A groundbreaking study by researchers at Ruhr-University Bochum has revealed how fibromyalgia can alter the brain’s structure and function.
What is Fibromyalgia?
Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, and tenderness in specific areas of the body. It can significantly impact a person’s quality of life, and understanding its effects on the brain may help in developing better treatments.
The Study
Led by Professor Martin Diers and Benjamin Mosch, the research team analyzed magnetic resonance imaging (MRI) data from 23 women with fibromyalgia and 21 healthy control participants. They aimed to investigate the volume of grey matter (nerve cells) in pain-processing areas of the brain and the white matter (fiber connections) that transmits signals between nerve cells.
Key Findings
The study found significant changes in the brain’s pain network for those with fibromyalgia. Specifically, they observed a reduction in grey matter volume in regions responsible for processing and evaluating pain. This decrease was particularly noticeable in areas involved in inhibiting pain, suggesting that fibromyalgia sufferers might have less capacity to suppress pain signals.
Changes were also found in the thalamus, an important hub for pain processing. The alterations in the white matter of fibromyalgia patients indicated an abnormal transmission of pain signals compared to healthy individuals.
Brain Structure and Behavior
The researchers related these structural brain changes to the participants’ perceptions and behaviors. They discovered that the extent of reduced grey matter volume was inversely related to the amount of pain reported by patients. Interestingly, the volume of a brain region called the putamen was linked to both depressive symptoms and activity levels. Lower putamen volume was associated with higher depression and lower activity, suggesting that maintaining an active lifestyle might help mitigate some brain changes associated with fibromyalgia.
Implications
This study provides valuable insights into how fibromyalgia affects the brain, highlighting the importance of both neural and behavioral factors in managing the condition. By understanding these changes, researchers hope to develop more effective treatments that address both the physical and mental aspects of fibromyalgia.
A recent study published in the Annals of Internal Medicine has some reassuring news for older adults dealing with neuropathy or fibromyalgia. The research found that gabapentin, a medication commonly prescribed for these conditions, is not associated with a higher risk of falls compared to another drug, duloxetine.
Key Findings:
Participants: The study analyzed data from 57,086 adults aged 65 and older.
Conditions: Participants had conditions like diabetic neuropathy, postherpetic neuralgia, or fibromyalgia.
Comparison: Researchers compared the risk of falls in patients taking gabapentin to those taking duloxetine over 6 months.
Results: Gabapentin did not show an increased risk of fall-related visits or hospitalizations compared to duloxetine.
Why It Matters:
Painful conditions such as neuropathy significantly increase the risk of falls in older adults. Medications used to treat these conditions, like gabapentin, have come under scrutiny for potentially increasing fall risks. This study helps to clarify that gabapentin, when compared to duloxetine, does not lead to a higher rate of falls, addressing previous safety concerns.
Study Details:
The study was a comparator trial using a target trial emulation framework, which provides a more accurate picture by comparing new users of both medications under similar conditions. This design helps to reduce bias and confounding factors that might skew the results.
Researchers emphasize the importance of accurate risk assessments for pain medications. This is crucial because many patients with pain feel they are often undertreated. The findings of this study can help inform discussions between physicians and patients about the safe use of gabapentin for managing pain.
Overall, this study provides valuable insights and reassurance for older adults and their healthcare providers about the use of gabapentin.
Ease stiffness and feel relief from chronic conditions causing your pain, such as arthritis and fibromyalgia. In this gentle joint video, I will walk you through exercises that gently strengthen and stretch common troublesome areas. This workout begins with a warm-up in a standing position, and then halfway through, we move to a seated position in a chair. If you are only able to complete the seated portion, then just fast forward to that section (about the 15-minute mark), please make sure that you are in a warm environment. This will make sure that your muscles relax and don’t cramp up. It is also essential to stay hydrated. Drinking water will help lubricate your joints.
Fibromyalgia is a poorly understood disorder, but researchers are making breakthroughs that may help identify both its causes and potential treatments.
Over 70% of chronic pain cases are women. Effective treatment of pain has been hampered by an entirely subjective protocol for measuring pain severity, with variation introduced in patient assessments and physician biases. Credit Arocamora, CC BY-SA 4.0
Chronic pain affects millions of people, with women experiencing more severe and frequent pain than men. Over 70% of chronic pain cases involve women. However, measuring and managing pain remains a complex challenge. There is currently no objective method to quantify pain, which makes it difficult to tailor treatments effectively. Additionally, there are significant variations in how patients experience pain and how physicians respond. A new research initiative aims to address these issues.
Tufts University, in collaboration with external partners, has been selected by the Advanced Research Projects Agency for Health (ARPA-H) as an award recipient for the Sprint for Women’s Health. This initiative aims to develop new technologies for quantitatively measuring pain in patients, to improve care and accelerate the development of new treatments. The team will receive $3.03 million in funding over the next two years.
Various factors, such as inflammation, damaged nerves, or conditions like fibromyalgia, can cause chronic pain. Each of these causes may require a different treatment approach. Regardless of its origin, pain is highly subjective and can be influenced by psychological, social, and other factors. While elite athletes and soldiers often train to tolerate high levels of pain, individual reactions to pain can vary significantly among those who experience it.
Standard practice in assessing pain in the clinical setting is entirely subjective—something most of us have experienced if asked to measure it on a chart using smiling to frowning emoticons.
Subjectivity in assessing pain is not just on the patient’s side. Bias also occurs on the treatment side, with some minority groups being undertreated for managing pain compared to the general population.
“Having an objective, quantitative tool to assess pain will help eliminate subjective variables and provide a more rational basis for treatment,” said Sameer Sonkusale, a professor of electrical and computer engineering at the Tufts School of Engineering and the principal investigator on the project. The project includes collaborators from the Uniformed Services University of Health Sciences (USU), The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), and Northwestern Medicine.
The research team plans to screen more than 30 biomarkers, including stress hormones, inflammation markers, and neurotransmitters in the interstitial fluid that circulates between skin cells. Additionally, they will monitor physiological responses such as fluctuations in heart rate, galvanic skin response, and breathing patterns.
These biomarkers were identified in earlier studies as linked to a patient’s experience of pain, but this is the first effort to create a composite panel of markers to generate a quantitative score for pain.
The biomarker data will be merged with answers to pain questionnaires collected from women at several sites, including the Defense and Veterans Center for Integrative Pain Management and Northwestern Medicine. Shuchin Aeron, an electrical and computer engineering associate professor at Tufts, will apply artificial intelligence and machine learning to combine these factors into an objective and quantitative pain score.
The researchers will narrow the panel to five or more of the most reliable pain-linked biomarkers. These biomarkers can be monitored on a portable, wearable device for clinical site and remote pain assessment. The results would instantly be reported to the physician or the patient on a smartwatch or ring.
The availability of such devices would not only improve pain management. Still, it could also accelerate the development of new drugs and treatments, which could benefit from an objective measure of their effectiveness.
“While pain reporting is subjective and dependent on many extraneous factors, for the same pain level, the measurable physiological markers and signals are expected to be similar from one individual to the next,” said Sonkusale. “Considering an observed gender bias in the prevalence and approach to treatment of chronic pain, this technology addresses a large unmet medical need for women, creating a path to more effective pain management.”
“It has been extremely challenging to objectively quantify nociplastic pain—the type of pain involving nervous system sensitization in conditions like fibromyalgia that are quite common in women. This study could provide a way to objectively quantify pain in a way that will greatly help their treatment,” said Steven P Cohen, Edmond I Eger Professor of Anesthesiology and Pain Medicine at Northwestern Medicine.
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