Abstract
Studies with functional neuroimaging support the hypothesis of central pain augmentation in fibromyalgia syndrome (FMS) with functional differences in areas of the medial pain system. To clarify whether these findings are unique to patients with FMS, BOLD-signal patterns during and before tonic experimental pain were compared to healthy controls and patients with rheumatoid arthritis (RA) as a chronic pain disorder of somatic origin. We expected different BOLD-signal patterns in areas of the medial pain system that were most pronounced in patients with FMS. An fMRI-block design before, during and after an incision was performed in patients with FMS (n = 17), RA (n = 16) and in healthy controls (n = 17). A 2-factorial model of BOLD-signal changes was designed to explore significant differences of brain activation between the groups during the pain stimulus. Additionally, the correlation of brain activity during the anticipation of pain with the amount of the impending pain was determined. We observed a FMS-unique temporal brain activation of the frontal cortex in patients with FMS. Moreover, areas of the motor cortex and the cingulate cortex presented a FMS-specific relation between brain activity during pain anticipation and the magnitude of the subsequent pain experience. Our results support the hypothesis that central mechanisms of pain processing in the frontal cortex and cingulate cortex may play an important role in patients with FMS.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
Burgmer M, Pogatzki-Zahn E, Gaubitz M, Wessoleck E, Heuft G, Pfleiderer B (2009) Altered brain activity during pain processing in fibromyalgia. Neuroimage 44:502–508
Chua P, Krams M, Toni I, Passingham R, Dolan R (1999) A functional anatomy of anticipatory anxiety. Neuroimage 9:563–571
Cook DB, Lange G, Ciccone DS, Liu WC, Steffener J, Natelson BH (2004) Functional imaging of pain in patients with primary fibromyalgia. J Rheumatol 31:364–378
Davis KD, Taub E, Duffner F, Lozano AM, Tasker RR, Houle S, Dostrovsky JO (2000) Activation of the anterior cingulate cortex by thalamic stimulation in patients with chronic pain: a positron emission tomography study. J Neurosurg 92:64–69
Desmeules JA, Cedraschi C, Rapiti E, Baumgartner E, Finckh A, Cohen P, Dayer P, Vischer TL (2003) Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum 48:1420–1429
Drevets WC, Burton H, Videen TO, Snyder AZ, Simpson JR Jr, Raichle ME (1995) Blood flow changes in human somatosensory cortex during anticipated stimulation. Nature 373:249–252
Duncan GH, Kupers RC, Marchand S, Villemure JG, Gybels JM, Bushnell MC (1998) Stimulation of human thalamus for pain relief: possible modulatory circuits revealed by positron emission tomography. J Neurophysiol 80:3326–3330
Forman SD, Cohen JD, Fitzgerald M, Eddy WF, Mintun MA, Noll DC (1995) Improved assessment of significant activation in functional magnetic resonance imaging (fMRI): use of a cluster-size threshold. Magn Reson Med 33:636–647
Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, Clauw DJ (2004) Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum 50:613–623
Giesecke T, Gracely RH, Williams DA, Geisser ME, Petzke FW, Clauw DJ (2005) The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. Arthritis Rheum 52:1577–1584
Gracely RH, Petzke F, Wolf JM, Clauw DJ (2002) Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 46:1333–1343
Gracely RH, Geisser ME, Giesecke T, Grant MA, Petzke F, Williams DA, Clauw DJ (2004) Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127:835–843
Granges G, Littlejohn G (1993) Pressure pain threshold in pain-free subjects, in patients with chronic regional pain syndromes, and in patients with fibromyalgia syndrome. Arthritis Rheum 36:642–646
Hsieh JC, Belfrage M, Stone-Elander S, Hansson P, Ingvar M (1995) Central representation of chronic ongoing neuropathic pain studied by positron emission tomography. Pain 63:225–236
Hsieh JC, Stone-Elander S, Ingvar M (1999) Anticipatory coping of pain expressed in the human anterior cingulate cortex: a positron emission tomography study. Neurosci Lett 262:61–64
Jones AK, Derbyshire SW (1997) Reduced cortical responses to noxious heat in patients with rheumatoid arthritis. Ann Rheum Dis 56:601–607
