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Brain Scans Document Fibromyalgia Pain

Mon Jun 17, 5:29 PM ET

By Stenson

NEW YORK (Reuters Health) - Brain scans of people with fibromyalgia offer

the first hard evidence of what patients already know: Their pain is real

and their threshold for tolerating it is substantially lower than that of

most individuals.

" When patients with fibromyalgia tell us that they're tender, that they're

experiencing pain at a much lower level than people without the condition,

they are in fact experiencing that pain, " said Dr. Clauw, a professor

of medicine at the University of Michigan Medical Center in Ann Arbor.

" This is the first neurobiological evidence of the veracity of their pain, "

he told Reuters Health.

Fibromyalgia affects an estimated 2% to 4% of the population, mostly women.

Patients commonly report feeling tenderness, stiffness and sometimes

unbearable pain in various areas of the body. They also may suffer from

fatigue, depression and gastrointestinal problems. Some doctors without

expertise in fibromyalgia have dismissed patients' complaints because there

have been no documented physical signs of the disorder.

" I hope this study helps convince physicians that this is a real condition, "

Clauw said.

In the new report, published in a recent issue of Arthritis & Rheumatism,

Clauw and colleagues studied 16 people who had been diagnosed with

fibromyalgia and 16 healthy people who had not (the " control " group). All

underwent a type of detailed brain scan known as functional magnetic

resonance imaging (fMRI) while an instrument intermittently applied

different levels of pressure to their left thumbnail.

When all study participants received the same level of mild pressure, blood

flow increased much more in the brains of patients with fibromyalgia than

among those in the control group. The increased blood flow--which is a

" surrogate measure " for nerve activity--occurred in areas of the brain known

to be associated with pain, Clauw noted.

In addition, when study participants were subjected to different levels of

pressure, fibromyalgia patients reported pain at half the level of pressure

that caused the same feelings of pain among the healthy controls, results

showed.

Clauw said the findings suggest that something is awry with the way the

central nervous system processes painful stimuli in fibromyalgia patients.

Future research should be aimed at identifying the problem and working to

develop better treatments, he added.

SOURCE: Arthritis & Rheumatism 2002;46:1333-1343.