The contribution of sensory system functional connectivity reduction to clinical pain in fibromyalgia

被引:115
作者
Pujol, Jesus [1 ,2 ]
Macia, Didac [1 ]
Garcia-Fontanals, Alba [3 ]
Blanco-Hinojo, Laura [1 ,4 ]
Lopez-Sola, Marina [1 ,5 ]
Garcia-Blanco, Susana [6 ]
Poca-Dias, Violant [6 ]
Harrison, Ben J. [7 ]
Contreras-Rodriguez, Oren [1 ]
Monfort, Jordi [8 ]
Garcia-Fructuoso, Ferran [6 ]
Deus, Joan [1 ,3 ]
机构
[1] Hosp Mar, CRC Mar, Dept Magnet Resonance, Barcelona 08003, Spain
[2] CIBERSAM G21, Ctr Invest Biomed Red Salud Mental, Barcelona, Spain
[3] Autonomous Univ Barcelona, Dept Clin & Hlth Psychol, Barcelona, Spain
[4] Hosp Mar Res Inst, Inst Neuropsychiat & Addict, Barcelona, Spain
[5] Univ Colorado, Dept Psychol & Neurosci, Boulder, CO 80309 USA
[6] Hosp CIMA Sanitas, Dept Rheumatol, Barcelona, Spain
[7] Univ Melbourne, Melbourne Neuropsychiat Ctr, Dept Psychiat, Melbourne, Vic, Australia
[8] Hosp Mar, Dept Rheumatol, Barcelona, Spain
基金
英国医学研究理事会;
关键词
Fibromyalgia; fMRI; Functional connectivity; Sensory system; Pain modulation; SPINAL-CORD-INJURY; INTRINSIC BRAIN CONNECTIVITY; PRIMARY SOMATOSENSORY CORTEX; NEUROPATHIC PAIN; EVOKED PAIN; GENERALIZED HYPERVIGILANCE; SPONTANEOUS FLUCTUATIONS; PERIAQUEDUCTAL GRAY; PARIETAL OPERCULUM; TEMPORAL ANALYSIS;
D O I
10.1016/j.pain.2014.04.028
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
Fibromyalgia typically presents with spontaneous body pain with no apparent cause and is considered pathophysiologically to be a functional disorder of somatosensory processing. We have investigated potential associations between the degree of self-reported clinical pain and resting-state brain functional connectivity at different levels of putative somatosensory integration. Resting-state functional magnetic resonance imaging was obtained in 40 women with fibromyalgia and 36 control subjects. A combination of functional connectivity-based measurements were used to assess (I) the basic pain signal modulation system at the level of the periaqueductal gray (FAG); (2) the sensory cortex with an emphasis on the parietal operculum/secondary somatosensory cortex (SII); and (3) the connectivity of these regions with the self-referential "default mode" network. Compared with control subjects, a reduction of functional connectivity was identified across the 3 levels of neural processing, each showing a significant and complementary correlation with the degree of clinical pain. Specifically, self-reported pain in fibromyalgia patients correlated with (1) reduced connectivity between PAG and anterior insula; (2) reduced connectivity between SII and primary somatosensory, visual, and auditory cortices; and (3) increased connectivity between SII and the default mode network. The results confirm previous research demonstrating abnormal functional connectivity in fibromyalgia and show that alterations at different levels of sensory processing may contribute to account for clinical pain. Importantly, reduced functional connectivity extended beyond the somatosensory domain and implicated visual and auditory sensory modalities. Overall, this study suggests that a general weakening of sensory integration underlies clinical pain in fibromyalgia. (C) 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:1492 / 1503
页数:12
相关论文
共 78 条
[1]
HEAT-INDUCED PAIN DIMINISHES VIBROTACTILE PERCEPTION - A TOUCH GATE [J].
APKARIAN, AV ;
STEA, RA ;
BOLANOWSKI, SJ .
SOMATOSENSORY AND MOTOR RESEARCH, 1994, 11 (03) :259-267
[2]
Beyond feeling: Chronic pain hurts the brain, disrupting the default-mode network dynamics [J].
Baliki, Marwan N. ;
Geha, Paul Y. ;
Apkarian, A. Vania ;
Chialvo, Dante R. .
JOURNAL OF NEUROSCIENCE, 2008, 28 (06) :1398-1403
[3]
Chronic pain and the emotional brain: Specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain [J].
Baliki, Marwan N. ;
Chialvo, Dante R. ;
Geha, Paul Y. ;
Levy, Robert M. ;
Harden, R. Norman ;
Parrish, Todd B. ;
Apkarian, A. Vania .
JOURNAL OF NEUROSCIENCE, 2006, 26 (47) :12165-12173
[4]
Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment [J].
Baron, Ralf ;
Binder, Andreas ;
Wasner, Gunnar .
LANCET NEUROLOGY, 2010, 9 (08) :807-819
[5]
Periaqueductal gray An interface for behavioral control [J].
Benarroch, Eduardo E. .
NEUROLOGY, 2012, 78 (03) :210-217
[6]
Brett M., 2002, 8 INT C FUNCT MAPP H, V16
[7]
Cortical Hubs Revealed by Intrinsic Functional Connectivity: Mapping, Assessment of Stability, and Relation to Alzheimer's Disease [J].
Buckner, Randy L. ;
Sepulcre, Jorge ;
Talukdar, Tanveer ;
Krienen, Fenna M. ;
Liu, Hesheng ;
Hedden, Trey ;
Andrews-Hanna, Jessica R. ;
Sperling, Reisa A. ;
Johnson, Keith A. .
JOURNAL OF NEUROSCIENCE, 2009, 29 (06) :1860-1873
[8]
BURCKHARDT CS, 1991, J RHEUMATOL, V18, P728
[9]
Multiple parietal operculum subdivisions in humans: Tactile activation maps [J].
Burton, Harold ;
Sinclair, Robert J. ;
Wingert, Jason R. ;
Dierker, Donna L. .
SOMATOSENSORY AND MOTOR RESEARCH, 2008, 25 (03) :149-162
[10]
EULAR evidence-based recommendations for the management of fibromyalgia syndrome [J].
Carville, S. F. ;
Arendt-Nielsen, S. ;
Bliddal, H. ;
Blotman, F. ;
Branco, J. C. ;
Buskila, D. ;
Da Silva, J. A. P. ;
Danneskiold-Samsoe, B. ;
Dincer, F. ;
Henriksson, C. ;
Henriksson, K. G. ;
Kosek, E. ;
Longley, K. ;
McCarthy, G. M. ;
Perrot, S. ;
Puszczewicz, M. ;
Sarzi-Puttini, P. ;
Silman, A. ;
Spaeth, M. ;
Choy, E. H. .
ANNALS OF THE RHEUMATIC DISEASES, 2008, 67 (04) :536-541