Posts tagged fibromyalgia
Articles and news from the latest research reports.
Hypersensitivity to Non-Painful Events May Be Part of Pathology in Fibromyalgia
New research shows that patients with fibromyalgia have hypersensitivity to non-painful events based on images of the patients’ brains, which show reduced activation in primary sensory regions and increased activation in sensory integration areas. Findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR), suggest that brain abnormalities in response to non-painful sensory stimulation may cause the increased unpleasantness that patients experience in response to daily visual, auditory and tactile stimulation.
Fibromyalgia is a chronic, musculoskeletal syndrome characterized by widespread pain, affecting roughly two percent of the world population, say experts. According to the ACR, five million people in the U.S. have fibromyalgia, which is more prevalent among women. In previous studies fibromyalgia patients report reduced tolerance to normal sensory (auditory, visual, olfactory, and tactile) stimulation in addition to greater sensitivity to pain.
For the present study, researchers used functional magnetic resonance imaging (fMRI) to assess brain response to sensory stimulation in 35 women with fibromyalgia and 25 healthy, age-matched controls. Patients had an average disease duration of 7 years and a mean age of 47.
According to the study, patients reported increased unpleasantness in response to multisensory stimulation in daily life activities. Furthermore, fMRI displayed reduced activation of both the primary and secondary visual and auditory areas of the brain, and increased activation in sensory integration regions. These brain abnormalities mediated the increased unpleasantness to visual, auditory and tactile stimulation that patients reported to experience in daily life.
Lead study author, Dr. Marina López-Solà from the Institute of Cognitive Science, University of Colorado Boulder said, “Our study provides new evidence that fibromyalgia patients display altered central processing in response to multisensory stimulation, which are linked to core fibromyalgia symptoms and may be part of the disease pathology. The finding of reduced cortical activation in the visual and auditory brain areas that were associated with patient pain complaints may offer novel targets for neurostimulation treatments in fibromyalgia patients.”
(Source: eu.wiley.com)
Electrical Brain Stimulation Might Help Fibromyalgia Patients
By using magnetic brain stimulation on patients with fibromyalgia, French researchers say they were able to improve some of the patients’ symptoms.
Specifically, the technique, called transcranial magnetic stimulation, raised quality of life and emotional and social well-being among patients suffering from the condition, the researchers found in a small study.
"This improvement is associated with an increase in brain metabolism, which argues for a physical cause for this disorder and for the possibility of changes in areas of the brain to improve the symptoms," said lead researcher Dr. Eric Guedj, of Aix-Marseille University and the National Center for Scientific Research, in Marseille.
"Previous studies in patients with fibromyalgia have suggested an alteration of brain areas is involved in the regulation of pain and emotion," he said.
The objective of this study was to demonstrate that it is possible to modulate these brain areas using transcranial magnetic stimulation to correct brain abnormalities and improve patients’ symptoms, Guedj said.
During treatment, patients wear a cap lined with electrodes that send small electric charges to targeted areas of the brain. The idea is to stimulate these areas and alter how they react.
The report was published March 26 in the journal Neurology.
It’s shocking: Ultra-focused electric current helps brain curb pain
Imagine significantly reducing a persistent migraine or fibromyalgia by a visit to a doctor who delivers low doses of electricity to the brain.
Alex DaSilva, assistant professor of prosthodontics at the University of Michigan, and colleagues are optimizing the next generation for such a technique, called high-definition transcranial direct current stimulation, or HD-tDCS.
The researchers have published several studies with the conventional tDCS, which also treats pain by “shocking” the brain with low doses of electrical current delivered noninvasively through electrodes placed on the scalp. The current modulates targeted areas of the brain, and one of the mechanisms is by activating the release of opioid-like painkillers.
HD-tDCS delivers an even more precisely focused current to the targeted areas of the brain. Preliminary reports have shown better pain relief in patients and a longer and more pronounced effect on the brain, said DaSilva, who heads the Headache and Orofacial Pain Effort Laboratory at the U-M School of Dentistry.
