Brain Signals Disrupted in Fibromyalgia Patients

Brain Signals Disrupted in Fibromyalgia Patients

A disruption in brain signals may contribute to increased pain sensitivity in fibromyalgia patients, according to new research.

A small study published in the journal Arthritis & Rheumatism suggests that this altered brain processing may contribute to hyperalgesia – causing widespread pain and a lack of response to opioid pain medication.

bigstock-Human-brain-chart-with-colored-11863427“In patients with fibromyalgia there is an alteration in the central nervous system pain processing and a poor response to topical pain treatments, trigger point injections and opioids,” said lead author Dr. Marco Loggia from Massachusetts General Hospital and Harvard Medical School in Boston.

“Our study examines the disruption of brain function involved in the individual experience of pain anticipation and pain relief.”

Researchers enrolled 31 patients with fibromyalgia and 14 healthy participants. Magnetic resonance images (MRI) of the brain and cuff pressure pain stimulation on a leg were performed on all subjects. During the MRI, participants received visual cues alerting them of impending pain onset (pain anticipation) and pain offset (relief anticipation).

The MRI images showed that during both pain anticipation and pain relief, fibromyalgia patients had a less robust response in the parts of their brains involved in sensory, affective, cognitive and pain regulating processes.

In healthy subjects, the ventral tegmental area (VTA) — a group of neurons in the center of the brain involved in the processing of reward and punishment — displayed activation during pain anticipation and stimulation, and then deactivated when a participant anticipated pain relief.

For fibromyalgia patients, however, the VTA responses during periods of pain, and anticipation of pain and relief, were significantly reduced or inhibited.

“Our findings suggest that fibromyalgia patients exhibit altered brain responses to punishing and rewarding events, such as expectancy of pain and relief of pain,” said Loggia.

“These observations may contribute to explain the heightened sensitivity to pain, as well as the lack of effectiveness of pain medications such as opioids, observed in these patients. Future studies should further investigate the neurochemical basis underlying these dysfunctions.”

One possible explanation for the reduced response in fibromyalgia patients is that they always experienced some degree of ongoing pain, and never felt the full benefit of pain relief as the healthy participants in the study.

The National Institutes of Health estimates that 5 million Americans suffer from fibromyalgia, a poorly understood disorder characterized by chronic deep tissue pain, fatigue, headaches, depression and lack of sleep. There is no known cure and many medications prescribed to treat fibromyalgia are ineffective.

Authored by: Pat Anson, Editor

There are 22 comments for this article
  1. LarryK at 8:44 pm

    Yes, I get hot flashes multiple times a day. I’m a 35 y/o male, so I definitely shouldn’t be getting them. I easily overheat, even in the winter (eastern Wa state.) To the point of sweating. I tried to tie it to something but, it seems to be independent of outside factors. I have to constantly balance between being too hot or, the cold hurting my legs. So, I usually have to switch between shorts and long pants throughout the day.

  2. Sue at 7:20 pm

    I have had fibromyalgia for over 25 years and I have tremors, also. I am glad to find out someone else has them too. A few weeks ago after a long trip, my shoulders and feet, ankles, and wrists started hurting also, not just the back, knees and hips. Blood tests showed my Rheumatoid Factor was high and I may have Rheumatoid Arthritis, instead of just arthritis that I have had. My neck is stiff and a chiropractor does help. I, also, sleep with a c-pap. I sure do need that. My feet really bother me at night if I have walked a lot. Water aerobics is about the best exercise I can get. Does anyone else have hot spells. I am warm most of the time–covers off and on all night.

  3. Cindy at 9:14 am

    I’ve lived with Fibro and other types of pain for so many years that I finally just accept this is my life. I took high doses of pain meds to the point that I couldn’t function. So I gave those all up! I took glucosamine tabs and for the first time I was actually pain free. I stopped taking them because of drug interaction with prescription meds for other problems and the pain came rushing back. I stopped telling people that I have it because they looked at me like I was crazy or gave me pity which I couldn’t stand. I have had to change my diet to a healthy one because of being type 2 diabetic now and that has helped a lot. Eating healthy is a big plus and especially finding which foods or spices cause pain. Leave them out and you do pretty well. I can’t exercise the way I’d like so walking is my only option. Some days I can go far and some days not so much. I do what I can. My husband has been very understanding and knows that my bad days I don’t do much. Good days I go like a house on fire and then two days later I can hardly move. I take Excedrin only for my pain and headaches. I refuse to take any more ibuprofen as it tore up my stomach. Celebrex, Ultram, and other like them gave me a swollen tongue, 50+ weight gain that I haven’t been able to lose, etc. I’ve tried a lot of home remedies and “cures” to make my head spin. What I have found is find what causes your pain and alleviate them from your life. Get 8 hours of rest and the hard one…keep your stress level as low as possible. I hear you…how does one do that? I can’t give you a definite answer to that! 🙂 Thanks for letting me “spout” off here. Like so many of you…no one really wants to hear your story…

