Fibromyalgia Pain Isn't All In Patients' Heads, New Brain Study

Discussion in 'Fibromyalgia Main Forum' started by fight4acure, Jun 12, 2006.

  1. fight4acure

    fight4acure Member

    I received this article in the email, from Sherrie from AFFTER (Advocates for Fibromyalgia Funding, Treatment, Education, & Research).

    June 12,2006



    There are two related studies that involve functional MRI of the brain. The first one involves fibromyalgia patients, and the second study is on people with chronic low back pain. The findings were similar. These studies are very important because they validate with an MRI picture of the brain, that people with fibromyalgia are indeed feeling more pain than normal controls. This technology offers hope for the future of fibromyalgia research.




    “The results, which will be presented Oct. 27 at the annual meeting of the American College of Rheumatology in New Orleans, may help lead researchers to important findings on lower back pain, and on enhanced pain perception in general.

    Senior authors Richard Gracely, Ph.D., and Daniel Clauw, M.D., did the study at Georgetown University Medical Center and the National Institutes of Health, but are now continuing the work at the University of Michigan Health System. In May, they and their colleagues published a paper in the journal Arthritis and Rheumatism on pain perception in fibromyalgia patients.”



    See the two articles in their entirety below.

    (I know you know it is real, so please no sarcasm, I just wanted to show that this is good news that they're actually looking into this more. Please read below!)

    Fibromyalgia Pain Isn't All In Patients' Heads, New Brain Study Finds

    ANN ARBOR, MI -- A new brain-scan study confirms scientifically what fibromyalgia patients have been telling a skeptical medical community for years: They're really in pain.

    October 28, 2002

    article source:

    http://www.sciencedaily.com/releases/2002/06/020607073056.htm

    Source: University Of Michigan Health System
    Posted: June 7, 2002

    In fact, the study finds, people with fibromyalgia say they feel severe pain, and have measurable pain signals in their brains, from a gentle finger squeeze that barely feels unpleasant to people without the disease. The squeeze's force must be doubled to cause healthy people to feel the same level of pain -- and their pain signals show up in different brain areas.

    The results, published in the current issue of Arthritis & Rheumatism, the journal of the American College of Rheumatology, may offer the proof of fibromyalgia's physical roots that many doubtful physicians have sought. It may also open doors for further research on the still-unknown causes of the disease, which affects more than 2 percent of Americans, mainly women.

    Lead authors Richard Gracely, Ph.D., and Daniel Clauw, M.D., did the study at Georgetown University Medical Center and the National Institutes of Health, but are now continuing the work at the University of Michigan Health System. In an editorial in the same issue, Clauw and U-M rheumatologist Leslie Crofford, M.D., stress the importance of fibromyalgia research and care.

    To correlate subjective pain sensation with objective views of brain signals, the researchers used a super-fast form of MRI brain imaging, called functional MRI or fMRI, on 16 fibromyalgia patients and 16 people without the disease. As a result, they say, the study offers the first objective method for corroborating what fibromyalgia patients report they feel, and what's going on in their brains at the precise moment they feel it. And, it gives researchers a road map of the areas of the brain that are most -- and least -- active when patients feel pain.

    "The fMRI technology gave us a unique opportunity to look at the neurobiology underlying tenderness, which is a hallmark of fibromyalgia," says Clauw. "These results, combined with other work done by our group and others, have convinced us that some pathologic process is making these patients more sensitive. For some reason, still unknown, there's a neurobiological amplification of their pain signals."

    Further results from the study were presented last year at the ACR annual meeting. The project will continue later this year at UMHS, joining other fMRI fibromyalgia research now under way.

    For decades, patients and physicians have built a case that fibromyalgia is a specific, diagnosable chronic disease, characterized by tenderness and stiffness all over the body as well as fatigue, headaches, gastrointestinal problems and depression. Many patients with the disease find it interferes with their work, family and personal life. Statistics show that far more women than men are affected, and that it occurs mostly during the childbearing years.

    The ACR released classification criteria for fibromyalgia in 1990, to help doctors diagnose it and rule out other chronic pain conditions. Clauw and Crofford's editorial looks at the current state of research, and calls for rheumatologists to take the lead in fibromyalgia care and science.

    But many skeptics have debated the very existence of fibromyalgia as a clearly distinct disorder, saying it seemed to be rooted more in psychological and social factors than in physical, biological causes. Their argument has been bolstered by the failure of research to find a clear cause, an effective treatment, or a non-subjective way of assessing patients.

    While the debate has raged, neuroscientists have begun to use brain scan technology to identify the areas of the normal human brain that become most active during pain. A few studies have even assessed the blood flow in those areas in fibromyalgia patients during baseline brain scans. The new study is the first to use both high-speed scanning and a painful stimulus.

    In the study, fibromyalgia patients and healthy control subjects had their brains scanned for more than 10 minutes while a small, piston-controlled device applied precisely calibrated, rapidly pulsing pressure to the base of their left thumbnail. The pressures were varied over time, using painful and non-painful levels that had been set for each patient prior to the scan.

