healthy controls (HC). This marker of glial activation was increased in several brain regions implicated in FM pathology from previous neuroimaging studies. We also report positive associations between TSPO PET signal in several of these regions and subjective ratings of fatigue, one of the most common symptoms reported by FM patients (Clauw, 2014, Wolfe et al., 2011). Our observations are supportive of a role for neuroimmune/glial activation in FM pathology.

These results conform to a body of clinical data suggesting a possible association between neuroinflammation and FM. Several studies of FM patients demonstrated elevated CSF levels of molecules implicated in neuroglial signaling, such as fractalkine and IL-8. You can read this complete research paper from here. 

 

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Related article: Systematic Inflammation found in Fibromyalgia

Study Reference:

Massachusetts General Hospital. “Research teams find widespread inflammation in the brains of fibromyalgia patients: PET imaging studies reveal elevated glial activation, correlation with fatigue levels.” ScienceDaily. ScienceDaily, 27 September 2018. 

Mass General Researchers Make a Key Discovery for Diagnosing Fibromyalgia Patients via massgeneral.org

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