INHIBITED FUNCTIONAL BRAIN ACTIVITY IN FIBROMYLAGIA

我们提出了两项研究，目的是更好地了解 抑制功能性脑活动（通过局部脑血 血流[rCBF]）和异常疼痛感知的发病机制， 纤维肌痛（FM）。 为了实现这一目标，我们将测试六个假设 基于我们实验室开发的FM病因模型。 具体而言，我们希望确定是否：（a）功能性大脑 静息状态下丘脑和尾状核的活动 疼痛感知的行为指数可靠地区分FM 来自慢性疲劳综合征（CFS）或严重 （B）FM患者与健康对照组不同。 三个对照组在脑功能变化方面 活动在丘脑，尾状核，适当的躯体感觉 皮质和前扣带回在暴露于疼痛时， 测痛仪刺激 我们将招募（a）30名原发性 根据美国流变学会（ACR）标准的FM;（B）30例患者 根据疾病控制中心的标准，CFS患者没有疼痛， 不符合FM的ACR标准;（c）30例当前主要 抑郁症谁是无痛，不符合标准的其他电流 精神病诊断或FM或CFS的标准;以及（d）30名健康 无疼痛且不符合FM或CFS标准的对照组。 将从适当的UAB门诊招募患者， 将从伯明翰社区招募控制人员。 所有受试者 都是右撇子女性 我们建议测量（a）疼痛阈值 用于5对ACR压痛点的测痛仪刺激，以及 感觉辨别能力和反应偏差的行为指标; (b)使用单光子发射计算机断层扫描（SPECT）的rCBF 成像;和（c）对焦虑的问卷测量的响应， 抑郁症和疼痛，以及结构化的精神病访谈。 的 拟议的研究代表了FM研究的进步，因为它们 包括使用实验操作以及相关的 评价FM的病因模型的研究。结果还 将帮助我们更好地理解 在FM患者中观察到的功能性脑活动抑制， 休息条件。

We propose two studies with the aim of better understanding the role of inhibited functional brain activity (assessed by regional cerebral blood flow [rCBF]) and abnormal pain perception in the etiopathogenesis of fibromyalgia (FM). To accomplish this aim, we will test six hypotheses based on an etiopathogenetic model of FM developed in our laboratory. Specifically, we wish to determine whether: (a) functional brain activity in the thalamus and caudate nucleus during resting conditions and behavioral indices of pain perception reliably distinguish FM patients from patient with chronic fatigue syndrome (CFS) or major depression and healthy controls; and (b) FM patients differ from the three comparison groups with respect to changes in functional brain activity in the thalamus, caudate nucleus, appropriate somatosensory cortices, and anterior cyngulate gyrus upon exposure to painful dolorimeter stimulation. We will recruit (a) 30 patients with primary FM by American College of Rheumatology (ACR) criteria; (b) 30 patients with CFS by Centers for Disease Control criteria who are pain-free and do not meet ACR criteria for FM; (c) 30 patients with current major depression who are pain-free and do not meet criteria for other current psychiatric diagnoses or criteria for FM or CFS; and (d) 30 healthy controls who are pain-free and do not meet criteria for FM or CFS. Patients will be recruited from appropriate UAB outpatient clinics and controls will be recruited from the Birmingham community. All subjects will be right-handed women. We propose to measure (a) pain thresholds for dolorimeter stimulation of 5 paired ACR tender points as well as behavioral indices of sensory discrimination ability and response bias; (b) rCBF using single photon emission computed tomographic (SPECT) imaging; and (c) responses to questionnaire measures of anxiety, depression, and pain as well as a structured psychiatric interview. The proposed studies represent an advance in the study of FM since they include the use of an experimental manipulation as well as correlational studies to evaluate an etiopathogenetic model of FM. The results also will help us to better understand the mechanisms responsible for inhibited functional brain activity observed in FM patients during resting conditions.