Dr. Clauw has received consulting fees, speaking fees, and/or honoraria from Pfizer, Forest, Cypress Biosciences, Pierre Fabre, UCB, and AstraZeneca (less than $10,000 each).
Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity†
Article first published online: 6 APR 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 62, Issue 8, pages 2545–2555, August 2010
How to Cite
Napadow, V., LaCount, L., Park, K., As-Sanie, S., Clauw, D. J. and Harris, R. E. (2010), Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity. Arthritis & Rheumatism, 62: 2545–2555. doi: 10.1002/art.27497
The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of our funding agencies.
- Issue published online: 3 AUG 2010
- Article first published online: 6 APR 2010
- Manuscript Accepted: 30 MAR 2010
- Manuscript Received: 2 DEC 2009
- NIH (National Center for Complementary and Alternative Medicine). Grant Numbers: K01-A002166, R01-AT-004714, F05-AT-003770, P01-AT-002048, K01-AT-01111
- National Center for Research Resources. Grant Numbers: P41-RR-14075, GCRC M01-RR-01066
- Mental Illness and Neuroscience Discovery Institute
- Pfizer Inc.
- Institute of Information Technology Advancement, Korea. Grant Number: IITA-2008 [C1090-0801-0002]
- US Department of Defense (Army grant). Grant Number: DAMD-W81XWH-07-2-0050
- Dana Foundation Award in Brain and Immuno-Imaging
Fibromyalgia (FM) is considered to be the prototypical central chronic pain syndrome and is associated with widespread pain that fluctuates spontaneously. Multiple studies have demonstrated altered brain activity in these patients. The objective of this study was to investigate the degree of connectivity between multiple brain networks in patients with FM, as well as how activity in these networks correlates with the level of spontaneous pain.
Resting-state functional magnetic resonance imaging (FMRI) data from 18 patients with FM and 18 age-matched healthy control subjects were analyzed using dual-regression independent components analysis, which is a data-driven approach for the identification of independent brain networks. Intrinsic, or resting-state, connectivity was evaluated in multiple brain networks: the default mode network (DMN), the executive attention network (EAN), and the medial visual network (MVN), with the MVN serving as a negative control. Spontaneous pain levels were also analyzed for covariance with intrinsic connectivity.
Patients with FM had greater connectivity within the DMN and right EAN (corrected P [Pcorr] < 0.05 versus controls), and greater connectivity between the DMN and the insular cortex, which is a brain region known to process evoked pain. Furthermore, greater intensity of spontaneous pain at the time of the FMRI scan correlated with greater intrinsic connectivity between the insula and both the DMN and right EAN (Pcorr < 0.05).
These findings indicate that resting brain activity within multiple networks is associated with spontaneous clinical pain in patients with FM. These findings may also have broader implications for how subjective experiences such as pain arise from a complex interplay among multiple brain networks.