the impact of patient beliefs regarding their ability to cope with and
control pain on the level of pain itself. Sometimes these beliefs
accurately reflect the level of pain the patients are experiencing.
This study appears to show a strong connection between CNS processing
problems and the most likely accurate patient beliefs regarding their
pain - even after adjusting for negative beliefs.
AJNR Am J Neuroradiol. 2011 Aug 25. [Epub ahead of print]
Cerebral Blood Flow Alterations in Pain-Processing Regions of Patients
with Fibromyalgia Using Perfusion MR Imaging.
Foerster BR, Petrou M, Harris RE, Barker PB, Hoeffner EG, Clauw DJ, Sundgren PC.
Division of Neuroradiology, Department of Radiology, and Departments
of Anesthesiology, Psychiatry, and Internal Medicine, Division of
Rheumatology, University of Michigan, Ann Arbor, Michigan; Russell H.
Morgan Department of Radiology and Radiological Science, Johns Hopkins
University School of Medicine, Baltimore, Maryland; VA Ann Arbor
Healthcare System, Ann Arbor, Michigan; and Department of Diagnostic
Radiology, Clinical Sciences Lund, Lund University, Lund, Sweden.
Abstract
BACKGROUND AND PURPOSE:
Widespread pain sensitivity in patients with FM suggests a CNS
processing problem. The purpose of this study was to assess
alterations in perfusion as measured by DSC in a number of brain
regions implicated in pain processing between patients with FM and
healthy controls.
MATERIALS AND METHODS:
Twenty-one patients with FM and 27 healthy controls underwent
conventional MR imaging and DSC. For DSC, 12 regions of interest were
placed in brain regions previously implicated in pain processing. rCBF
values were calculated for each region of interest. Subjects answered
mood/pain coping questionnaires and underwent clinical/experimental
pain assessment.
RESULTS:
There were significant correlations between the thalamic rCBF values
and the pain-control beliefs of FM subjects. The strength of the
relationship between clinical pain measures and thalamic rCBF values
increased after adjusting for pain-control beliefs. There was a
significantly different distribution pattern of rCBF values across
various brain regions between the FM group and the healthy controls.
There was a lower degree of correlation in the FM group between the
thalamic rCBF values and the other brain regions relative to the
healthy controls.
CONCLUSIONS:
Significant correlations were found between thalamic rCBF values and
pain belief values. These data suggest that there are baseline
alterations of brain perfusion in patients with FM. rCBF values of the
thalami exhibited lower correlations with respect to other brain
regions thought to be involved in pain processing compared with those
in healthy controls.
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