Kawamata M, Watanabe H, Nishikawa K, Takahashi T, Kozuka Y, Kawamata T, Omote K, Namiki A (2002) Different mechanisms of development and maintenance of experimental incision-induced hyperalgesia in human skin. Anesthesiology 97:550–559
Kong J, Gollub RL, Rosman IS, Webb JM, Vangel MG, Kirsch I, Kaptchuk TJ (2006) Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance imaging. J Neurosci 26:381–388
Lautenschlager J, Mau W, Kohlmann T, Raspe HH, Struve F, Bruckle W, Zeidler H (1997) Comparative evaluation of a German version of the health assessment questionnaire and the hannover functional capacity questionnaire. Z Rheumatol 56:144–155
Lorenz J, Minoshima S, Casey KL (2003) Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation. Brain 126:1079–1091
Melzack R (1987) The short-form McGill Pain Questionnaire. Pain 30:191–197
Petzke F, Clauw DJ, Ambrose K, Khine A, Gracely RH (2003) Increased pain sensitivity in fibromyalgia: effects of stimulus type and mode of presentation. Pain 105:403–413
Peyron R, Garcia-Larrea L, Deiber MP, Cinotti L, Convers P, Sindou M, Mauguiere F, Laurent B (1995) Electrical stimulation of precentral cortical area in the treatment of central pain: electrophysiological and PET study. Pain 62:275–286
Ploghaus A, Tracey I, Gati JS, Clare S, Menon RS, Matthews PM, Rawlins JN (1999) Dissociating pain from its anticipation in the human brain. Science 284:1979–1981
Porro CA, Baraldi P, Pagnoni G, Serafini M, Facchin P, Maieron M, Nichelli P (2002) Does anticipation of pain affect cortical nociceptive systems? J Neurosci 22:3206–3214
Sawamoto N, Honda M, Okada T, Hanakawa T, Kanda M, Fukuyama H, Konishi J, Shibasaki H (2000) Expectation of pain enhances responses to nonpainful somatosensory stimulation in the anterior cingulate cortex and parietal operculum/posterior insula: an event-related functional magnetic resonance imaging study. J Neurosci 20:7438–7445
Singer T, Seymour B, O’Doherty J, Kaube H, Dolan RJ, Frith CD (2004) Empathy for pain involves the affective but not sensory components of pain. Science 303:1157–1162
Staud R, Rodriguez ME (2006) Mechanisms of disease: pain in fibromyalgia syndrome. Nat Clin Pract Rheumatol 2:90–98
Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ (1987) The Pain Disability Index: psychometric and validity data. Arch Phys Med Rehabil 68:438–441
Tracey I (2005) Nociceptive processing in the human brain. Curr Opin Neurobiol 15:478–487
Tzourio-Mazoyer N, Landeau B, Papathanassiou D, Crivello F, Etard O, Delcroix N, Mazoyer B, Joliot M (2002) Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 15:273–289
Valet M, Sprenger T, Boecker H, Willoch F, Rummeny E, Conrad B, Erhard P, Tolle TR (2004) Distraction modulates connectivity of the cingulo-frontal cortex and the midbrain during pain—an fMRI analysis. Pain 109:399–408
Vierck CJ Jr (2006) Mechanisms underlying development of spatially distributed chronic pain (fibromyalgia). Pain 124:242–263
Willoch F, Gamringer U, Medele R, Steude U, Tolle TR (2003) Analgesia by electrostimulation of the trigeminal ganglion in patients with trigeminopathic pain: a PET activation study. Pain 103:119–130
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172
Wright KD, Asmundson GJ, McCreary DR (2001) Factorial validity of the short-form McGill pain questionnaire (SF-MPQ). Eur J Pain 5:279–284
Zambreanu L, Wise RG, Brooks JC, Iannetti GD, Tracey I (2005) A role for the brainstem in central sensitisation in humans. Evidence from functional magnetic resonance imaging. Pain 114:397–407
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370
Acknowledgments
Dr Burgmer was supported by the ‘Innovative Medizinische Förderung’ (IMF), University of Münster, Germany (IMF BU120618). We have no conflicts of interest involving this work.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Burgmer, M., Pogatzki-Zahn, E., Gaubitz, M. et al. Fibromyalgia unique temporal brain activation during experimental pain: a controlled fMRI Study. J Neural Transm 117, 123–131 (2010). https://doi.org/10.1007/s00702-009-0339-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-009-0339-1