Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia

作者：Truini A; Tinelli E; Gerardi M C; Calistri V; Iannuccelli C; La Cesa S; Tarsitani L; Mainero C; Sarzi Puttini P; Cruccu G; Caramia F; Di Franco M

来源：Clinical and Experimental Rheumatology, 2016, 34(2): S129-S133.

• fibromyalgia
• magnetic resonance imaging
• periaqueductal grey
• endogenous pain modulatory system

Objective. Emerging evidence associates chronic pain syndrome, such as fibromyalgia, with endogenous pain modulatory system dysfunction, leading to an impaired descending pain inhibition. In this study, using resting state functional magnetic resonance imaging (fMRI), we aimed at seeking possible functional connectivity changes of the periaqueductal gray (PAG), a brainstem area that belongs to the endogenous pain modulatory system, in patients with fibromyalgia.
Methods. In 20 patients with fibromyalgia and 15 healthy subjects, we investigated FAG functional connectivity using resting-state fMRI. We also analysed the correlation between clinical variables, such as pain severity, disease duration, and depressive personality traits with FAG functional connectivity.
Results. Compared with control subjects, we identified that patients with fibromyalgia had an increased PAG connectivity with insula, anterior cingulate cortex, and anterior prefrontal cortex. The functional connectivity between PAG and the rostral ventral medulla, however, was not concordantly increased. FAG functional connectivity correlated with pain severity, disease duration, and the depressive personality trait rating.
Conclusion. Our fMRI study showing abnormal resting state functional connectivity of the PAG suggests that patients with fibromyalgia have an endogenous pain modulatory system dysfitnction, possibly causing an impaired descending pain inhibition. This abnormal PAG functioning might underlaythe chronic pain these patients suffer from.

• 出版日期2016-4