Fibromyalgia is a debilitating condition affecting more than 5 million Americans, but it is still widely misdiagnosed and misunderstood. It can take up to five years for a proper diagnosis, and many patients report having been told that the condition does not exist. Women are more prone to the disease, and it can be caused by stress, physical or emotional trauma, or certain viruses. Symptoms include fatigue, difficulty concentrating, insomnia, nervousness, and depression, as well as muscle and joint pain. Pain is often a subjective experience, leading to a lack of understanding from healthcare providers. However, recent research has identified changes in the size and volume of gray and white matter in the brains of fibromyalgia patients, specifically in areas responsible for pain inhibition. These changes can be reversed through medication, exercise, and cognitive behavioral therapy. While the study’s findings are not new, they reaffirm the biological basis of fibromyalgia and provide hope for those suffering from the condition.
Additional Piece:
While fibromyalgia may not be a household name, millions of people worldwide suffer from this chronic and debilitating condition. Despite ongoing research, there are no known cures for fibromyalgia, and treatment is largely focused on managing symptoms. However, recent advancements in brain imaging and neuroscience have shed some much-needed light on the condition, providing insights into how it affects sufferers on a biological level.
Firstly, let’s take a closer look at fibromyalgia itself. The condition is characterized by widespread musculoskeletal pain that affects the entire body. In addition to pain, sufferers may also struggle with fatigue, sleep disturbances, headaches, depression, and irritable bowel syndrome (IBS). It is typically diagnosed through a physical exam and a review of the patient’s medical history, which can include blood tests, X-rays, and other imaging scans. Diagnosing fibromyalgia can be complicated due to the subjective nature of pain and may require multiple visits to a healthcare provider or specialist.
One of the biggest challenges faced by people with fibromyalgia is the lack of understanding and awareness surrounding the condition. Due to the lack of objective evidence, some healthcare providers have dismissed patients’ complaints as being purely psychological. This stigma can make it exceedingly difficult for sufferers to access the care and support they need.
However, recent research has contributed greatly to our understanding of fibromyalgia by shedding light on the biological mechanisms that underlie the condition. One area of particular interest is the brain. Advances in brain imaging techniques such as MRI and fMRI have allowed researchers to explore the structural and functional changes in the brains of patients with fibromyalgia.
The most significant finding so far has been the identification of changes in the pain processing and evaluation regions of the brain, which can lead to altered pain perception and the amplification of pain signals. These changes are accompanied by a reduction in gray matter in certain areas of the brain responsible for pain inhibition, as well as modifications to the connectivity in the white matter fiber pathways.
Importantly, these changes are not necessarily permanent and can be reversed through a combination of medication, exercise, and cognitive-behavioral therapy. Certain medications such as SNRIs and gabapentinoids are particularly useful in treating fibromyalgia, as they can help to alleviate symptoms while also working to reverse some of the structural changes in the brain.
What does this mean for fibromyalgia sufferers? For one, it reinforces the biological basis of the condition, providing validation for those who have struggled to receive proper care and treatment for their symptoms. It also provides hope that, with the right interventions, some of the structural changes in the brain can be reversed, leading to improved quality of life and symptom management.
However, much more research is needed to fully understand the complex interplay between the brain and fibromyalgia. Improved diagnostic tools, such as biological markers or blood tests, could provide more objective evidence of the condition and help to reduce the lengthy diagnosis times currently experienced by many patients. Additionally, ongoing research is needed to explore the potential links between fibromyalgia and other conditions such as depression, IBS, and chronic fatigue syndrome.
In the meantime, it is essential that we continue to raise awareness of fibromyalgia and work to reduce the stigma surrounding the condition. With continued research and support, there is hope that one day we may find a cure for this debilitating condition.
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June 13, 2023: In 1993, Lynne Matallana lived a “wonderful life.” Recently married, the 38-year-old Californian was a partner in an advertising agency. But his life was turned upside down after surgery for endometriosis.
“I actually woke up during surgery and the next day I developed excruciating pain, beyond excruciating, and I was bedridden,” she said. The pain brought insomnia, inability to eat, and debilitating exhaustion. “It completely changed my life, and I had no idea what happened.”
Matallana spent the next 2 years “going from doctor to doctor” before finally being diagnosed fibromyalgia. “It was a relief to have a diagnosis and finally have a name for what was happening to me, and I’ve heard so many other people say the same thing,” she said.
