The brain changes associated with pain in fibromyalgia may be reversible

June 13, 2023 – In the year 1993, Lynn Matalana was living a “wonderful life.” Newly married, the 38-year-old Californian was a partner in an advertising agency. But her life was turned upside down after surgery due to endometriosis.

“I actually woke up during the surgery, and the next day, I had excruciating pain — more than excruciating — and became bedridden,” she said. The pain brought insomnia, inability to eat, and debilitating fatigue. “It completely changed my life, and I had no idea what happened.”

Matalana spent the next two years “going from one doctor to the next” before she was finally diagnosed fibromyalgia;. “It was such a relief to get a diagnosis and finally get a name for what was happening to me, and I heard so many other people say the same thing,” she said.

However, she said, “It was 1995, and not much was known about fibromyalgia, and the doctors basically said there was nothing they could do for me.”

Pain and the brain

Unfortunately, Matalana’s story is typical. Although fibromyalgia is very common, it affects the most of 5 million Americans, is still being misdiagnosed and misunderstood. In fact, the average time for a patient to be diagnosed with fibromyalgia can be up to 5 years.

Fibromyalgia may result from physically or emotionally stressful events, including a serious injury, car accident, or certain viruses. Women are more likely to have fibromyalgia. Its symptoms include extreme tiredness, difficulty concentrating and remembering (sometimes called “fibro fog” or “brain fog”), insomnia, nervousness, and depression. Pain (usually in the muscles and joints) is a characteristic symptom.

And because pain is a subjective experience — no one can feel someone else’s pain — some health care professionals did not take the symptoms seriously. Many patients who have been diagnosed with fibromyalgia by a rheumatologist or pain medicine specialist say they have been told by another health care provider that:Fibromyalgia is not present. “

Hopefully, this trend will begin to change, as more research finds “objective” ways to determine the pain that accompanies fibromyalgia.

In a recent study, The researchers used magnetic resonance imaging data to explore brain regions involved in pain processing and emotional evaluation and found that in patients with fibromyalgia, these regions undergo changes. The changes affect the volume of the brain’s gray matter, which contains nerve cells, as well as the white matter, which mainly consists of fiber connections whose task is to transmit signals between nerve cells.

The researchers compared MRI data from 23 women with fibromyalgia and 21 healthy people.

One of our goals was to determine whether there were differences in the direction of water molecule diffusion in specific brain regions; In other words, whether we can detect any regional differences in signal transmission,” said lead study author Benjamin Mosch, a PhD student at the University of Bochum in Germany, he said in a press release.

The researchers found changes in gray matter volume 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. “These areas are significantly reduced in size in patients,” Mosch said.

Alterations have also been found in signaling in the thalamus – a brain region known to play a key role in pain processing. Differences in white matter between patients and controls suggest alterations in pain signaling in people with fibromyalgia.

Also, the researchers investigated how these structural changes in the brain relate to the perceptions and behavior of the subjects in the study. They found that the greater the volume loss in certain areas of the brain, the more pain people with fibromyalgia experienced.

Changes in the brain can be reversed

When researchers analyzed the relationship between depressive symptoms or activity levels and volume change in specific regions of the brain, they found that the volume of an area called the putamen was smaller in those with more depressive symptoms but larger in those with higher activity levels. .

“This suggests that brain changes may not be permanent but can be affected — in other words, they may be reversible, for example, through active daily living,” Mosch said.

These findings are neither “new nor surprising,” said Daniel Klaw, a professor of anesthesiology, rheumatology, and psychiatry at the University of Michigan.

Brain changes “are not permanent — these parameters often become more normal with effective treatments,” said Cloe, who is also director of the university’s Chronic Pain and Fatigue Research Center.

He said some medications — including some antidepressants, called selective serotonin and norepinephrine reuptake inhibitors (SNRIs), and gabapentinoids, used to treat herpes zoster, restless legs syndrome, and seizures — are in addition to non-drug therapies, such as education, exercise and cognitive behavioral therapy. Therapy, is helpful for fibromyalgia and may help reverse some brain changes.

Although the study may not contain dramatically new findings, Matalana, co-founder and director of the National Fibromyalgia Association, said, “When it comes to research on pain, people really do have to hear the same things over and over before the medical system decides to. Pain is a real thing.”

For her, “The study is another step toward continuing to prove that people with fibromyalgia have a true biological basis for their pain and you can actually see changes on an MRI scan.”

More importantly, “the study shows that some of these changes are reversible, which is especially important because people need to know that they will not continue to get worse over time and never have quality of life again,” said Matalana, who is the author of the book. The Complete Idiot’s Guide to Fibromyalgia.

Today, Matalana still suffers from some of the symptoms of fibromyalgia, such as increased sensitivity to sound and smell, as well as trouble sleeping. “My central nervous system is obviously more sensitive than others,” she said. It is encouraging that she no longer suffers from pain in her entire body.

In closing, let us remember that every ending brings forth a new beginning. As we conclude this article, may we embrace the lessons learned, the insights gained, and the possibilities that lie ahead. Together, let us step forward with courage and optimism, for the journey continues , and our potential knows no bounds.

Source_by_webmd.com/

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