Unique Brain Connectivity in Fibromyalgia

Increased Importance Assigned to Pain

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Has anyone ever told you it seemed like you were obsessed with your pain? It's a fairly common thing for those of us with fibromyalgia to hear. Doctors use the term catastrophizing, meaning that we treat pain as a catastrophe.

Now, thanks to a new study published in Arthritis & Rheumatology, we may be able tell them exactly why that is – with brain images to back it up!

Researchers used functional magnetic resonance imaging (fMRI) to watch what happens in the brains of people with fibromyalgia at rest (with just their normal pain levels) vs. while they experience deep-tissue pain caused by tight blood-pressure cuffs on their legs.

They were looking especially at connectivity – which areas of the brains were working together and to what degree – in fibromyalgia vs. healthy control subjects.

While at rest, the fibro brains showed abnormally low connectivity between multiple regions when compared to controls. Those with more pain at rest had less connectivity than those with less pain at rest.

Once the pain was applied, however, people with fibromyalgia had increased connectivity between part of the somatosensory cortex and the anterior insula. The somatosensory cortex is the area that receives information about physical sensation, such as pain, from the nerves and spinal cord. The anterior insula deals with autonomic information (the automatic functions of your body) and assigns importance to them, thus telling your brain what to pay attention to.

This suggests that in fibromyalgia, our brains assign higher importance and prominence to pain.

It's not that we're "making a big deal" out of it, as in over-reacting. We're subject to a physiological emphasis in our brains.

Think of it like this: It's the difference between when your toddler calls for you and when he shrieks for you; or the difference between hearing a phone ring in the middle of the afternoon and responding calmly vs. it ringing in the middle of the night, yanking you out of sleep in a panic because something must be horribly wrong for someone to call you at that hour.

I can certainly relate to the difference. My fibromyalgia is in remission, but I'm still in significant pain because I've developed arthritis. I remember how fibromyalgia pain seemed insistent and made it difficult or even impossible to focus on anything else. The pain I have now often hurts just as bad, but it's a lot easier for me to tune out.

Researchers also say this study suggests pain, pain catastrophizing, autonomic dysfunction, and pain amplification in us are all linked to this increased connectivity.

The next step, they say, is to find treatments that can help lessen this connectivity and bring it more in line with normal levels. They're interested in observing our brains during cognitive behavioral therapy to see what's happening there – and whether they can improve it.

Source:

Kim J, et al. Arthritis & rheumatology. 2015 Jan 26. [Epub ahead of print.] The somatosensory link: S1 functional connectivity is altered by sustained pain and associated with clinical/autonomic dysfunction in fibromyalgia.

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