PMID- 22294427
OWN - NLM
STAT- MEDLINE
DCOM- 20120914
LR  - 20211021
IS  - 1529-0131 (Electronic)
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 64
IP  - 7
DP  - 2012 Jul
TI  - Decreased intrinsic brain connectivity is associated with reduced clinical pain 
      in fibromyalgia.
PG  - 2398-403
LID - 10.1002/art.34412 [doi]
AB  - OBJECTIVE: A major impediment to the development of novel treatment strategies 
      for fibromyalgia (FM) is the lack of an objective marker that reflects 
      spontaneously reported clinical pain in patients with FM. Studies of 
      resting-state intrinsic brain connectivity in FM have demonstrated increased 
      insular connectivity to the default mode network (DMN), a network whose activity 
      is increased during nontask states. Moreover, increased insular connectivity to 
      the DMN was associated with increased spontaneous pain levels. However, as these 
      analyses were cross-sectional in nature, they provided no insight into dynamic 
      changes in connectivity or their relationship to variations in self-reported 
      clinical pain. The purpose of this study was to evaluate longitudinal changes in 
      the intrinsic brain connectivity of FM patients treated with nonpharmacologic 
      interventions known to modulate pain levels in this patient population, and to 
      test the hypothesis that the reduction of DMN-insula connectivity following 
      therapy would correlate with diminished pain. METHODS: Seventeen FM patients 
      underwent resting-state functional magnetic resonance imaging at baseline and 
      following 4 weeks of a nonpharmacologic intervention to diminish pain. Intrinsic 
      DMN connectivity was evaluated using probabilistic independent components 
      analysis. Longitudinal changes in intrinsic DMN connectivity were evaluated by 
      paired analysis, and correlations between longitudinal changes in clinical pain 
      and changes in intrinsic DMN connectivity were investigated by multiple linear 
      regression analysis. Changes in clinical pain were assessed with the short form 
      of the McGill Pain Questionnaire (SF-MPQ). RESULTS: Clinical pain as assessed 
      using the sensory scale of the SF-MPQ was reduced following therapy (P=0.02). 
      Intrinsic DMN connectivity to the insula was reduced, and this reduction 
      correlated with reductions in pain (corrected P<0.05). CONCLUSION: Our findings 
      suggest that intrinsic brain connectivity can be used as a candidate objective 
      marker that reflects changes in spontaneous chronic pain within individual FM 
      patients. We propose that intrinsic connectivity measures could potentially be 
      used in either research or clinical settings as a complementary, more objective 
      outcome measure for use in FM.
CI  - Copyright (c) 2012 by the American College of Rheumatology.
FAU - Napadow, Vitaly
AU  - Napadow V
AD  - Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 
      Charlestown, MA 02129, USA. vitaly@nmr.mgh.harvard.edu
FAU - Kim, Jieun
AU  - Kim J
FAU - Clauw, Daniel J
AU  - Clauw DJ
FAU - Harris, Richard E
AU  - Harris RE
LA  - eng
GR  - P01 AT002048-07/AT/NCCIH NIH HHS/United States
GR  - R01 AT005280-02/AT/NCCIH NIH HHS/United States
GR  - P01-AT-006663/AT/NCCIH NIH HHS/United States
GR  - K01 AT001111/AT/NCCIH NIH HHS/United States
GR  - P01 AT006663-01/AT/NCCIH NIH HHS/United States
GR  - R01 AT004714/AT/NCCIH NIH HHS/United States
GR  - P01 AT006663/AT/NCCIH NIH HHS/United States
GR  - K01 AT001111-05/AT/NCCIH NIH HHS/United States
GR  - R01 AT005280/AT/NCCIH NIH HHS/United States
GR  - K01-AT-01111/AT/NCCIH NIH HHS/United States
GR  - P01 AT002048/AT/NCCIH NIH HHS/United States
GR  - R01-AT-004714/AT/NCCIH NIH HHS/United States
GR  - R01 AT004714-03/AT/NCCIH NIH HHS/United States
GR  - R01-AT-005280/AT/NCCIH NIH HHS/United States
GR  - P01-AT-002048/AT/NCCIH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
SB  - IM
MH  - Adult
MH  - Aged
MH  - Brain/*physiopathology
MH  - Brain Mapping
MH  - Female
MH  - Fibromyalgia/*physiopathology
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Magnetic Resonance Imaging
MH  - Middle Aged
MH  - Nerve Net/*physiopathology
MH  - Pain/*physiopathology
MH  - Pain Measurement
PMC - PMC3349799
MID - NIHMS353321
EDAT- 2012/02/02 06:00
MHDA- 2012/09/15 06:00
PMCR- 2013/07/01
CRDT- 2012/02/02 06:00
PHST- 2012/02/02 06:00 [entrez]
PHST- 2012/02/02 06:00 [pubmed]
PHST- 2012/09/15 06:00 [medline]
PHST- 2013/07/01 00:00 [pmc-release]
AID - 10.1002/art.34412 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2012 Jul;64(7):2398-403. doi: 10.1002/art.34412.