Is Central Pain similar to fibromyalgia?

Fibromyalgia is a rather common condition. This is not to say it doesn’t amount to much. Chronic aching/burning in the muscles is upsetting to those who have it. Because it is so common, the imaging centers can gather cohort studies much, much more easily than of CP patients.

Just to review, there are several methods of brain imaging currently being used. Those involving ionizing radiation include PET and SPECT. SPECT is single photon emission computerized tomography. It is not as accurate as PET, but only a single gamma ray is emitted, whereas in PET, there is a double ray. The radioactive material has a slower decay in SPECT and there is also the advantage that it is not necessary to have a particle acclerator on site to run SPECT. Using information about oxygen consumption, researchers derive information on which areas of the brain are active. Technecium 99 (Tc) is one of the isotopes used, but Xenon and Iodine are also common. We actually prefer functional MRI and tensor MRI, because no ionizing radiation is used, but we will take data from wherever we can get it.

Fibromyalgia is a pain disorder in muscles. Soreness, tenderness, and burning are commmon. It is typically localized to a region. In one study in France of hyperalgesic FM patients, ALL WOMEN, (See Guedj, E. et al Eur J Nucl Med Mol Imaging. 2006 Aug 25), it was found that:

(99m)Tc-ECD SPECT was able to give superior imaging compared to the traditional (99m)Tc-HMPAO SPECT. Using ECD SPECT, these scientists found that in fibromyalgia, affective areas of the brain relating to pain (frontal, cingulate, medial temporal and cerebellar cortices) significantly hypoperfused (had less blood flow) while the discriminative areas, such as the somatosensory cortex had INCREASED blood flow (hyperperfusion).

We are always interested to see brain imaging confirm clinical pain, since the public and the medical profession are so resistant to even the idea of nerve injury pain.

If a “minor” condition such as FM is enough to alter the brain, then we can look for really major abnormalities in those with the ghastly devastations of severe central pain. This is not to minimize the suffering of those with FM, but it is the difference between a punch and being set on fire.