This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Burgmer, M. Articles by Pfleiderer, B. Search for Related Content PubMed PubMed Citation Articles by Burgmer, M. Articles by Pfleiderer, B. Related Collections Musculoskeletal Radiology and Brain Imaging

Decreased Gray Matter Volumes in the Cingulo-Frontal Cortex and the Amygdala in Patients With Fibromyalgia

From the Department of Psychosomatics and Psychotherapy (M.B., M.W., S.H., G.H.), the Department of Medicine B (M.G.), Interdisciplinary Centre for Clinical Research Münster (IZKF), and Department of Psychiatry and Psychotherapy (C.K.), and the Department of Clinical Radiology (B.P.), University Hospital Münster, Münster, Germany.

Address correspondence and reprint requests to Markus Burgmer, Department of Psychosomatics and Psychotherapy, University Hospital Münster, Domagkstr. 22, 48153 Münster, Germany. E-mail: burgmem{at}mednet.uni-muenster.de

Objective: Studies in fibromyalgia syndrome with functional neuroimaging support the hypothesis of central pain augmentation. To determine whether structural changes in areas of the pain system are additional preconditions for the central sensitization in fibromyalgia we performed voxel based morphometry in patients with fibromyalgia and healthy controls.

Methods: We performed 3 Tesla magnetic resonance imaging of the brain in 14 patients with fibromyalgia and 14 healthy controls. Regional differences of the segmented and normalized gray matter volumes in brain areas of the pain system between both groups were determined. In those areas in which patients structurally differed from healthy controls, the correlation of disease-related factors with gray matter volumes was analyzed.

Results: Patients presented a decrease in gray matter volume in the prefrontal cortex, the amygdala, and the anterior cingulate cortex (ACC). The duration of pain or functional pain disability did not correlate with gray matter volumes. A trend of inverse correlation of gray matter volume reduction in the ACC with the duration of pain medication intake has been detected.

Conclusions: Our results suggest that structural changes in the pain system are associated with fibromyalgia. As disease factors do not correlate with reduced gray matter volume in areas of the cingulo-frontal cortex and the amygdala in patients, one possible interpretation is that volume reductions might be a precondition for central sensitization in fibromyalgia.

Key Words: fibromyalgia • VBM • pain • amygdala • cingulo-frontal cortex

Abbreviations: ACC = anterior cingulate cortex; fMRI = functional magnetic resonance imaging; FMS = fibromyalgia syndrome; HADS = Hospital Anxiety and Depression Scale; PAG = periaqueductal grey; PDI = Pain Disability Index; PTSD = posttraumatic stress disorder; ROI = region of interest; SPM = statistical parametric mapping; SSRIs = selective serotonin reuptake inhibitors; TCAs = tricyclic antidepressants; VBM = voxel-based morphometry; 3T = 3 Tesla.