No consistent difference in gray matter volume between individuals with fibromyalgia and age-matched healthy subjects when controlling for affective disorder

Fibromyalgia (FM) is thought to involve abnormalities in central pain processing. Recent studies involving small samples have suggested alterations in gray matter volume (GMV) in brains of FM patients. Our objective was to verify these findings in a somewhat larger sample using voxel-based morphomet...

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Bibliographic Details
Published in:	Pain (Amsterdam) Vol. 143; no. 3; pp. 262 - 267
Main Authors:	Hsu, Michael C., Harris, Richard E., Sundgren, Pia C., Welsh, Robert C., Fernandes, Carlo R., Clauw, Daniel J., Williams, David A.
Format:	Journal Article
Language:	English
Published:	Philadelphia, PA Elsevier B.V 01-06-2009 Lippincott Williams & Wilkins, Inc Elsevier
Subjects:	Adult Age Factors Anxiety Disorders - pathology Anxiety Disorders - physiopathology Anxiety Disorders - psychology Atrophy - pathology Atrophy - physiopathology Biological and medical sciences Brain - pathology Brain - physiopathology Brain Mapping Cerebral Cortex - pathology Cerebral Cortex - physiopathology Clinical Medicine Data Interpretation, Statistical Depression Depressive Disorder - pathology Depressive Disorder - physiopathology Depressive Disorder - psychology Diseases of striated muscles. Neuromuscular diseases Diseases of the osteoarticular system Female Fibromyalgia Fibromyalgia - pathology Fibromyalgia - physiopathology Fibromyalgia - psychology Functional Laterality - physiology Gray matter Humans Image Processing, Computer-Assisted Klinisk medicin Magnetic Resonance Imaging Medical and Health Sciences Medical sciences Medicin och hälsovetenskap Middle Aged Miscellaneous. Osteoarticular involvement in other diseases Mood Disorders - pathology Mood Disorders - physiopathology Mood Disorders - psychology MRI Neurology Neuropsychological Tests Pain Predictive Value of Tests Radiologi och bildbehandling Radiology, Nuclear Medicine and Medical Imaging Sensitivity and Specificity Voxel-based morphometry Fibromyalgia Depression Pain MRI Gray matter Voxel-based morphometry Human Affect affectivity Segmentation Diseases of the osteoarticular system Cluster Personality Nuclear magnetic resonance imaging Striated muscle disease Chronic Modulation Anxiety Morphometry
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Summary:	Fibromyalgia (FM) is thought to involve abnormalities in central pain processing. Recent studies involving small samples have suggested alterations in gray matter volume (GMV) in brains of FM patients. Our objective was to verify these findings in a somewhat larger sample using voxel-based morphometry (VBM), while controlling for the presence of affective disorders (AD). T1-weighted magnetic resonance image (MRI) brain scans were obtained on 29 FM patients with AD, 29 FM patients without AD, and 29 age-matched healthy controls (HCs) using a 3T scanner. Segmentation, spatial normalization, and volumetric modulation were performed using an automated protocol within SPM5. Smoothed gray matter segments were entered into a voxel-wise one-way ANOVA, and a search for significant clusters was performed using thresholding methods published in previous studies (whole-brain threshold of p<.05 correcting for multiple comparisons; region-of-interest (ROI) threshold of p⩽.001 uncorrected, or p<.05 small-volume corrected). The whole-brain analysis did not reveal any significant clusters. ROI-based analysis revealed a significant difference in left anterior insula GMV among the three groups (xyz={−28, 21, 9}; p=.026, corrected). However, on post-hoc testing, FM patients without AD did not differ significantly from HC with respect to mean GMV extracted from this cluster. A significant negative correlation was found between mean cluster GMV and scores of trait anxiety (State-Trait Personality Inventory, Trait Anxiety scale; rho=−.470, p<.001). No other significant clusters were found on ROI-based analysis. Our results emphasize the importance of correcting for AD when carrying out VBM studies in chronic pain.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0304-3959 1872-6623 1872-6623
DOI:	10.1016/j.pain.2009.03.017