A new study using brain imaging has found distinct differences between the brains of fibromyalgia patients and those of healthy individuals.
Fibromyalgia is a condition which leads to widespread musculoskeletal pain which is often so severe that patients are left disabled, unable to work or even perform everyday household tasks unaided. It is estimated that 2-4% of the world's population is affected by the condition, most of these being women, with the prevalence being higher in developed nations; although this could be down to greater awareness.
Along with the pain patients experience various other troubling symptoms including fatigue, stiffness, sleep disturbances, cognitive difficulties such as poor memory and concentration (collectively known as "brain fog"), as well as digestive complaints (irritable bowel syndrome is more common in fibromyalgia than the general population).
Often referred to as an "invisible illness" because it cannot be diagnosed by lab tests, patients generally look healthy and there are no visible signs of damage or inflammation in muscles and joints as there are in say, arthritis, fibromyalgia is often dismissed by both the public and the medical profession. In fact, a survey conducted by researchers from the University of Oslo, Norway, at the end of 2007 found that doctors ranked fibromyalgia near the bottom of a list of disorders when asked to place them in order of importance or prestige (read this story). This could obviously affect patient care with the researchers suggesting fibromyalgia patients may need to kick up a fuss to get adequate treatment.
Now however, results from a French study are being seen as the latest addition to a growing body of evidence proving the physical reality of fibromyalgia. The researchers say this is exactly the type of evidence required to convince diehard sceptics of the reality of fibromyalgia as a physical pain disorder.
The research was conducted at the Centre Hospitalier-Universitaire de la Timone and used a brain scanning technique called single photon emission computed tomography (SPECT) to look for differences in brain function between fibromyalgia patients and healthy control subjects.
The study involved 20 women who had been diagnosed with fibromyalgia and 10 healthy women with no history of fibromyalgia or other muscoloskeletal or related conditions, acting as a control group. In addition to the SPECT scans the participants were asked to complete questionnaires regarding their levels of pain and disability, as well as levels of anxiety and depression. Psychological disorders such as anxiety and depression are often cited as the source of pain in those diagnosed with fibromyalgia but lead researcher Dr. Eric Guedj said that the abnormalities found in the brain scans done during the study were unrelated to anxiety and depression levels.
The results of the brain scans showed that the women with fibromyalgia had irregularities in "brain perfusion", essentially abnormal blood flow in the brain. There was hyperperfusion (increased blood flow) in brain areas associated with pain perception and and hypoperfusion (decreased blood flow) in areas associated with emotional procession. In combination with the questionnaire data the scans revealed that these abnormalities were directly connected to the intensity of pain and other symptoms.
Dr. Guedj said "We showed in our study that the functional abnormalities [in brain blood flow] observed were mainly related to disability."
The results of this research and similar previous studies led the French researchers to conclude that fibromyalgia is a disorder of pain processing in the brain which results in sensations of pain being heightened. They hope this knowledge will result in changes in the way fibromyalgia patients are cared for.
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