  4. Penny Simpson at 3:34 am

    I’m just at a loss for a cure. Not eating processed foods, only healthy foods seem to help. My dr’s p.a. suggested the Ayuvedic diet, she said one patient w/fibro tried it totally committed and it worked so i’m getting the ingredients (spices??) to give it a shot. We all know we would try just about anything. If it doesn’t work, try something else. My support group leader praises gluten free, ie..healthy lol. What works for one doesn’t necessarily work for another, I think. I’ve lost weight and hasn’t seemed to affect it much. I do take Norco 10 along with a host of other meds but the Norco is best at lowering the pain level. Now if I my dr would just not freak out about loosing his license, that would be helpful! I changed dr’s but don’t think the one I have really believes in fibro (who can blame him w/all the druggies?) but he took me on from another dr and I am an established patient. I woke up with cramps in both legs this morn cuz I felt good enough to walk down the road and back yesterday. Its about to get cold and i’m bracing for it because changes in the weather kill me. I used to be a hot natured person, now I fear the cold 🙁
    I just think this all has something to do with hormones because that’s what women have in common and some men, right?? I’m sure they’ve probably tested that but if not, hope they do….painfully yours…penny

  5. Sherry at 6:29 am

    I suffered with Fibro for 14 yrs. probably a little more, before I was finally diagnosed. My family condemned me about my “supposed” pain to just the slightest touch, which would usually leave a bruise. My kids mantra about me was, “Don’t touch Mom, you’ll leave a bruise.” When I would come home from work totally exhausted & just crash on the couch I became a lazy mother that didn’t want cook or clean for them. No one believed me about all my sensitivities to smells that would make me break out or be unable to breathe, to cigarette smoke that would break out my face terribly

  6. shirlie at 6:24 am

    I had Rheumatic Fever when I was a small child .I truely feel that this has made my fibro worse when I have a flare. I sleep issues bad,tremors ,leg and arm pain always and back pain I can never get relief from.. I am tired of being told that it is all in my head and not having the support system that I need,, what the heck do they expect us to do..

  7. marcia king at 3:23 am

    I have been diagnosed about 12 years now.|I would like to know More about a cure,There are Mil;s of out there who suffer 24/7. I have been on so many different meds its not funny.I recently told my Doctor NO more pills I doped all my pills on his desk, I keep one for pain and one scrip for sleep.I;m not doing any better as far as pain but my mind is clearer,not always thinking about ended my life. To all who suffer Lets fight for a cure

  8. Elizabeth at 1:48 am

    I got Fibromyalgia in 1991 after my husband got sick and it was a very stressful time. From everything my Mom told me about my grandmother, I’m sure she had it also. She was always complaining of being sick and depressed. They finally operated on her with a frontal labatomy. She died a few days later, about a month before I was even born. I can’t even imagine what she went through. I’m so fortunate to have a husband who understands. I’ve often explained to people that this feels like you do during the flu-ache all over. Then a few months ago, our mechanic was telling my husband that he has fibromyalgia. And he explained it the same way I do. It’s hard because people look at you and you don’t look sick so they don’t understand.

  9. rhijulbec at 9:41 pm

    This “guaifenesin” treatment has been proved to be bunkum, snake oil, not at all effective. Pls don’t try to sell books and “cures” here. Its cruel and unethical!!!

  10. Vicki at 6:11 pm

    This is the strangest disease, I feel like a voodoo doll, random pains and muscle weakness, all the other weird symptoms… meds just keep things down to a dull roar, but there are always those pains that suddenly stab at you that apparently won’t be affected by my meds. I want a cure, but until then, I’ll take awareness, it’s important to have supportive people in my life rather than people who think I am a hypochondriac. I wouldn’t wish this on an enemy, why would I want to have it myself!?!

  11. LarryK at 5:55 pm

    I’m not sure on genetics yet. I have a detailed family history, going back a few hundred years. From what we can tell, no one in the family has had it. I have tremors as well, no one else in the family has had that either. Both my boys have them as well though. That doesn’t completely count it out though. As a geneticist told me, it has to start with someone.

    I was very active before its onset. I was able to run very well (5 min miles) and, I did a lot of mountain biking and physical activity. I did have arthritic lower vertebrae in the L4/L5 level since I was a teen though. I was able to just power through any pain it gave me. Which was usually from standing still for too long, as in a military formation for example.

