No consistent difference in gray matter volume between individuals with fibromyalgia and age-matched healthy subjects when controlling for affective disorder.
Fibromyalgia (FM) is thought to involve abnormalities in central pain processing. Recent studies involving small samples have suggested alterations in gray matter volume (GMV) in brains of FM patients. Our objective was to verify these findings in a somewhat larger sample using voxel-based morphometry (VBM), while controlling for the presence of affective disorders (AD). T1-weighted magnetic resonance image (MRI) brain scans were obtained on 29 FM patients with AD, 29 FM patients without AD, and 29 age-matched healthy controls (HCs) using a 3T scanner. Segmentation, spatial normalization, and volumetric modulation were performed using an automated protocol within SPM5. Smoothed gray matter segments were entered into a voxel-wise one-way ANOVA, and a search for significant clusters was performed using thresholding methods published in previous studies (whole-brain threshold of p<.05 correcting for multiple comparisons; region-of-interest (ROI) threshold of p< or =.001 uncorrected, or p<.05 small-volume corrected). The whole-brain analysis did not reveal any significant clusters. ROI-based analysis revealed a significant difference in left anterior insula GMV among the three groups (xyz={-28, 21, 9}; p=.026, corrected). However, on post-hoc testing, FM patients without AD did not differ significantly from HC with respect to mean GMV extracted from this cluster. A significant negative correlation was found between mean cluster GMV and scores of trait anxiety (State-Trait Personality Inventory, Trait Anxiety scale; rho=-.470, p<.001). No other significant clusters were found on ROI-based analysis. Our results emphasize the importance of correcting for AD when carrying out VBM studies in chronic pain.
Department of Physical Medicine & Rehabilitation, University of Michigan Chronic Pain & Fatigue Research Center, 24 Frank Lloyd Wright Drive, Lobby M, P.O. Box 385, Ann Arbor, MI 48106, USA Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA Department of Radiology, University of Michigan, Ann Arbor, MI, USA College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor, MI, USA Department of Medicine, University of Michigan, Ann Arbor, MI, USA Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
Michael C
MC
Hsu
Richard E
RE
Harris
Pia C
PC
Sundgren
Robert C
RC
Welsh
Carlo R
CR
Fernandes
Daniel J
DJ
Clauw
David A
DA
Williams
D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D001284:Atrophy / Q000473:pathology* / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D003866:Depressive Disorder / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019964:Mood Disorders / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity