First posted: http://www.mecfsforums.com/index.php/topic,13119.0/topicseen.html Brain Activity Signals Pain in Fibromyalgia 08 Aug 2012 ⋅ by Kristan Binczewski https://www.medify.com/blog/brain-activity-signals-pain-in-fibromyalgia/ An MRI That Measures Intrinsic Brain Connectivity Provides Data on Fibromyalgia Pain 'A major obstacle in the development of treatments for patients with fibromyalgia is the inability to detect spontaneous pain. But a new MRI that measures resting brain activity and connectivity may be the answer. Studies of resting-state intrinsic brain connectivity in fibromyalgia have demonstrated increased insular connectivity to the default mode network (DMN), a network of brain regions that are active when the individual is not focused on the outside world and is at wakeful rest. Increased insular connectivity (area of the brain where pain is judged) to the DMN was associated with increased spontaneous pain levels. In a study published in the Journal of Arthritis and Rheumatology, researchers evaluated longitudinal changes in the intrinsic brain connectivity of fibromyalgia patients treated with non-pharmacologic interventions known to modulate pain levels. During the course of a month, the patients underwent nine sessions of acupuncture using a protocol that has shown efficacy for fibromyalgia pain. They also had functional MRI scans before and after the month of treatment. Researchers observed that clinical pain was reduced following therapy. Intrinsic DMN connectivity to the insula was also reduced, which correlated to reductions in pain. These findings suggest that intrinsic brain connectivity can be used as a candidate objective marker that reflects changes in spontaneous chronic pain within individual fibromyalgia patients. Medify, which has over 2,165 research abstracts on fibromyalgia, is on a mission to provide patients and their loved ones access to the best information online about their medical condition.' Further news: Medpage today: http://www.medpagetoday.com/clinical-context/Fibromyalgia/33547 Decreased intrinsic brain connectivity is associated with reduced clinical pain in fibromyalgia. Full abstract: https://www.medify.com/insights/art...ed-with-reduced-clinical-pain-in-fibromyalgia OBJECTIVE: A major impediment to the development of novel treatment strategies for fibromyalgia (FM) is the lack of an objective marker that reflects spontaneously reported clinical pain in patients with FM. Studies of resting-state intrinsic brain connectivity in FM have demonstrated increased insular connectivity to the default mode network (DMN), a network whose activity is increased during nontask states. Moreover, increased insular connectivity to the DMN was associated with increased spontaneous pain levels. However, as these analyses were cross-sectional in nature, they provided no insight into dynamic changes in connectivity or their relationship to variations in self-reported clinical pain. The purpose of this study was to evaluate longitudinal changes in the intrinsic brain connectivity of FM patients treated with nonpharmacologic interventions known to modulate pain levels in this patient population, and to test the hypothesis that the reduction of DMN-insula connectivity following therapy would correlate with diminished pain. METHODS: Seventeen FM patients underwent resting-state functional magnetic resonance imaging at baseline and following 4 weeks of a nonpharmacologic intervention to diminish pain. Intrinsic DMN connectivity was evaluated using probabilistic independent components analysis. Longitudinal changes in intrinsic DMN connectivity were evaluated by paired analysis, and correlations between longitudinal changes in clinical pain and changes in intrinsic DMN connectivity were investigated by multiple linear regression analysis. Changes in clinical pain were assessed with the short form of the McGill Pain Questionnaire (SF-MPQ). RESULTS: Clinical pain as assessed using the sensory scale of the SF-MPQ was reduced following therapy (P = 0.02). Intrinsic DMN connectivity to the insula was reduced, and this reduction correlated with reductions in pain (corrected P < 0.05). CONCLUSION: Our findings suggest that intrinsic brain connectivity can be used as a candidate objective marker that reflects changes in spontaneous chronic pain within individual FM patients. We propose that intrinsic connectivity measures could potentially be used in either research or clinical settings as a complementary, more objective outcome measure for use in FM.