  12. Laura at 4:53 pm

    I have had this since the age of four. I believe this is part of arthritis. I have never been able to run. I was told all my life you don’t look sick your range of motion is still pretty good-so I don’t believe you have pain. Thank God I have a high pain tolerance but too much pain makes anyone tired. This runs in my family I think the key is to do research on the genes in families. Also I take Advil Cold and Sinus that has guifenicin in it and works quickly. Tofranil and remeron may help too but they might contribute to weight gain but I think it is worth it for me. Good luck

  13. Sabrina at 4:04 pm

    Cheryl Fink, check out the book “what your doctor may not tell you about fibromyalgia” written by Dr. Paul St. Amand, a doctor who had suffered with fibro. It’s a great book & he talks about reversing the disease with a medicine called guaifenesin. I’m still reading the book & am looking into teasing fibro with this medicine. I also have changed my diety to gluten free & cook with coconut oil (Virgin organic coconut oil) & I use Himalayan pink sea salt to cook with & sprinkle in to my food. It’s made a difference & I’ve noticed when I I find myself being lazy& cheat on my gluten free diety, I’m paying for it the next day with loads of pain & other symptoms. Just thought I’d share what had helped me

  14. Grace at 4:01 pm

    This explains a lot. I am having a lot of pain breakthroughs such as I have never had before. Along with arthritis in my knees, I get pain like needles being put in my knee. I get pain in individual toes randomly. I’m this sudy as done but we need more. We don’t want just to be treated—we want a CURE!

  15. Sabrina at 3:56 pm

    I’ve had fibro for a long time. I’m 31 & had early signs of the disease since I was in intermediate school, but didn’t realize it until recently when I started researching fibromyalgia in more detail. Within my research, I’ve discovered a book called “what your doctor may not tell you about fibronyalgia”
    written by Dr. Paul St. Amand, a doctor who had suffered with fibromyalgia. He talks about a medicine that may reverse the disease. It’s called Guaifenesin, often prescribed for gout, but also reverses fibromyalgia…. it may be something worth looking into for some of you fibro sufferers out there. I’m currently still reading the book & and am lioking into guaifenesin treatments.
    I just thought I’d share it with all of you fellow fibro sufferers.

  16. Nicole Vetor at 3:07 pm

    I have been recently diagnosed with this horrible disease. My worse pains are in the small of my back and my thighs. I have a hard time sleeping because of the pain in my legs seems to be getting worse. Just recently broke out on my arm with a little rash and was told that was the fibromyalgia. I also have my good days and bad days.Thank you so much for this opportunity to share.

  17. Cheryl Fink at 1:07 pm

    Have had this terrible disease for over 33 years. Been thru it all. I now suffer from muscle and nerve pain, chronic fatigue, depression, anxiety, headaches. Wish they would do more research. I would do almost anything to be free of this.

  18. Peggy Critchlow at 12:42 pm

    I thought I was a different duck about not getting high on my pain medicine. I might go to sleep with a little more but never get high. It just knocks the pain down a little bit to tolerable. I get awakened every single day with excruciating pain too, especially in the small of my back/spine/sacral area. My worst pain is in my spine/tendons, sacral area, thigh/tendons, hip flexors but a lot of times elsewhere. I get nerve pain a lot on the bottom half. The list is endless and I wonder sometimes because I’ve read about MS and I can’t tell the difference in the symptoms as far as my body is concerned.

  19. Candi at 8:01 am

    Getting a good night’s sleep is part of the key to lessening the symptoms, at least for me. I use Benadryl so that if I do wake up I’m groggy enough to fall back to sleep. Hot baths, walking, reducing stress (yah I know, very funny) and massages really help.

  20. Mikki Sage Harper at 8:43 am

    Pain so bad that it wakes me in from my sleep…Yeah, I know about that one…and I keep thinking, they have misdiagnosed me that there is something wrong that they can fix and make the pain go away…wishful thinking…Thru the many years I have had this, I have experienced pain so bad I couldn’t walk and then feeling good enough to wonder is anything really wrong with me back to the excruciating pain again…I want someone to fix my brain so I don’t have to play this game anymore…

  21. LarryK at 7:38 am

    I’m glad they looked at the always in pain aspect. I was reading this, getting ready my reply to that effect. I would think that is the same reason opiods don’t work as well (they do to a point, a lot of us are on 1 type or another.) When there is a lot of pain to cut through, they don’t do much. I would suspect that it is the reason those of us on opiods don’t get the usual “high” effect from them as well. People are surprised when I tell them I’m on long acting morphine. Especially when I tell them I take it 3 times a day. I think they expect me to be a drooling lump.

    @ Shirley:
    You aren’t the only one who wakes up from pain. I have it even in my dreams. The way you describe your pain being always there, I have that as well. With the exception of the first 2ish months of onset, I have always had it. However, I only have it in my lower body (small fiber fibromyalgia.) It is severe, but at least it isn’t above my waist. The only triggers I have is being on my feet. It makes the pain intensify, dramatically, the longer I’m on my feet. The cold air adds an additional, separate sensation, layer of pain on the skin of my legs as well.

  22. Shirley at 10:37 pm

    That is the worse part it never totally goes away, I’m so greatful for what relief I do get and SLEEP is awesome when I can get it hate the kind of sleep ya only ge from pure exhaustion and then when you move in your sleep being jerked awake from sheer pain really sucks seems tears just come and go but the pain really stays in certain areas in me but it does spread and hits spots that it formally hadn’t. That’s when it just make ya wonder what’s up with this I’ve had it for years but the past couple years have been mind blowing… Thanks for listening sometimes seems everyone including ones who are suppose to understand look at me like it’s BS and it’s not…