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Evidence of dysfunctional pain inhibition in fibromyalgia reflected in rACC during provoked pain
Pain, 05/07/09

Jensen KB et al. – Data validate previous reports of dysfunctional endogenous pain inhibition in fibromyalgia (FMS) and advance the understanding of the central pathophysiologic mechanisms, providing a new direction for the development of successful treatments in FMS.

• An evaluation of the cerebral response to individually calibrated pain provocations of a pain-free body region
• Subjects: 16 female FMS pts and 16 age-matched controls
• Brain activity was measured using functional MRI (fMRI) during individually calibrated painful pressures representing 50 mm on a VAS ranging from 0 to 100 mm

• Pts exhibited higher sensitivity to pain provocation as they required less pressure to evoke equal pain magnitudes
• Despite lower pressures applied in pts at VAS 50 mm, the fMRI-analysis revealed no difference in activity in brain regions
• However, in the primary link in the descending pain regulating system pts failed to respond to pain provocation
• The attenuated response to pain in this brain region is the first demonstration of a specific brain region where the impairment of pain inhibition in FMS pts is expressed

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