Altered Functional Magnetic Resonance Imaging Responses to Nonpainful Sensory Stimulation in Fibromyalgia Patients

López‐Solà, Marina; Pujol, Jesús; Wager, Tor D.; Garcia-Fontanals, Alba; Blanco‐Hinojo, Laura; Garcia-Blanco, S.; Poca-Dias, Violant; Harrison, Ben J; Contreras‐Rodríguez, Oren; Monfort, Jordi; Garcia-Fructuoso, Ferran J; Deus, Joan

doi:10.1002/art.38781

Cited by 101 publications

(120 citation statements)

References 50 publications

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“…Previous research has shown that reduced resting-state functional connectivity in sensory-motor systems and augmented unpleasant reactions to nonpainful sensory stimuli are strongly predictive of clinical pain in FM patients (33,34). We might hypothesize that a low basal muscle tone could contribute to this reduced connectivity in a process leading to peripheral sensitization.…”

Section: Discussionmentioning

confidence: 91%

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Soriano‐Maldonado

Ruiz

Aparicio

et al. 2015

Arthritis Care & Research

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Objective. This population-based cross-sectional study aimed to characterize the association of different components of physical fitness with pain levels, pain-related catastrophizing, and chronic pain self-efficacy in women with fibromyalgia (FM). Methods. A total of 468 women with FM participated. The experience of pain was assessed with different tools (algometry, a numeric rating scale [revised FM impact questionnaire], a visual analog scale, and the bodily pain subscale on the Short Form 36 health survey). We also assessed pain-related catastrophizing and chronic pain self-efficacy. Physical fitness was assessed with performance-based tests (Senior Fitness Test battery and handgrip dynamometry). A standardized composite score was computed for each component of physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility), and their average comprised a clustered global fitness profile. Results. Overall, higher physical fitness was consistently associated with lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy (regardless of the pain assessment method and the fitness test evaluated). Muscle strength and flexibility were independently associated with pain (P < 0.005 for both), and participants with high muscle strength plus high flexibility (combined effect) had the lowest levels of pain in this population. Aerobic fitness and flexibility were independently associated with pain-related catastrophizing (P < 0.001 for both) and chronic pain self-efficacy (P < 0.001 for both), and participants with high flexibility plus high aerobic fitness (combined effect) had the best catastrophizing and self-efficacy profiles. Conclusion. Our results suggest that higher physical fitness is associated with lower levels of pain, lower pain-related catastrophizing, and higher chronic pain self-efficacy in women with FM. These results might have implications for future intervention studies in this population.

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Section: Discussionmentioning

confidence: 91%

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Soriano‐Maldonado

Ruiz

Aparicio

et al. 2015

Arthritis Care & Research

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“…Second, responses to nonpainful sensory stimuli may not be augmented in early sensory cortices but may appear augmented during later stages of sensory integration as suggested by a recent functional MRI study. 31 The experimental design of this study was methodologically sound. First, the interpulse interval of 100 milliseconds has been shown to be sufficiently short to identify a significant PPS in the S1.…”

Section: Discussionmentioning

confidence: 99%

Disinhibition of the primary somatosensory cortex in patients with fibromyalgia

Lim

Roosink

Kim

et al. 2015

Pain

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Fibromyalgia (FM) is a chronic widespread pain condition linked to central sensitization. Altered excitability of sensorimotor cortex has been proposed as an underlying pathology of FM. This study aimed to investigate intracortical excitability of the primary somatosensory cortex (S1) and its potential role in clinical pain in patients with FM. Somatosensory evoked magnetic fields were recorded in 17 right-handed females with FM and 21 age-, sex-, and handedness-matched healthy control subjects. Paired-pulse median nerve stimulation was delivered to the left and right wrist. We assessed the peak-to-peak amplitudes of the N20m-P35m and peak amplitude of each N20m and P35m component. Paired-pulse suppression (PPS) of the second response was quantified as the ratio of the amplitudes of the second to the first response. Patients with FM displayed significantly higher PPS ratio for the N20m-P35m in both hemispheres, indicating reduced intracortical inhibition in the S1. Notably, PPS ratio for the P35m was higher in patients with FM than in healthy controls, whereas no differences were apparent in PPS ratio for the N20m in both hemispheres. For both the N20m-P35m and the P35m in the left hemisphere, PPS ratios were positively associated with the sensory pain on the short-form McGill Pain Questionnaire. This study demonstrated that intracortical inhibition in the S1 is compromised bilaterally in patients with FM, and the extent of disinhibition can be closely associated with increased clinical pain. Our results suggest that changes of intracortical inhibition of the S1 may contribute to the pathophysiology of FM pain.

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“…FM patients also commonly experience anxiety, depression, and other pain syndromes including IBS, TMD, and VVS. Psychophysical testing has repeatedly demonstrated enhanced sensitivity to a wide array of painful and non-painful stimulation [3–5]. …”

Section: Brief Description Of Each “Central Sensitivity Syndrome”mentioning

confidence: 99%

Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature

Walitt

Čeko²,

Gracely³

et al. 2016

CRR

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Central sensitivity syndromes are characterized by distressing symptoms, such as pain and fatigue, in the absence of clinically obvious pathology. The scientific underpinnings of these disorders are not currently known. Modern neuroimaging techniques promise new insights into mechanisms mediating these postulated syndromes. We review the results of neuroimaging applied to five central sensitivity syndromes: fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, temporomandibular joint disorder, and vulvodynia syndrome. Neuroimaging studies of basal metabolism, anatomic constitution, molecular constituents, evoked neural activity, and treatment effect are compared across all of these syndromes. Evoked sensory paradigms reveal sensory augmentation to both painful and non-painful stimulation. This is a transformative observation for these syndromes, which were historically considered to be completely of hysterical or feigned in origin. However, whether sensory augmentation represents the cause of these syndromes, a predisposing factor, an endophenotype, or an epiphenomenon cannot be discerned from the current literature. Further, the result from cross-sectional neuroimaging studies of basal activity, anatomy, and molecular constituency are extremely heterogeneous within and between the syndromes. A defining neuroimaging “signature” cannot be discerned for any of the particular syndromes or for an over-arching central sensitization mechanism common to all of the syndromes. Several issues confound initial attempts to meaningfully measure treatment effects in these syndromes. At this time, the existence of “central sensitivity syndromes” is based more soundly on clinical and epidemiological evidence. A coherent picture of a “central sensitization” mechanism that bridges across all of these syndromes does not emerge from the existing scientific evidence.

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Altered Functional Magnetic Resonance Imaging Responses to Nonpainful Sensory Stimulation in Fibromyalgia Patients

Cited by 101 publications

References 50 publications

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Association of Physical Fitness With Pain in Women With Fibromyalgia: The al‐Ándalus Project

Disinhibition of the primary somatosensory cortex in patients with fibromyalgia

Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature

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