INHIBITED FUNCTIONAL BRAIN ACTIVITY IN FIBROMYLAGIA

我们提出了两项研究，目的是更好地了解 功能性脑活动受抑(通过局部脑血进行评估 流[rCBF])和异常痛觉在痛觉异常的发病机制中的作用 纤维肌痛(FM)。为了实现这一目标，我们将检验六个假设 根据我们实验室建立的FM的发病机制模型。 具体地说，我们希望确定：(A)功能大脑 静息状态下丘脑和尾状核的活动 疼痛感知的行为指标能够可靠地区分FM 来自慢性疲劳综合征(CFS)患者或主要 抑郁症和健康对照；以及(B)FM患者不同于 关于脑功能变化的三个对照组 丘脑、尾状核的活动，适当的躯体感觉 暴露于疼痛时的大脑皮层和前扣带回 测角仪刺激。我们将招募(A)30名初诊患者 美国风湿病学会(ACR)标准的FM；(B)30名患者 根据疾病控制中心的CFS标准，他们没有疼痛， 不符合ACR的FM标准；(C)30名当前主要疾病患者 抑郁症患者无痛且不符合其他疾病的诊断标准 精神疾病诊断或FM或CFS的标准；和(D)30名健康 控制无痛且不符合FM或CFS标准的患者。 患者将从适当的UAB门诊诊所招募，并 控制组将从伯明翰社区招募。所有科目 都是惯用右手的女人。我们建议测量(A)痛阈值 用于5对ACR投标点的测速计模拟以及 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)对焦虑问卷测量的答复， 抑郁、疼痛以及有条理的精神病学访谈。这个 拟议的研究代表了调频研究的进步，因为它们 包括使用实验操作以及相关 对FM病因模型进行评价的研究。结果还包括 将有助于我们更好地理解负责 FM患者的功能性脑活动受抑 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.