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.
Abbreviations
- ANOVA
- analysis of variance
- BPCQ-INT
- Beliefs about Pain Control Questionnaire-International
- CBF
- cerebral blood flow
- CES-D
- Center for Epidemiological Studies Depression Scale
- CNS
- central nervous system
- CSQ-CAT
- Catastrophizing Component of the Coping Strategies Questionnaire
- DSC
- dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging
- EPI
- echo-planar imaging
- FM
- fibromyalgia
- fMRI
- functional MR imaging
- PET
- positron-emission tomography
- rCBF
- relative cerebral blood flow
- SE
- spin-echo
- SPECT
- single-photon emission tomography
- STPI
- Spielberger's Trait Personality Inventory
- VAS
- visual analog scale
- © 2011 by American Journal of Neuroradiology