"Fibromyalgia Can No Longer Be Called The “Invisible” Syndrome"

[Kyla]

The study this article is based on appears to be a year old, but hasn't been posted on here (at least not that I could find).

I thought it was interesting that they found abnormalities via SPECT, as I know Dr. Hyde has been using SPECT to diagnose ME patients for years, but I have never heard of it being studied in fibro (though I don't know much about fibro research).

Does anyone know if any of these are the same findings as in ME?

http://personalhealthmedication.com/fibromyalgia-can-no-longer-be-called-the-invisible-syndrome/

Excerpt:

Fibromyalgia Can No Longer Be Called The “Invisible” Syndrome

Using single photon emission computed tomography (SPECT), researchers in France were able to detect functional abnormalities in certain regions in the brains of patients diagnosed with fibromyalgia, reinforcing the idea that symptoms of the disorder are related to a dysfunction in those parts of the brain where pain is processed.
“Fibromyalgia is frequently considered an ‘invisible syndrome’ since musculoskeletal imaging is negative,” said Eric Guedj, M.D., and lead author of the study. “Past imaging studies of patients with the syndrome, however, have shown above-normal cerebral blood flow (brain perfusion) in some areas of the brain and below-normal in other areas. After performing whole-brain scans on the participants, we used a statistical analysis to study the relationship between functional activity in even the smallest area of the brain and various parameters related to pain, disability and anxiety/depression.”


In the study, which was reported in the November issue of The Journal of Nuclear Medicine, 20 women diagnosed with fibromyalgia and 10 healthy women as a control group responded to questionnaires to determine levels of pain, disability, anxiety and depression. SPECT was then performed, and positive and negative correlations were determined.

The researchers confirmed that patients with the syndrome exhibited brain perfusion abnormalities in comparison to the healthy subjects. Further, these abnormalities were found to be directly correlated with the severity of the disease. An increase in perfusion (hyperperfusion) was found in that region of the brain known to discriminate pain intensity, and a decrease (hypoperfusion) was found within those areas thought to be involved in emotional responses to pain.

In the past, some researchers have thought that the pain reported by fibromyalgia patients was the result of depression rather than symptoms of a disorder. “Interestingly, we found that these functional abnormalities were independent of anxiety and depression status,” Guedj said...

 

[barbc56]

I see you are in Canada, but in the states The American College of Rheumatologist recognizes FM. Im not sure if they still call it an invisible illness because o this study. I should send this to my family.

Thanks for posting this.

Barb

 

[Woolie]

@Kyla, thanks for posting. I had a look at the paper. Turns out its not new, its from 2008:
http://jnm.snmjournals.org/content/49/11/1798.full.pdf html?sid=99df29d8-4e4d-4320-ae97-eb7c3d05f439

I'm very suspicious of it, for these reasons:

In particular, the relationship between somatosensory hyperfusion and fibromyalgia clinical severity is reported for, to our knowledge, the first time and reinforces the central sensitization hypothesis (2,15).

This is a dangerous trend in this line of research. You find high levels of activity in some area of the brain that responds to pain and call it "central sensitization". Of course, anyone experiencing real peripheral pain will also respond to that pain in their brain. So this activity does not demonstrate central sensitization at all.

I object to this especially strongly, because "central sensitization" is starting to be used as the new high-tech name for psychosomatic. Many advocates of the concept allow for the possibility that the "sensitization" could be caused by psychological factors. You can see how the psychobabblers might get hold of this and use it to trot out a whole sexy new set of theories that sound like real science.

On the other hand, correlation obtained with anterior temporal perfusion suggests the involvement of the limbic system. Hypoperfusion of this area could be related to reduced affective appraisal and responsiveness, frequently observed in patients with fibromyalgia (15).

Okay, now this is going in a dangerous direction. These researchers found loads of differences between FM patients and controls. But what they appeared to be hoping for was some under- or overactivation in some emotional processing centre. The didn't find it, but made a big deal out of a bit of anterior temporal lobe underactivation, claiming that this region is "close to" the limbic system (an area believed to be involved in emotion processing).

First of all, you can’t work backwards like this from an area of the brain to a conclusion about what that area’s doing (examples, the anterior temporal lobe is important for our knowledge of concepts, and our knowledge of our personal life history, and many other things, which one do you pick?).

Second, brain abnormalities do not always mean that the problem originates in your brain. They could be a response to something going on elsewhere in your body. If you stuck a knife in someone's leg, you'd probably see "abnormal brain activity". The problem isn't being caused by the brain, the brain's just responding.

Third, you’re not supposed to “fish” through your data for the one thing that vaguely points to something you believe in (an emotional problem) and ignore the rest.

Grr……

 

[Toxed]

I just want to say that all the "imaging" I had, for any reason, makes me worse. This was true before I got chemically sensitive in 2003-2004. Wether it was for spinal damage from being rear ended or from the neurologist who confirmed my Fibro diagnosis. They need to use methods to diagnose, and "treat" that don't hurt us more. End Rant.

 

[Woolie]

PS This paper, on the same topic, is much better:

Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia
http://onlinelibrary.wiley.com/doi/10.1002/art.10225/full

They applied pain (pressure on the thumb) to FM patients and controls. They found that the patients reported the pain as more severe overall than the controls.

So they did another comparison, where they equated the pain intensity for both groups (so in other words, they ramped up the pressure for controls, till it felt to the controls like they were experiencing the same amount of pain as the patients).

There were pretty reliable differences between the patients and controls in a range of regions associated with emotional processing. Paradoxically, the FM patients actually showed a reduced emotional response to the pain when compared with controls.

Conclusion: FM patients feel pain more, but react to it less emotionally, They're kind of used to it.