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Resting brain activity measured by an adaptation of functional magnetic resonance imaging (fMRI) appears to be associated with spontaneous clinical pain in patients with fibromyalgia, suggesting a potential objective measure of pain in this setting. Vitaly Napadow, PhD, with the Massachusetts General Hospital in Charlestown, and colleagues reported their findings in the August 2010 issue of Arthritis and Rheumatology.

"Resting-state functional-connectivity MRI is a recent adaptation of fMRI that may be promising for the assessment of associations of spontaneous functional pain with specific brain network activity," the study authors write.

In the current study, Dr. Napadow and colleagues sought to establish the degree of connectivity within multiple brain networks in fibromyalgia, as well as the correlation between network activity and spontaneous pain.

The study included 18 patients with fibromyalgia and 18 healthy individuals matched for age. They evaluated resting (intrinsic) connectivity in 3 brain networks: (1) the default mode network (DMN), which is most active at rest and is deactivated during performance of externally focused tasks; (2) the executive attention network (EAN), involved with cognitive processing of memory and attention; and (3) the medial visual network, which served as a control and is involved in processing visual information.

Fibromyalgia patients had greater connectivity within the DMN and right EAN and greater connectivity between the DMN and the insular cortex, a region of the brain that processes evoked pain. In addition, they found a direct link to ratings of self-reported spontaneous pain at the time of the scan and the extent of both right EAN and DMN connectivity to the insula.

According to the researchers, the findings "strongly implicate the insular cortex as being a key node in the elevated intrinsic connectivity in patients with fibromyalgia."

"The results of this study provide direct evidence of disrupted intrinsic connectivity within multiple brain networks in patients with fibromyalgia," Dr. Napadow and colleagues conclude. Their approach "represents a novel step forward in finding the neural correlates of spontaneous clinical pain," they add.

Source: Medscape