Decreased central mu-opioid receptor availability in fibromyalgia.
The underlying neurophysiology of acute pain is fairly well characterized, whereas the central mechanisms operative in chronic pain states are less well understood. Fibromyalgia (FM), a common chronic pain condition characterized by widespread pain, is thought to originate largely from altered central neurotransmission. We compare a sample of 17 FM patients and 17 age- and sex-matched healthy controls, using mu-opioid receptor (MOR) positron emission tomography. We demonstrate that FM patients display reduced MOR binding potential (BP) within several regions known to play a role in pain modulation, including the nucleus accumbens, the amygdala, and the dorsal cingulate. MOR BP in the accumbens of FM patients was negatively correlated with affective pain ratings. Moreover, MOR BP throughout the cingulate and the striatum was also negatively correlated with the relative amount of affective pain (McGill, affective score/sensory score) within these patients. These findings indicate altered endogenous opioid analgesic activity in FM and suggest a possible reason for why exogenous opiates appear to have reduced efficacy in this population.
Harris
Richard E
RE
Department of Internal Medicine, The University of Michigan, Ann Arbor, Michigan 48109, USA. reharris@med.umich.edu
Clauw
Daniel J
DJ
Scott
David J
DJ
McLean
Samuel A
SA
Gracely
Richard H
RH
Zubieta
Jon-Kar
JK
D015670:Acupuncture Therapy / Q000379:methods; D000328:Adult; D000679:Amygdala / Q000378:metabolism; D005260:Female; D005356:Fibromyalgia / Q000378:metabolism* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D009714:Nucleus Accumbens / Q000378:metabolism; D010147:Pain Measurement / Q000379:methods; D011485:Protein Binding / Q000502:physiology; D017450:Receptors, Opioid, mu / Q000037:antagonists & inhibitors* / Q000378:metabolism*
D017450:Receptors, Opioid, mu