Still, he said, this was “in 1995, and not much was known about fibromyalgia, and the doctors basically said there was nothing they could do for me.”
pain and brain
Unfortunately, Matallana’s story is typical. Although fibromyalgia is quite common and affects more of 5 million Americans, continues to be misdiagnosed and misunderstood. In fact, the average time for a patient to be diagnosed with fibromyalgia can be up to 5 years.
Fibromyalgia can be caused by stressful physical or emotional events, including a serious injury, a car accident, or certain viruses. Women are more prone to fibromyalgia. Its symptoms include extreme fatigue, difficulty concentrating and remembering (sometimes called “fibrous fog” or “brain fog”), insomnia, nervousness, and depression. Pain (usually in the muscles and joints) is one of the characteristic symptoms.
And because pain is a subjective experience—no one can feel another person’s pain—some healthcare professionals haven’t taken the symptoms seriously. Many patients diagnosed with fibromyalgia by a rheumatologist or pain medicine specialist say that another health care provider had told them that “Fibromyalgia does not exist.”
Hopefully, this trend is beginning to change, as more research finds “objective” ways to identify the pain that accompanies fibromyalgia.
In a recent study, the researchers used MRI data to explore the brain regions involved in pain processing and emotional evaluation and found that in fibromyalgia patients, these areas undergo changes. The changes affect the size of the gray matter in the brain, which contains neurons, and also the white matter, which consists mainly of fiber connections whose job it is to transmit signals between nerve cells.
The researchers compared MRI data from 23 women with fibromyalgia and 21 healthy people.
“One of our objectives was to determine if there are variations in the direction of diffusion of water molecules in specific areas of the brain; in other words, if we can detect regional distinctions in signal transmission,” said the study’s lead author, Benjamin Mosch, a doctoral candidate at the University of Bochum in Germany. said in a press release.
The researchers found changes in the volume of gray matter within the brain’s pain network. “We discovered a reduction in gray matter within specific regions responsible for pain inhibition in patients, compared to healthy controls. The volume of these regions decreased significantly in the patients,” Mosch said.
Alterations in signal transmission were also found in the thalamus, a region of the brain known to play a central role in pain processing. Differences in white matter between patients and healthy controls suggested that there were modifications in pain signals in people with fibromyalgia.
In addition, the researchers investigated how these structural brain changes relate to the perceptions and behavior of the people in the study. They found that the greater the volume loss in certain brain regions, the more pain people with fibromyalgia experienced.
Brain changes can be reversed
When the researchers looked at the relationship between depression symptoms or activity levels and volume change in certain areas of the brain, they found that the volume of a region called the putamen was smaller in people with more symptoms of depression, but larger in people with higher activity levels. .
“This suggests that the changes in the brain may not be permanent, but may be influenced – in other words, they may be reversible, for example, through active daily life,” Mosch said.
These findings are not “new or surprising,” Daniel Clauw, MD, a professor of anesthesiology, rheumatology and psychiatry at the University of Michigan, said in an interview.
The brain changes “are not permanent; these parameters often become more normal with effective therapies,” said Clauw, who is also director of the university’s Chronic Pain and Fatigue Research Center.
He said certain medications, including some antidepressants called selective serotonin and norepinephrine reuptake inhibitors (SNRIs) and gabapentinoids, which are used to treat shingles, restless legs syndrome and seizures, as well as non-drug therapies such as education, exercise and cognitive behavioral therapy. therapy, are useful for fibromyalgia and may help reverse some of the brain changes.
Matallana, who is co-founder and director of the National Fibromyalgia Association, said that while the study may not contain dramatically new findings, “when it comes to pain research, people really have to hear the same things over and over again before the medical system decides that pain is real.”
For her, “the study is one more step to continue demonstrating that people with fibromyalgia have a real biological basis for their pain and, in fact, changes can be seen on their MRI.”
Even more important, “the study shows that some of these changes are reversible, which is especially important because people need to know that they won’t keep getting worse and worse over time and never have quality of life again,” said Matallana, who is the author of the book The complete idiot’s guide to fibromyalgia.
To this day, Matallana continues to have some symptoms of fibromyalgia, such as extra sensitivity to sound and smell, as well as trouble sleeping. “It’s clear that my central nervous system is much more sensitive than other people’s,” she said. Fortunately, he no longer has pain throughout his body.
https://www.webmd.com/fibromyalgia/news/20230613/pain-related-brain-changes-in-fibromyalgia-may-be-reversible?src=RSS_PUBLIC
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