Several studies have now confirmed that fibromyalgia is less likely a rheumatoid or muscular disorder and more likely a neurological disorder. Unfortunately, these studies aren’t getting us a faster diagnosis or (more importantly) better treatment options.
Neuroimaging is pretty neat. It actually allows researchers to see activity in the brain as it corresponds to various stimuli – this could be emotions, images, or even pain.
The great thing about functional neuroimaging is that there is no arguing with it or debating whether or not the pain is real. It shows up on the imaging. The problem with neuroimaging is that it’s expensive. Especially in the case of fMRI it’s cost-prohibitive to be used as a diagnostic tool.
A 2010 study used fMRI scans to compare the brain activity at rest in those with fibromyalgia versus those without. Fibromyalgia patients showed a range of pain severity (as would be expected) and it was found that those with more pain showed a higher level of connectivity between different portions of the brain.
Basically, it seems that those suffering from fibromyalgia have a higher level of connectivity between between the default mode network (DMN) and the right executive attention network (EAN). The DMN is involved in thoughts about oneself and the EAN is involved in memory and attention.
“This work shows there is increased connectivity between different brain centers that connect the purely sensory pain processing centers of the brain with some of the emotional and evaluative parts of the brain, or areas of the brain that take a sensory stimulus and say, “How do I interpret this? How do I feel about this’?” Mease said.
If I understand this correctly, what they are saying is that those of us with Fibro have more active brains when we are at rest. This may explain why it is harder for us to sleep, as well as why we feel more pain.
When our brains should be resting they are still up processing various pains that they should be able to ignore.
Since this study in 2010 many more have been completed and continue to find that pain processing is not only visible in brain scans but that it takes part over multiple regions of the brain.
Many studies point to pain processing pathways, specifically those involved in inhibiting pain.
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Napadow, V., LaCount, L., Park, K., As‐Sanie, S., Clauw, D. J., & Harris, R. E. (2010). Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity. Arthritis & Rheumatism, 62(8), 2545-2555.
Pamfil, C., & Choy, E. H. S. (2018). Functional MRI in rheumatic diseases with a focus on fibromyalgia. Clinical and experimental rheumatology, 36(5), 82-85.