Neural correlates of control over pain in fibromyalgia patients
The perceived lack of control over the experience of pain is arguably-one major cause of agony and impaired life quality in patients with chronic pain disorders as fibromyalgia (FM). The way perceived control affects subjective pain as well as the underlying neural mechanisms have so far not been in...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221315822300044X |
| _version_ | 1827989338237960192 |
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| author | Benjamin Mosch Verena Hagena Stephan Herpertz Michaela Ruttorf Martin Diers |
| author_facet | Benjamin Mosch Verena Hagena Stephan Herpertz Michaela Ruttorf Martin Diers |
| author_sort | Benjamin Mosch |
| collection | DOAJ |
| description | The perceived lack of control over the experience of pain is arguably-one major cause of agony and impaired life quality in patients with chronic pain disorders as fibromyalgia (FM). The way perceived control affects subjective pain as well as the underlying neural mechanisms have so far not been investigated in chronic pain. We used functional magnetic resonance imaging (fMRI) to examine the neural correlates of self-controlled compared to computer-controlled heat pain in healthy controls (HC, n = 21) and FM patients (n = 23). Contrary to HC, FM failed to activate brain areas usually involved in pain modulation as well as reappraisal processes (right ventrolateral (VLPFC), dorsolateral prefrontal cortex (DLPFC) and dorsal anterior cingulate cortex (dACC)). Computer-controlled (compared to self-controlled) heat revealed significant activations of the orbitofrontal cortex (OFC) in HC, whereas FM activated structures that are typically involved in neural emotion processing (amygdala, parahippocampal gyrus). Additionally, FM displayed disrupted functional connectivity (FC) of the VLPFC, DLPFC and dACC with somatosensory and pain (inhibition)-related areas during self-controlled heat stimulation as well as significantly decreased gray matter (GM) volumes compared to HC in DLPFC and dACC. The described functional and structural changes provide evidence for far-reaching impairments concerning pain-modulatory processes in FM. Our investigation represents a first demonstration of dysfunctional neural pain modulation through experienced control in FM according to the extensive functional and structural changes in relevant sensory, limbic and associative brain areas. These areas may be targeted in clinical pain therapeutic methods involving TMS, neurofeedback or cognitive behavioral trainings. |
| first_indexed | 2024-04-10T00:17:21Z |
| format | Article |
| id | doaj.art-67ec565a4cd2490bb51266ced8d63f52 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-04-10T00:17:21Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-67ec565a4cd2490bb51266ced8d63f522023-03-16T05:04:13ZengElsevierNeuroImage: Clinical2213-15822023-01-0137103355Neural correlates of control over pain in fibromyalgia patientsBenjamin Mosch0Verena Hagena1Stephan Herpertz2Michaela Ruttorf3Martin Diers4Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum 44791, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum 44791, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum 44791, GermanyComputer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim 68167, Germany; Mannheim Institute for Intelligent Systems in Medicine, Heidelberg University, Mannheim 68167, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum 44791, Germany; Corresponding author at: Clinical and Experimental Behavioral Medicine, Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1–3, 44791 Bochum, Germany.The perceived lack of control over the experience of pain is arguably-one major cause of agony and impaired life quality in patients with chronic pain disorders as fibromyalgia (FM). The way perceived control affects subjective pain as well as the underlying neural mechanisms have so far not been investigated in chronic pain. We used functional magnetic resonance imaging (fMRI) to examine the neural correlates of self-controlled compared to computer-controlled heat pain in healthy controls (HC, n = 21) and FM patients (n = 23). Contrary to HC, FM failed to activate brain areas usually involved in pain modulation as well as reappraisal processes (right ventrolateral (VLPFC), dorsolateral prefrontal cortex (DLPFC) and dorsal anterior cingulate cortex (dACC)). Computer-controlled (compared to self-controlled) heat revealed significant activations of the orbitofrontal cortex (OFC) in HC, whereas FM activated structures that are typically involved in neural emotion processing (amygdala, parahippocampal gyrus). Additionally, FM displayed disrupted functional connectivity (FC) of the VLPFC, DLPFC and dACC with somatosensory and pain (inhibition)-related areas during self-controlled heat stimulation as well as significantly decreased gray matter (GM) volumes compared to HC in DLPFC and dACC. The described functional and structural changes provide evidence for far-reaching impairments concerning pain-modulatory processes in FM. Our investigation represents a first demonstration of dysfunctional neural pain modulation through experienced control in FM according to the extensive functional and structural changes in relevant sensory, limbic and associative brain areas. These areas may be targeted in clinical pain therapeutic methods involving TMS, neurofeedback or cognitive behavioral trainings.http://www.sciencedirect.com/science/article/pii/S221315822300044XFibromyalgiaPainfMRIFunctional connectivityVoxel-based morphometry |
| spellingShingle | Benjamin Mosch Verena Hagena Stephan Herpertz Michaela Ruttorf Martin Diers Neural correlates of control over pain in fibromyalgia patients NeuroImage: Clinical Fibromyalgia Pain fMRI Functional connectivity Voxel-based morphometry |
| title | Neural correlates of control over pain in fibromyalgia patients |
| title_full | Neural correlates of control over pain in fibromyalgia patients |
| title_fullStr | Neural correlates of control over pain in fibromyalgia patients |
| title_full_unstemmed | Neural correlates of control over pain in fibromyalgia patients |
| title_short | Neural correlates of control over pain in fibromyalgia patients |
| title_sort | neural correlates of control over pain in fibromyalgia patients |
| topic | Fibromyalgia Pain fMRI Functional connectivity Voxel-based morphometry |
| url | http://www.sciencedirect.com/science/article/pii/S221315822300044X |
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