Striatal grey matter increase in patients suffering from fibromyalgia -: A voxel-based morphometry study
Striatal grey matter increase in patients suffering from fibromyalgia -: A voxel-based morphometry study
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DOI：
10.1016/j.pain.2007.05.010
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发表时间：
2007-11-01
期刊：
影响因子：
7.4
通讯作者：
Bogdahn, U.
中科院分区：
文献类型：
--
作者：
Schmidt-Wilcke, T.;Luerding, R.;Bogdahn, U.
纤维肌痛是一种所谓的功能性疼痛综合征，属于慢性紧张型头痛、不典型面部疼痛等慢性疼痛综合征。纤维肌痛患者遭受广泛的“深”肌肉疼痛，并经常报告伴随的抑郁发作、疲劳和认知障碍。纤维肌痛患者肌肉或软组织结构异常的明确证据缺乏。越来越多的证据表明，纤维肌痛的临床疼痛必须通过涉及伤害性感觉的中枢结构的病理活动来理解。我们应用磁共振成像和基于体素的形态计量学，来确定纤维肌痛是否与局部脑形态改变有关。我们调查了20例确诊为原发性纤维肌痛的患者和22例健康对照。VBM显示右侧颞上回(灰质减少)、左侧丘脑后部(灰质减少)、左侧眶前皮质(灰质增加)、左侧小脑(灰质增加)和双侧纹状体(灰质增加)有明显的脑形态改变。我们的数据表明，纤维肌痛与患有这种慢性疼痛障碍的患者中枢神经系统的结构变化有关。它们可能反映了慢性伤害性输入的结果，也可能与纤维肌痛的发病机制有关。已知受影响的区域既是躯体感觉系统的一部分，也是运动系统的一部分。(C)2007年国际疼痛研究协会。爱思唯尔出版，版权所有。
Fibromyalgia (FM), among other chronic pain syndromes, such as chronic tension type headache and atypical face pain, is classified as a so-called dysfunctional pain syndrome. Patients with fibromyalgia suffer from widespread, "deep" muscle pain and often report concomitant depressive episodes, fatigue and cognitive deficits. Clear evidence for structural abnormalities within the muscles or soft tissue of fibromyalgia patients is lacking. There is growing evidence that clinical pain in fibromyalgia has to be understood in terms of pathological activity of central structures involved in nociception. We applied MR-imaging and voxel-based morphometry, to determine whether fibromyalgia is associated with altered local brain morphology. We investigated 20 patients with the diagnosis of primary fibromyalgia and 22 healthy controls. VBM revealed a conspicuous pattern of altered brain morphology in the right superior temporal gyrus (decrease in grey matter), the left posterior thalamus (decrease in grey matter), in the left orbitofrontal cortex (increase in grey matter), left cerebellum (increase in grey matter) and in the striatum bilaterally (increase in grey matter). Our data suggest that fibromyalgia is associated with structural changes in the CNS of patients suffering from this chronic pain disorder. They might reflect either a consequence of chronic nociceptive input or they might be causative to the pathogenesis of fibromyalgia. The affected areas are known to be both, part of the somatosensory system and part of the motor system. (C) 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.