Decreased gray matter volumes in the cingulo-frontal cortex and the amygdala in patients with fibromyalgia.
OBJECTIVE
Studies in fibromyalgia syndrome with functional neuroimaging support the hypothesis of central pain augmentation. To determine whether structural changes in areas of the pain system are additional preconditions for the central sensitization in fibromyalgia we performed voxel based morphometry in patients with fibromyalgia and healthy controls.


METHODS
We performed 3 Tesla magnetic resonance imaging of the brain in 14 patients with fibromyalgia and 14 healthy controls. Regional differences of the segmented and normalized gray matter volumes in brain areas of the pain system between both groups were determined. In those areas in which patients structurally differed from healthy controls, the correlation of disease-related factors with gray matter volumes was analyzed.


RESULTS
Patients presented a decrease in gray matter volume in the prefrontal cortex, the amygdala, and the anterior cingulate cortex (ACC). The duration of pain or functional pain disability did not correlate with gray matter volumes. A trend of inverse correlation of gray matter volume reduction in the ACC with the duration of pain medication intake has been detected.


CONCLUSIONS
Our results suggest that structural changes in the pain system are associated with fibromyalgia. As disease factors do not correlate with reduced gray matter volume in areas of the cingulo-frontal cortex and the amygdala in patients, one possible interpretation is that volume reductions might be a precondition for central sensitization in fibromyalgia.
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstr. 22, 48153 Münster, Germany. burgmem@mednet.uni-muenster.de
Markus
M
Burgmer
Markus
M
Gaubitz
Carsten
C
Konrad
Marco
M
Wrenger
Sebastian
S
Hilgart
Gereon
G
Heuft
Bettina
B
Pfleiderer
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology; D001931:Brain Mapping; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology; D005625:Frontal Lobe / Q000473:pathology*; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D010147:Pain Measurement; D017397:Prefrontal Cortex / Q000473:pathology; D011594:Psychometrics