Session Title: Fibromyalgia and Soft Tissue Disorders II
Session Type: Abstract Submissions (ACR)
Background/Purpose: Fibromyalgia (FM) is commonly associated with catastrophizing, a set of negative emotional and cognitive processes related to pain. Catastrophizing is suggested to augment pain sensitivity through increased attention to pain and exaggerated emotional processing of pain. FM is associated with grey matter (GM) decreases in cortical medial frontal regions thought to be involved in attention to pain and pain modulation. We investigated the relationship between GM alterations and measures of pain, specifically hypothesizing that in fibromyalgia GM decreases in the medial frontal regions will be related to pain catastrophizing, as well as to pain sensitivity.
Methods: We recruited 29 female FM patients and 29 female controls matched for age, handedness, education, body mass index, physical activity, and socioeconomic status. All subjects underwent anatomical magnetic resonance imaging (MRI). Catastrophizing was assessed using the Pain Catastrophizing Scale; pain intensity and unpleasantness were assessed in response to a standardized pressure stimulus applied on the thumbnail. MRI data were preprocessed in SPM8. Voxel-wise GM differences were examined using independent sample t-tests while controling for age.
Results: Pain catastrophizing was higher in the FM patients (p<0.001), as was pain unpleasantness (p=0.011), with a trend for pain intensity (p=0.079). FM patients had decreased GM in the medial prefrontal cortex (MPFC), superior frontal gyrus, and premotor cortex (p<0.05 cluster-corrected). In FM patients, GM in the MPFC was negatively correlated with catastrophizing (p=0.022), pain intensity (p=0.048), and pain unpleasatness (p=0.020).
Conclusion: This study shows a three-way relationship between MPFC changes, catastrophizing and pain sensitivity, indicating that structural alerations in FM might contribute to the patients’ phenotype.
M. A. Fitzcharles,
Pfizer Inc, Lilly, Purdue, Valeant,
M. C. Bushnell,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/grey-matter-decrease-in-fibromyalgia-is-related-to-pain-catastrophizing-and-pain-sensitivity/