MRI Studies

[Guest guest]

Unless I read this wrong, this shows some advances for Fibro detection. I'm

attending the Conference in LA the 21 & 22nd of September and hope to hear

more good news. If you'd like me to share what I learn, just let me know.

~RILEY~

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PRESS RELEASE PAGE

June 7, 2002

Fibromyalgia pain isn't all in patients' heads, new brain study finds MRI

scans give first objective measure of mysterious ailment, provide road map

for future study

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ANN ARBOR, MI - A new brain-scan study confirms scientifically what

fibromyalgia patients have been telling a skeptical medical community for

years: They're really in pain.

In fact, the study finds, people with fibromyalgia say they feel severe pain,

and have measurable pain signals in their brains, from a gentle finger

squeeze that barely feels unpleasant to people without the disease. The

squeeze's force must be doubled to cause healthy people to feel the same

level of pain - and their pain signals show up in different brain areas.

The results, published in the May issue of Arthritis & Rheumatism, the

journal of the American College of Rheumatology, may offer the proof of

fibromyalgia's physical roots that many doubtful physicians have sought. It

may also open doors for further research on the still-unknown causes of the

disease, which affects more than 2 percent of Americans, mainly women.

Lead authors Gracely, Ph.D., and Clauw, M.D., did the study at

town University Medical Center and the National Institutes of Health,

but are now continuing the work at the University of Michigan Health System.

In an editorial in the same issue, Clauw and U-M rheumatologist

Crofford, M.D., stress the importance of fibromyalgia research and care.

To correlate subjective pain sensation with objective views of brain signals,

the researchers used a super-fast form of MRI brain imaging, called

functional MRI or fMRI, on 16 fibromyalgia patients and 16 people without the

disease. As a result, they say, the study offers the first objective method

for corroborating what fibromyalgia patients report they feel, and what's

going on in their brains at the precise moment they feel it. And, it gives

researchers a road map of the areas of the brain that are most - and least -

active when patients feel pain.

" The fMRI technology gave us a unique opportunity to look at the neurobiology

underlying tenderness, which is a hallmark of fibromyalgia, " says Clauw.

" These results, combined with other work done by our group and others, have

convinced us that some pathologic process is making these patients more

sensitive. For some reason, still unknown, there's a neurobiological

amplification of their pain signals. "

Further results from the study were presented last year at the ACR annual

meeting. The project will continue later this year at UMHS, joining other

fMRI fibromyalgia research now under way.

For decades, patients and physicians have built a case that fibromyalgia is a

specific, diagnosable chronic disease, characterized by tenderness and

stiffness all over the body as well as fatigue, headaches, gastrointestinal

problems and depression. Many patients with the disease find it interferes

with their work, family and personal life. Statistics show that far more

women than men are affected, and that it occurs mostly during the

childbearing years.

The ACR released classification criteria for fibromyalgia in 1990, to help

doctors diagnose it and rule out other chronic pain conditions. Clauw and

Crofford's editorial looks at the current state of research, and calls for

rheumatologists to take the lead in fibromyalgia care and science.

But many skeptics have debated the very existence of fibromyalgia as a

clearly distinct disorder, saying it seemed to be rooted more in

psychological and social factors than in physical, biological causes. Their

argument has been bolstered by the failure of research to find a clear cause,

an effective treatment, or a non-subjective way of assessing patients.

While the debate has raged, neuroscientists have begun to use brain scan

technology to identify the areas of the normal human brain that become most

active during pain. A few studies have even assessed the blood flow in those

areas in fibromyalgia patients during baseline brain scans. The new study is

the first to use both high-speed scanning and a painful stimulus.

In the study, fibromyalgia patients and healthy control subjects had their

brains scanned for more than 10 minutes while a small, piston-controlled

device applied precisely calibrated, rapidly pulsing pressure to the base of

their left thumbnail. The pressures were varied over time, using painful and

non-painful levels that had been set for each patient prior to the scan.

The study's design gave two opportunities to compare patients and controls:

the pressure levels at which the pain rating given by patients and control

subjects was the same, and the rating that the two different types of

participants gave when the same level of pressure was applied.

The researchers found that it only took a mild pressure to produce

self-reported feelings of pain in the fibromyalgia patients, while the

control subjects tolerated the same pressure with little pain.

" In the patients, that same mild pressure also produced measurable brain

responses in areas that process the sensation of pain, " says Clauw. " But the

same kind of brain responses weren't seen in control subjects until the

pressure on their thumb was more than doubled. "

Though brain activity increased in many of the same areas in both patients

and control subjects, there were striking differences too. Patients feeling

pain from mild pressure had increased activity in 12 areas of their brains,

while the control subjects feeling the same pressure had activation in only

two areas. When the pressure on the control subjects' thumbs was increased,

so did their pain rating and the number of brain areas activated. But only

eight of the areas were the same as those in patients' brains.

In all, the fibromyalgia patients' brains had both some areas that were

activated in them but not in controls, and some areas that stayed " quiet " in

them but became active in the brains of controls feeling the same level of

pain. This response suggests that patients have enhanced response to pain in

some brain regions, and a diminished response in others, Clauw says.

The study was supported in part by the National Fibromyalgia Research

Association, the U.S. Army and the NIH. In addition to Clauw and Gracely, the

research team included Petzke, M.D.; and M. Wolf, BA.

Special notes on this release

PATIENT NOTE:

This study on fibromyalgia pain explores basic brain science and its

connection with pain perception. It does not suggest specific new treatment

options, and the participants did not receive any pain relief from taking

part in the study. We do hope to continue this line of research in the

future, and we will need more research volunteers at that time. Many of our

future studies will attempt to learn more about the basic root causes of

fibromyalgia - - they will not seek to ease the symptoms of participants.

If you have been diagnosed with fibromyalgia and would like to be contacted

with further information about participating in fibromyalgia research at the

University of Michigan, please call , and enter category 6501.

After listening to the recording, press 1 to leave your name, phone number,

location and age after the tone.

If you are seeking treatment for fibromyalgia, please call the Arthritis

Foundation at 1- to learn how to find a specialist near you. You

can also visit their web site, www.arthritis.org, and enter your ZIP code to

find the chapter nearest you.

Thanks again for your interest in fibromyalgia research at the University of

Michigan Health System. We are glad to help improve the scientific

understanding of fibromyalgia, and we hope our work may some day lead to

better treatment strategies for everyone with this condition.