Cited by 1,263Fibromyalgia and Chronic Fatigue Syndrome ResearchPain Mechanisms and TreatmentsPain Management and Treatment

Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia

Gracely, Richard H., Petzke, Frank, Wolf, Julie M., Clauw, Daniel J.·2002·Arthritis & Rheumatism

Abstract

OBJECTIVE: To use functional magnetic resonance imaging (fMRI) to evaluate the pattern of cerebral activation during the application of painful pressure and determine whether this pattern is augmented in patients with fibromyalgia (FM) compared with controls. METHODS: Pressure was applied to the left thumbnail beds of 16 right-handed patients with FM and 16 right-handed matched controls. Each FM patient underwent fMRI while moderately painful pressure was being applied. The functional activation patterns in FM patients were compared with those in controls, who were tested under 2 conditions: the "stimulus pressure control" condition, during which they received an amount of pressure similar to that delivered to patients, and the "subjective pain control" condition, during which the intensity of stimulation was increased to deliver a subjective level of pain similar to that experienced by patients. RESULTS: Stimulation with adequate pressure to cause similar pain in both groups resulted in 19 regions of increased regional cerebral blood flow in healthy controls and 12 significant regions in patients. Increased fMRI signal occurred in 7 regions common to both groups, and decreased signal was observed in 1 common region. In contrast, stimulation of controls with the same amount of pressure that caused pain in patients resulted in only 2 regions of increased signal, neither of which coincided with a region of activation in patients. Statistical comparison of the patient and control groups receiving similar stimulus pressures revealed 13 regions of greater activation in the patient group. In contrast, similar stimulus pressures produced only 1 region of greater activation in the control group. CONCLUSION: The fact that comparable subjectively painful conditions resulted in activation patterns that were similar in patients and controls, whereas similar pressures resulted in no common regions of activation and greater effects in patients, supports the hypothesis that FM is characterized by cortical or subcortical augmentation of pain processing.

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Crossref · 10.1002/art.10225

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Authors
Gracely, R. H., Petzke, F., Wolf, J. M., & Clauw, D. J.
Affiliations
  • National Institutes of Health (US)
  • Georgetown University (US)
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
2002-05
Volume
46
Issue
5
Pages
1333-1343
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
OpenAlex
W2033577846
Cited by
1,263
References
50
Citations by year
2026: 17 · 2025: 37 · 2024: 28 · 2023: 34 · 2022: 44 · 2021: 59 · 2020: 36 · 2019: 42 · 2018: 39 · 2017: 33 · 2016: 67 · 2015: 61 · 2014: 72 · 2013: 64 · 2012: 78
FWCI
21.96
Type
journal article
Language
en
Open access
closed
Locations
  • Arthritis & Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
fibromyalgia, pain processing, cortical hyperexcitability, regional cerebral blood flow, brain activation patterns
MeSH terms
Adult, Aged, Brain, Female, Fibromyalgia, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pain, Psychophysics, Pain Threshold

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