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Published in: Rheumatology International 11/2007

01-09-2007 | Original Article

The effects of multidisciplinary therapy on positron emission tomography of the brain in fibromyalgia: a pilot study

Authors: Brian Walitt, Tresa Roebuck-Spencer, Guiseppe Esposito, Frances Atkins, Joseph Bleiberg, Gregory Foster, Arthur Weinstein

Published in: Rheumatology International | Issue 11/2007

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Abstract

Aberrant central neurological functioning is believed to contribute to the abnormal sensations of fibromyalgia (FM). This pilot study sought to determine if alterations in regional brain metabolism from baseline occur in FM after undergoing a multidisciplinary therapeutic regimen. Regional brain metabolic activity was estimated using 18F-fluorodeoxyglucose positron emission tomography (18FDG PET). Nine participants with FM received an 8-week comprehensive treatment program. Serial testing with 18FDG PET and the Fibromyalgia Impact Questionnaire were performed. Statistical analysis was performed using repeated Wilcoxon signed rank tests. A clinical improvement (FIQ median change 20.68, P = 0.005) was noted with treatment. With treatment, increases in brain metabolism were noted in various components of the limbic system (P = 0.004–0.1). An increase in limbic metabolism was noted with concomitant symptomatic improvement, suggesting that the limbic system attenuates FM symptoms.
Literature
1.
go back to reference Kwiatek R, Barnden L, Tedman R, Jarrett R, Chew J, Rowe C, Pike K (2000) Regional cerebral blood flow in fibromyalgia: single-photon-emission computed tomography evidence of reduction in the pontine tegmentum and thalami. Arthritis Rheum 43(12):2823–2833PubMedCrossRef Kwiatek R, Barnden L, Tedman R, Jarrett R, Chew J, Rowe C, Pike K (2000) Regional cerebral blood flow in fibromyalgia: single-photon-emission computed tomography evidence of reduction in the pontine tegmentum and thalami. Arthritis Rheum 43(12):2823–2833PubMedCrossRef
2.
go back to reference Mountz JM, Bradley LA, Modell JG, Alexander RW, Triana-Alexander M, Aaron LA et al (1995) Fibromyalgia in women: abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthritis Rheum 38:926–938PubMedCrossRef Mountz JM, Bradley LA, Modell JG, Alexander RW, Triana-Alexander M, Aaron LA et al (1995) Fibromyalgia in women: abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthritis Rheum 38:926–938PubMedCrossRef
3.
go back to reference Gracely RH, Petzke F, Wolf JM, Clauw DJ (2002) Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 46(5):1333–1343PubMedCrossRef Gracely RH, Petzke F, Wolf JM, Clauw DJ (2002) Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 46(5):1333–1343PubMedCrossRef
4.
go back to reference Cook DB, Lange G, Ciccone DS, Liu WC, Steffener J, Natelson BH (2004) Functional imaging of pain in patients with primary fibromyalgia. J Rheum 31(2):364–378PubMed Cook DB, Lange G, Ciccone DS, Liu WC, Steffener J, Natelson BH (2004) Functional imaging of pain in patients with primary fibromyalgia. J Rheum 31(2):364–378PubMed
5.
go back to reference Gracely RH, Geisser ME, Giesecke T, Grant MA, Petzke F, Williams DA, Clauw DJ (2004) Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127(pt4):835–843PubMedCrossRef Gracely RH, Geisser ME, Giesecke T, Grant MA, Petzke F, Williams DA, Clauw DJ (2004) Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127(pt4):835–843PubMedCrossRef
6.
go back to reference Grant MAB, Farrell MJ, Kumar R et al (2001) FMRI evaluation of pain intensity coding in fibromyalgia patients and controls. Arthritis Rheum 44:s394CrossRef Grant MAB, Farrell MJ, Kumar R et al (2001) FMRI evaluation of pain intensity coding in fibromyalgia patients and controls. Arthritis Rheum 44:s394CrossRef
7.
