• Psychosomatic medicine · Jan 2012

    Disrupted functional connectivity of the pain network in fibromyalgia.

    • Ignacio Cifre, Carolina Sitges, Daniel Fraiman, Miguel Ángel Muñoz, Pablo Balenzuela, Ana González-Roldán, Mercedes Martínez-Jauand, Niels Birbaumer, Dante R Chialvo, and Pedro Montoya.
    • Research Institute on Health Sciences, University of the Balearic Islands, Cra. Valldemossa km 7.5, 07122 Palma de Mallorca, Spain.
    • Psychosom Med. 2012 Jan 1;74(1):55-62.

    ObjectiveTo investigate the impact of chronic pain on brain dynamics at rest.MethodsFunctional connectivity was examined in patients with fibromyalgia (FM) (n = 9) and healthy controls (n = 11) by calculating partial correlations between low-frequency blood oxygen level-dependent fluctuations extracted from 15 brain regions.ResultsPatients with FM had more positive and negative correlations within the pain network than healthy controls. Patients with FM displayed enhanced functional connectivity of the anterior cingulate cortex (ACC) with the insula (INS) and basal ganglia (p values between .01 and .05), the secondary somatosensory area with the caudate (CAU) (p = .012), the primary motor cortex with the supplementary motor area (p = .007), the globus pallidus with the amygdala and superior temporal sulcus (both p values < .05), and the medial prefrontal cortex with the posterior cingulate cortex (PCC) and CAU (both p values < .05). Functional connectivity of the ACC with the amygdala and periaqueductal gray (PAG) matter (p values between .001 and .05), the thalamus with the INS and PAG (both p values < .01), the INS with the putamen (p = .038), the PAG with the CAU (p = .038), the secondary somatosensory area with the motor cortex and PCC (both p values < .05), and the PCC with the superior temporal sulcus (p = .002) was also reduced in FM. In addition, significant negative correlations were observed between depression and PAG connectivity strength with the thalamus (r = -0.64, p = .003) and ACC (r = -0.60, p = .004).ConclusionsThese findings demonstrate that patients with FM display a substantial imbalance of the connectivity within the pain network during rest, suggesting that chronic pain may also lead to changes in brain activity during internally generated thought processes such as occur at rest.

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