Hypersensitivity to Non-Painful Events May be Part of Pathology in Fibromyalgia

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Fibromyalgia is a chronic, musculoskeletal syndrome characterized by widespread pain, affecting roughly two percent of the world population, say experts. According to the ACR, five million people in the U.S. have fibromyalgia, which is more prevalent among women.

In previous studies fibromyalgia patients report reduced tolerance to normal sensory (auditory, visual, olfactory, and tactile) stimulation in addition to greater sensitivity to pain. I am printing this study because it is pretty basic to the understanding of fibromyalgia. We feel pain when there shouldn’t be pain. It is interesting, in particular, to look at the areas of the brain that are activated when we do though.

Functional magnetic resonance imaging (fMRI) imaging of the brain

 Fibromyalgia pain dysfunction involves an increased sensitivity to pain known as hyperalgesia. A recent study published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR) shows that people with fibromyalgia have hypersensitivity even if events are non-painful based on Functional magnetic resonance imaging (fMRI) imaging of the brain.

The brain imaging reveals reduced activation in primary sensory regions and increased activation in sensory integration regions. These responses to non-painful stimulus may be the cause of problems with tactile, visual and auditory stimulation. Patients often do report reduced tolerance to environmental and sensory stimulus in addition to the pain.

Reduced activation of both the primary and secondary visual and auditory areas of the brain

For the present study, researchers used functional magnetic resonance imaging (fMRI) to assess brain response to sensory stimulation in 35 women with fibromyalgia and 25 healthy, age-matched controls. Patients had average disease duration of 7 years and a mean age of 47.

According to the study, patients reported increased unpleasantness in response to multisensory stimulation in daily life activities. Furthermore, fMRI displayed reduced activation of both the primary and secondary visual and auditory areas of the brain, and increased activation in sensory integration regions. These brain abnormalities mediated the increased unpleasantness to visual, auditory and tactile stimulation that patients reported to experience in daily life.

 

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Conclusion

The study concluded there was a strong “attenuation of brain responses to non-painful events in early sensory cortices, accompanied by an amplified response at later stages of sensory integration in the insula,” and these abnormalities are associated with the main FM symptoms suggesting this maybe be linked to the pathology of the syndrome.

Dr. Marina López-Solà from the University of Colorado Boulder stated, “Our study provides new evidence that fibromyalgia patients’ display altered central processing in response to multisensory stimulation, which are linked to core fibromyalgia symptoms and may be part of the disease pathology. The finding of reduced cortical activation in the visual and auditory brain areas that were associated with patient pain complaints may offer novel targets for neurostimulation treatments in fibromyalgia patients.”

Methods

Functional magnetic resonance imaging (fMRI) was used to assess brain response to auditory, visual and tactile-motor stimulation in 35 women with FM and 25 matched controls. Correlation and mediation analyses were performed to establish the relationship between brain responses and three types of outcomes: subjective hyper-sensitivity to daily sensory stimulation, spontaneous pain, and functional disability.

Hypersensitive responses to external stimuli

Hypersensitive responses to external stimuli, as displayed in FM patients, have been widely observed in various physical and biological systems such as cascade failures in a power-grid, abrupt state transitions in an electronic circuit and chemo-mechanical systems, epileptic seizures in the brain, and the sensitive frequency detection of the cochlea.

Explosive synchronization

A network property known as “explosive synchronization” (ES) has been studied as the underlying mechanism of abrupt state transitions within these types of systems and described as a discontinuous transition from an incoherent state to a synchronized state. In a network that displays ES condition(s), a perturbation rapidly propagates across the whole network through synchronization.

Our past work suggests that ES conditions are not present in the resting state of normal human brains. We hypothesized that ES may be a mechanism of FM hypersensitivity, with the expected result that FM patients with an enhanced ES condition would have greater network sensitivity and increased chronic pain.

EEG network configurations

To test this hypothesis, we first analyzed the resting-state EEG network configurations of 10 FM patients and assessed whether the FM brain network displayed characteristics of ES conditions (not found in normal humans), and the correlation between the strength of ES conditions and chronic pain intensity.

For the ES conditions, we examined positive degree frequency correlation, large frequency difference, and large frequency disassortativity (a tendency of higher frequency nodes to link with lower frequency nodes or vice versa) between linked nodes in the networks.

These are typical network conditions shown to suppress gradual synchronization, suddenly triggering global synchronization around a critical point. Second, we tested whether these ES conditions produce hypersensitive network characteristics in response to stimulation.

This network sensitivity was quantitatively compared between the human brain networks with ES and non-ES conditions using a frequency perturbation. The model and empirical data analysis provide convergent evidence that ES may be a network mechanism of FM hypersensitivity.

 

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Source: Arthritis & Rheumatology, September 15, 2014. By Marina López-Solà, Jesus Pujol, Tor D. Wager, Alba Garcia-Fontanals, Laura Blanco-Hinojo, Susana Garcia-Blanco, Violant Poca-Dias, Ben J. Harrison, Oren Contreras-Rodríguez, Jordi Monfort, Ferran Garcia-Fructuoso and Joan Deus. Department of Psychology and Neuroscience, Muenzinger D158, 345 UCB, Boulder, Colorado, 80309-0345. E-mail: marina.lopezsola@colorado.edu

Reference: Hypersensitivity To Non-Painful Events May Be Part Of Pathology In Fibromyalgia via ProHealth

 

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