Accelerated Brain Gray Matter Loss in Fibromyalgia Patients: Premature
Aging of the Brain?
Anil Kuchinad,1,2 Petra Schweinhardt,1 David A. Seminowicz,1 Patrick
B. Wood,1 Boris A. Chizh,4 and M. Catherine Bushnell1,2,3
1McGill Centre for Research on Pain, 2Department of Neurology and
Neurosurgery, and 3Department of Anesthesia and Faculty of Dentistry,
McGill University, Montreal, Quebec, Canada H3A 2B2, and
4GlaxoSmithKline, Addenbrooke's Centre for Clinical Investigation,
Addenbrooke's Hospital, Cambridge CB2 2GG, United Kingdom
Correspondence should be addressed to M. Catherine Bushnell, McGill
Centre for Research on Pain, 3640 University Street, Room M19,
Montreal, Quebec, Canada H3A 2B2. Email: Catherine.bushnell@mcgill.ca
Fibromyalgia is an intractable widespread pain disorder that is most
frequently diagnosed in women. It has traditionally been classified as
either a musculoskeletal disease or a psychological disorder.
Accumulating evidence now suggests that fibromyalgia may be associated
with CNS dysfunction. In this study, we investigate anatomical changes
in the brain associated with fibromyalgia. Using voxel-based
morphometric analysis of magnetic resonance brain images, we examined
the brains of 10 female fibromyalgia patients and 10 healthy controls.
We found that fibromyalgia patients had significantly less total gray
matter volume and showed a 3.3 times greater age-associated decrease
in gray matter than healthy controls. The longer the individuals had
had fibromyalgia, the greater the gray matter loss, with each year of
fibromyalgia being equivalent to 9.5 times the loss in normal aging.
In addition, fibromyalgia patients demonstrated significantly less
gray matter density than healthy controls in several brain regions,
including the cingulate, insular and medial frontal cortices, and
parahippocampal gyri. The neuroanatomical changes that we see in
fibromyalgia patients contribute additional evidence of CNS
involvement in fibromyalgia. In particular, fibromyalgia appears to be
associated with an acceleration of age-related changes in the very
substance of the brain. Moreover, the regions in which we demonstrate
objective changes may be functionally linked to core features of the
disorder including affective disturbances and chronic widespread pain.




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