    The study's design gave two opportunities to compare patients and controls: the pressure levels at which the pain rating given by patients and control subjects was the same, and the rating that the two different types of participants gave when the same level of pressure was applied.

    The researchers found that it only took a mild pressure to produce self-reported feelings of pain in the fibromyalgia patients, while the control subjects tolerated the same pressure with little pain.

    "In the patients, that same mild pressure also produced measurable brain responses in areas that process the sensation of pain," says Clauw. "But the same kind of brain responses weren't seen in control subjects until the pressure on their thumb was more than doubled."

    Though brain activity increased in many of the same areas in both patients and control subjects, there were striking differences too. Patients feeling pain from mild pressure had increased activity in 12 areas of their brains, while the control subjects feeling the same pressure had activation in only two areas. When the pressure on the control subjects' thumbs was increased, so did their pain rating and the number of brain areas activated. But only eight of the areas were the same as those in patients' brains.

    In all, the fibromyalgia patients' brains had both some areas that were activated in them but not in controls, and some areas that stayed "quiet" in them but became active in the brains of controls feeling the same level of pain. This response suggests that patients have enhanced response to pain in some brain regions, and a diminished response in others, Clauw says.

    The study was supported in part by the National Fibromyalgia Research Association, the U.S. Army and the NIH. In addition to Clauw and Gracely, the research team included Frank Petzke, M.D.; and Julie M. Wolf, BA. For more information on fibromyalgia research and treatment at UMHS, visit http://www.med.umich.edu/intmed/rheumatology/fmweb



    [This Message was Edited on 06/13/2006]
  2. fight4acure

    fight4acure Member

    Brain study of back pain sufferers yields intriguing results

    Article source: http://www.med.umich.edu/opm/newspage/2002/backpain.htm

    Scans show amplified pain signals in patients with back pain of unknown origin

    ANN ARBOR, MI - Patients with lower back pain that can't be traced to a specific physical cause may have abnormal pain-processing pathways in their brains, according to a new study led by University of Michigan researchers.

    The effect, which as yet has no explanation, is similar to an altered pain perception effect in fibromyalgia patients recently reported by the same research team.

    In fact, the study finds, people with lower back pain say they feel severe pain, and have measurable pain signals in their brains, from a gentle finger squeeze that barely feels unpleasant to people without lower back pain. People with fibromyalgia felt about the same pain from a squeeze of the same intensity.

    But the squeeze's force must be increased sharply to cause healthy people to feel the same level of pain - and their pain signals register p in different brain areas.

    The results, which will be presented Oct. 27 at the annual meeting of the American College of Rheumatology in New Orleans, may help lead researchers to important findings on lower back pain, and on enhanced pain perception in general.

    Senior authors Richard Gracely, Ph.D., and Daniel Clauw, M.D., did the study at Georgetown University Medical Center and the National Institutes of Health, but are now continuing the work at the University of Michigan Health System. In May, they and their colleagues published a paper in the journal Arthritis and Rheumatism on pain perception in fibromyalgia patients.

    To correlate subjective pain sensation with objective views of brain signals, the researchers used a super-fast form of MRI brain imaging, called functional MRI or fMRI. They looked at the brains of 15 people with lower back pain whose body scans showed no mechanical cause, such as a ruptured disk, for their pain. They also looked at 15 fibromyalgia patients and 15 normal control subjects.

    As a result, they say, the study offers the first objective method for corroborating what lower back pain patients report they feel, and what's going on in their brains at the precise moment they feel it. And, it continues to give researchers a road map of the areas of the brain that are most - and least - active when patients feel pain. The researchers hope that further study on larger groups of patients will yield more information on altered pain processing.

    "The fMRI technology gave us a unique opportunity to look at the neurobiology underlying tenderness, which is a hallmark of both lower back pain and fibromyalgia," says Clauw. "These results, combined with other work done by our group and others, have convinced us that some pathologic process is making these patients more sensitive. For some reason, still unknown, there's a neurobiological amplification of their pain signals."

    Lower back pain affects nearly all Americans from time to time, especially those who are overweight, sedentary or work in physically demanding jobs. The pain can interfere with life and work; problems stemming from lower back pain are the second most frequent cause of lost work days in adults under the age of 45, ranking below only the common cold.

    Much of the pain may be due to pulled muscles, strained ligaments, damaged joints or small tears in the disks that act as cushions between the bones of the spine - all causes that don't show up well on X-rays but often can be seen on CT or conventional MRI scans. These physical causes often disappear after a few weeks, but many patients have chronic or recurring lower-back pain.

    In the study, the lower-back pain patients were examined by CT scan to rule out mechanical causes of their pain. Then they, the fibromyalgia patients and the healthy control subjects had their brains scanned by fMRI for more than 10 minutes while a small, piston-controlled device applied precisely calibrated, rapidly pulsing pressure to the base of their left thumbnail. The pressures were varied over time, using painful and non-painful levels that had been set for each patient prior to the scan.

