Painful after-sensations in fibromyalgia are linked to catastrophizing and differences in brain response in the medial temporal lobe
Open accessAbstract
Fibromyalgia (FM) is a complex syndrome characterized by chronic widespread pain, hyperalgesia, and other disabling symptoms. Although the brain response to experimental pain in FM patients has been the object of intense investigation, the biological underpinnings of painful after-sensations (PAS), and their relation to negative affect have received little attention. In this cross-sectional cohort study, subjects with FM (n = 53) and healthy controls (n = 17) were assessed for PAS using exposure to a sustained, moderately painful cuff stimulus to the leg, individually calibrated to a target pain intensity of 40 of 100. Despite requiring lower cuff pressures to achieve the target pain level, FM patients reported more pronounced PAS 15 seconds after the end of cuff stimulation, which correlated positively with clinical pain scores. Functional magnetic resonance imaging revealed reduced deactivation of the medial temporal lobe (MTL; amygdala, hippocampus, parahippocampal gyrus) in FM patients, during pain stimulation, as well as in the ensuing poststimulation period, when PAS are experienced. Moreover, the functional magnetic resonance imaging signal measured during the poststimulation period in the MTL, as well as in the insular and anterior middle cingulate and medial prefrontal cortices, correlated with the severity of reported PAS by FM patients. These results suggest that the MTL plays a role in PAS in FM patients.Perspective PAS are more common and severe in FM, and are associated with clinical pain and catastrophizing. PAS severity is also associated with less MTL deactivation, suggesting that the MTL, a core node of the default mode network, may be important in the prolongation of pain sensation in FM.
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Catastrophizing has been identified as an indirect mechanism by which ACT reduces pain-related disability.
“catastrophizing has been identified as an indirect mechanism of ACT in reducing pain related disability 328.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [328]
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- Authors
- Schreiber, K. L., Loggia, M. L., Kim, J., Cahalan, C. M., Napadow, V., & Edwards, R. R.
- Affiliations
- Brigham and Women's Hospital (US)
- Korea Institute of Oriental Medicine (KR)
- Corresponding author
- Schreiber, Kristin L.
- ORCID
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 18
- Issue
- 7
- Pages
- 855-867
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC6102715
- OpenAlex
- W2594087554
- Cited by
- 54
- References
- 83
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 9 · 2019: 6 · 2018: 5 · 2015: 1
- FWCI
- 4.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1s10rr021110-01a1, 1s10rr023043-01)
- National Institute on Aging (R01AG034982)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR064367)
- National Center for Research Resources (S10-RR-023043, P41RR014075, S10‐RR‐021110)
- National Center for Complementary and Integrative Health (P01AT006663, R01AT007550)
- 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 catastrophizing, medial temporal lobe, amygdala, hippocampus, parahippocampal gyrus, brain deactivation, default mode network, insula, anterior cingulate cortex, medial prefrontal cortex, chronic widespread pain, hyperalgesia
- MeSH terms
- Adult, Brain Mapping, Cerebral Cortex, Cross-Sectional Studies, Female, Fibromyalgia, Humans, Limbic System, Magnetic Resonance Imaging, Male, Middle Aged, Pain, Severity of Illness Index, Temporal Lobe, Catastrophization, Pain Perception
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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