The increased precision of HD-tDCS means researchers can custom-place the electrodes to the skull. In this way, they can modulate specific areas in the brain to treat a wider range of conditions, such as neuropathic pain and stroke. Other uses include neurophysiological studies and cognitive and behavioral assessments.
One 20-minute session of HD-tDCS significantly reduced overall pain perception in fibromyalgia patients as described in one of the studies.
Researchers control the current by a portable device, which they hope physicians can eventually use in the clinic as a noninvasive treatment for chronic pain patients.
"We are working hard to make the technology available for clinical use at U-M," DaSilva said. "Our lab is getting a good number of emails from chronic pain patients looking for treatment."
The conventional technology is already available for many companies, and the HD-tDCS is being patented by the company of one of the developers.
To allow broad access and further investigation of the HD-tDCS technology by other researchers, DaSilva and colleagues released a scientific video demonstrating the step-by-step guideline of the research protocol: www.jove.com/embed/directions/50309?key=uahsva6y
Study finds evidence of nerve damage in around half of fibromyalgia patients
Small study could lead to identification of treatable diseases for some with chronic pain syndrome
About half of a small group of patients with fibromyalgia – a common syndrome that causes chronic pain and other symptoms – was found to have damage to nerve fibers in their skin and other evidence of a disease called small-fiber polyneuropathy (SFPN). Unlike fibromyalgia, which has had no known causes and few effective treatments, SFPN has a clear pathology and is known to be caused by specific medical conditions, some of which can be treated and sometimes cured. The study from Massachusetts General Hospital (MGH) researchers will appear in the journal PAIN and has been released online.
"This provides some of the first objective evidence of a mechanism behind some cases of fibromyalgia, and identifying an underlying cause is the first step towards finding better treatments," says Anne Louise Oaklander, MD, PhD, director of the Nerve Injury Unit in the MGH Department of Neurology and corresponding author of the Pain paper.
The term fibromyalgia describes a set of symptoms – including chronic widespread pain, increased sensitivity to pressure, and fatigue – that is believed to affect 1 to 5 percent of individuals in Western countries, more frequently women. While a diagnosis of fibromyalgia has been recognized by the National Institutes of Health and the American College of Rheumatology, its biologic basis has remained unknown. Fibromyalgia shares many symptoms with SFPN, a recognized cause of chronic widespread pain for which there are accepted, objective tests.
Designed to investigate possible connections between the two conditions, the current study enrolled 27 adult patients with fibromyalgia diagnoses and 30 healthy volunteers. Participants went through a battery of tests used to diagnose SFPN, including assessments of neuropathy based on a physical examination and responses to a questionnaire, skin biopsies to evaluate the number of nerve fibers in their lower legs, and tests of autonomic functions such as heart rate, blood pressure and sweating.
The questionnaires, exam assessments, and skin biopsies all found significant levels of neuropathy in the fibromyalgia patients but not in the control group. Of the 27 fibromyalgia patients, 13 had a marked reduction in nerve fiber density, abnormal autonomic function tests or both, indicating the presence of SFPN. Participants who met criteria for SFPN also underwent blood tests for known causes of the disorder, and while none of them had results suggestive of diabetes, a common cause of SFPN, two were found to have hepatitis C virus infection, which can be successfully treated, and more than half had evidence of some type of immune system dysfunction.
"Until now, there has been no good idea about what causes fibromyalgia, but now we have evidence for some but not all patients. Fibromyalgia is too complex for a ‘one size fits all’ explanation," says Oaklander, an associate professor of Neurology at Harvard Medical School. "The next step of independent confirmation of our findings from other laboratories is already happening, and we also need to follow those patients who didn’t meet SFPN criteria to see if we can find other causes. Helping any of these people receive definitive diagnoses and better treatment would be a great accomplishment."
(Source: massgeneral.org)