title: Self-perspective leads to increased activation of pain processing brain regions in fibromyalgia.
abstract: BACKGROUND
  Dysfunction of central nervous pain processing is assumed to play a key role in primary fibromyalgia (FM) syndrome. This pilot study examined differences of pain processing associated with adopting different interpersonal perspectives.
  
  
  METHODS
  Eleven FM patients and 11 healthy controls (HC) were scanned with functional magnetic resonance imaging. Participants were trained to take either a self-perspective or another person's perspective when viewing the visual stimuli. Stimuli showed body parts in painful situations of varying intensity (low, medium, and high) and visually similar but neutral situations.
  
  
  RESULTS
  Patients with FM showed a higher increase in blood oxygen level dependent (BOLD) response, particularly in the supplementary motor area (SMA). All pain-related regions of interest (anterior insula, somatosensory cortices, anterior cingulate cortex, and SMA) showed stronger modulation of BOLD responses in FM patients in the self-perspective. In contrast to pain processing regions, perspective-related regions (e.g. temporoparietal junction) did not differ between FM and HC.
  
  
  CONCLUSIONS
  The stronger response of all four pain processing cerebral regions during self-perspective is discussed in the light of disturbed bottom-up processing. Furthermore, the results confirm earlier reports of augmented pain processing in FM, and provide evidence for sensitization of central nervous pain processing.
authors: Medical Psychology and Medical Sociology, Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Medical Center, Mainz, Germany.
authors: Benjamin
authors: B
authors: Rahm
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Michael
authors: M
authors: Lacour
authors: Department of Psychology, and Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States.
authors: Jean
authors: J
authors: Decety
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Juliane
authors: J
authors: Müller
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Carl-Eduard
authors: CE
authors: Scheidt
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Joachim
authors: J
authors: Bauer
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Ralf
authors: R
authors: König
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Michael
authors: M
authors: Wirsching
authors: Department of Neurology, University of Freiburg, Freiburg, Germany.
authors: Volkmar
authors: V
authors: Glauche
authors: Medical Physics, Department of Radiology, University of Freiburg, Freiburg, Germany.
authors: Sabine
authors: S
authors: Ohlendorf
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Thomas
authors: T
authors: Unterbrink
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors: Armin
authors: A
authors: Hartmann
authors: Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany. Electronic address: andreas.joos@uniklinik-freiburg.de.
authors: Andreas A
authors: AA
authors: Joos
mesh_terms: D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement; D010865:Pilot Projects; D012647:Self-Assessment