Grey volume matter atrophy in FM as well - not associated with depression


Phoenix Rising Founder
Arizona in winter & W. North America otherwise
This is fantastic stuff. Grey matter atrophy in the areas of the brain related to sensory and pain processing. I actually would have thought the opposite- because the pain areas in FM are activated; actually the pain enhancing networks are activated and the pain reducing areas are inhibited...

But that was a silly conclusion by me because you would expect injury in the areas that weren't working properly and that;s what they found - but only in the pain producing areas - not in those associated with depression :Retro smile:

One study found found low grey volume in CFS in the lateral prefrontal cortex. Not sure how that relates to this area...but the anterior cingulate has been a focus in CFS as well by Chaudhuri and Behan -
In what may also be a compensatory reaction to impaired brain activity elsewhere, both fatigued MS and CFS patients exhibit a marked activation of the anterior cingulate region of the brain (Schmalling et. al. 2003). A part of the frontal lobe, the anterior cingulate is involved in the early stages of motor learning or planning and in ‘attentional tasks’. Interestingly, interferon A treatment, which often causes great fatigue, also results in increased anterior cingulate activation (Capuron et .al. 2005)

J Pain. 2010 Dec 9. [Epub ahead of print]
Gray Matter Volumes of Pain-Related Brain Areas are Decreased in Fibromyalgia Syndrome.

Robinson ME, Craggs JG, Price DD, Perlstein WM, Staud R.
Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida.

Fibromyalgia (FM) is a chronic, widespread musculoskeletal pain disorder that is very prevalent in the general population (approximately 5%). Accumulating evidence suggests that FM is associated with central pain processing abnormalities, ie, central sensitization. Several previous studies of chronic pain patients, including FM, have shown gray matter atrophy of brain areas associated with sensory and affective pain processing. These findings, however, have not been confirmed in all FM studies.

In this study, we investigated gray matter volumes of brain areas associated with pain-related areas of FM patients identified by functional brain imaging. Using voxel-based morphometric (VBM) analysis of magnetic resonance brain images, we compared 19 pain-related brain areas of 14 female FM patients and 11 healthy controls (NC). We found that FM patients had significantly less gray matter volumes than NC in 3 of these brain regions, including the anterior and mid-cingulate, as well as mid-insular cortices.

Importantly, FM patients demonstrated neither global gray matter atrophy nor gray matter changes associated with depression, as shown in some studies. Using a more stringent analysis than other VBM studies, we provide evidence for decreased gray matter volumes in a number of pain-related brain areas in FM. Although the mechanisms for these gray matter changes are presently unclear, they may contribute to some of the core features of this chronic disorder including affective disturbances and chronic widespread pain.

PERSPECTIVE: Increasing evidence supports the association of chronic pain with accelerated gray matter atrophy in pain disorders like low back pain, IBS, and FM syndrome. However, cause-effect relationships between chronic pain and decreased gray matter volumes have not been established yet and will require future prospective studies.
Here is the conclusion of the paper I wrote on Central Fatigue

Summary- These findings suggest the fatigue in CFS, MS and other diseases of central fatigue originates in abnormalities in deep brain circuits involved in motor planning and execution. The problem, then, appears to lie not in a disruption in the brains signal to the muscles but in brains ability to produce the signal in the first place. They suggest that the brains of central fatigue patients are hindered in their ability to integrate the multitude of signals involved in producing muscle activation. Thus this is a 'thinking' problem not a muscle problem. These findings appear to be in agreement with Chaudhuri and Behan’s model positing that disrupted deep brain (cortical-striatal (basal ganglia)-thalamo) circuitry plays an important role in central fatigue seen in CFS and other diseases.
This was such interesting work and I think it's been dropped.