    The study's design gave two opportunities to compare patients and controls. The subjective comparison measured the pressure levels at which the pain rating given by back pain patients, fibromyalgia patients and control subjects was the same. The objective comparison looked at the rating that the three types of participants gave when the same level of pressure was applied.

    The researchers found that it only took a mild pressure to produce self-reported feelings of pain in the lower-back pain and fibromyalgia patients, while the control subjects tolerated the same pressure with little pain.

    "In both the back pain patients and the fibromyalgia patients, that same mild pressure also produced measurable brain responses in areas that process the sensation of pain," says Clauw. "But the same kind of brain responses weren't seen in control subjects until the pressure on their thumb increased substantially."

    Though brain activity increased in many of the same areas in both patients and control subjects, there were striking differences, too. All the subjects had increased activity in eight areas of their brains, but lower-back pain patients showed no increased activity in two areas that were active in both fibromyalgia patients and normal control subjects. Meanwhile, fibromyalgia patients showed increased activation in two other areas not active in back pain patients and healthy subjects.

    This response suggests that lower-back pain patients have enhanced response to pain in some brain regions, and a diminished response in others, Clauw says.

    The study was supported in part by the National Fibromyalgia Research Association, the U.S. Army and the NIH. In addition to Clauw and Gracely, the research team included Thorsten Giesecke and Masilo Grant of UMHS, Karen Munoz of NIH, Reshma Kumar of Georgetown, and Alf Nachemson of the University of Gotenberg, Sweden.

    For more information on fibromyalgia research at UMHS, visit www.med.umich.edu/intmed/rheumatology/fmweb.



  3. kjfms

    kjfms Member

    This is great!!!!!

    I have often wondered why they couldn't measure the changes going on in the brain in FMS suffers when in pain.

    It seems several years ago I read about this being done on Migraine suffers with the same great results.

    Thank you so much for sharing this and bringing it to everyone's attention.

    We need to keep this bumped to the front page so everyone can read it. I know I will be bumping it.

    Thanks again great job,

    Karen :)
    [This Message was Edited on 06/12/2006]
  4. 69mach1

    69mach1 New Member

    i have read something about this a while a go...on the thumb deal...

    in a magazine in the gym while i was trying ot do my cardio...
    i don't know the word now..but i need to do it..

    but shoot going for a 10 minute walk and around the art and wine festival has me flaring again...or i should say more than normal....

    i hope all is well with you.

    hugs

    jodie
  5. victoria

    victoria New Member


    up again...

  6. kjfms

    kjfms Member

    ...a must read.
  7. 69mach1

    69mach1 New Member

    i have it in my buttock region as well...and tonight i am feeling kinda low...

    i hope you are doing well.. and thank you for keeping us all aprised on the recent develeopments..

    hugs

    jodie
  8. suzetal

    suzetal New Member

    I have a civil suit againt my LTD ins. co.I just sent it off to the law firm handling my case.

    LTD says all I have is depression .This will realy help my case.

    Thanks Again
    Take Care
    Sue
  9. kriket

    kriket New Member



    Maybe? We are getting somewhere. It will be nice when we have scientific evidence to not feel as though we have to prove our illness.


    Kriket
  10. ulala

    ulala New Member

    Great info!! I think we'll be seeing more and more studies like this.

    Hopefully these trickles of research studies will soon snowball and we can stand up and yell that we have this disease and have been suffering silently for a long time!

  11. 69mach1

    69mach1 New Member

    you have to fight even harder when you feel like crapola...not fair is it? we all know the answers of what that is and we know our darn bodies..


    shoot i didn't even know what the heck fibro and cfs was until the pcp told me i had it and three other doctors...and i think i was in denial when i was told i had mayofascial syndrome 10 years ago...on top of all tje stuff in my bio here..

    sending positive energy your way friend

    jodie
  12. 69mach1

    69mach1 New Member

    3 months you're about right i think,,,

    i just hope the psychi lady that goes on montel williams is right...i had read one of her books about 2 years ago how they were going to find a cure in 2008 or it was worded a treatment... i don't want to quote, because of the fibro fog...

    hugs to you


    jodie
  13. Mikie

    Mikie Moderator

    This will help everyone here who has to deal with nonbelievers in their lives.

    Love, Mikie
  14. Marta608

    Marta608 Member

    Thank you for posting this! Ann Arbor isn't far from me so if I can get to the point of driving for 40 minutes, I might go check it out.

    Marta
  15. suzetal

    suzetal New Member

    I wont give up.Thank You

    Take Care
    Sue
  16. pinsnneed1es

    pinsnneed1es New Member

  17. caroleye

    caroleye New Member

    Interesting how we're now just getting attention. UCLA was doing brain research in the early 80's. Amazing to me that it's taken this long to make "the" links.

    Thanks for posting this great info.

    LIGHT************carole
  18. kjfms

    kjfms Member