go back to reference Adiguzel O, Kaptanoglu E, Turgut B, Nacitarhan V (2004) The possible effect of clinical recovery on regional cerebral blood flow deficits in fibromyalgia: a prospective study with semiquantitative SPECT. Southern Med J 97(7):651–655CrossRef Adiguzel O, Kaptanoglu E, Turgut B, Nacitarhan V (2004) The possible effect of clinical recovery on regional cerebral blood flow deficits in fibromyalgia: a prospective study with semiquantitative SPECT. Southern Med J 97(7):651–655CrossRef
8.
go back to reference Wik G, Fischer H, Bragee B, Kristianson M, Frwdrikson M (2003) Retrosplenial cortical activation in the fibromyalgia syndrome. Neuroreport 14(4):619–621PubMedCrossRef Wik G, Fischer H, Bragee B, Kristianson M, Frwdrikson M (2003) Retrosplenial cortical activation in the fibromyalgia syndrome. Neuroreport 14(4):619–621PubMedCrossRef
9.
go back to reference Yunus M, Young C, Saeed S, Mountz J (2004) Positron emission tomography in patients with fibromyalgia syndrome and healthy controls. Arth Care Res 51(4):513–518CrossRef Yunus M, Young C, Saeed S, Mountz J (2004) Positron emission tomography in patients with fibromyalgia syndrome and healthy controls. Arth Care Res 51(4):513–518CrossRef
10.
go back to reference Wolfe F, Smythe HA, Yunus M et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172PubMedCrossRef Wolfe F, Smythe HA, Yunus M et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172PubMedCrossRef
11.
go back to reference Burckhardt C, Clark S, Bennett R (1991) The fibromyalgia impact questionnaire: development and validation. J Rheumatology 18:728–733 Burckhardt C, Clark S, Bennett R (1991) The fibromyalgia impact questionnaire: development and validation. J Rheumatology 18:728–733
12.
go back to reference Fallon J, Bujak D, Guardino S, Weinstein A (1999) The fibromyalgia impact questionnaire: a useful tool in evaluating patients with post-lyme disease syndrome. Arthritis Care Res 12(1):42–47PubMedCrossRef Fallon J, Bujak D, Guardino S, Weinstein A (1999) The fibromyalgia impact questionnaire: a useful tool in evaluating patients with post-lyme disease syndrome. Arthritis Care Res 12(1):42–47PubMedCrossRef
13.
go back to reference Goldenberg D, Mayskiy M, Mossey C, Ruthazer R, Schmid C (1996) A randomized double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia. Arthritis Rheum 39:1852–1859PubMedCrossRef Goldenberg D, Mayskiy M, Mossey C, Ruthazer R, Schmid C (1996) A randomized double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia. Arthritis Rheum 39:1852–1859PubMedCrossRef
14.
go back to reference Talairach J, Tournoux P (1993) Referentially oriented cerebral MRI anatomy. Thieme Medical Publishers. New York Talairach J, Tournoux P (1993) Referentially oriented cerebral MRI anatomy. Thieme Medical Publishers. New York
15.
go back to reference Holman AJ, Myers RR (2005) A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum 52:2492–2505CrossRef Holman AJ, Myers RR (2005) A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum 52:2492–2505CrossRef
16.
go back to reference Williams D, Gracely R (2006) Functional magnetic resonance imaging findings in fibromyalgia. Arthritis Res Therapy 8:224–231CrossRef Williams D, Gracely R (2006) Functional magnetic resonance imaging findings in fibromyalgia. Arthritis Res Therapy 8:224–231CrossRef
17.
go back to reference Maquet P, Dive D, Salmon E, von Frenckel R, Franck G (1990) Reproducibility of cerebral glucose utilization measured by PET and the [18F]-2-fluoro-2-deoxy-d-glucose method in resting, healthy human subjects. Eur J Nucl Med 16(4–6):267–273PubMedCrossRef Maquet P, Dive D, Salmon E, von Frenckel R, Franck G (1990) Reproducibility of cerebral glucose utilization measured by PET and the [18F]-2-fluoro-2-deoxy-d-glucose method in resting, healthy human subjects. Eur J Nucl Med 16(4–6):267–273PubMedCrossRef
Metadata
Title
The effects of multidisciplinary therapy on positron emission tomography of the brain in fibromyalgia: a pilot study
Authors
Brian Walitt
Tresa Roebuck-Spencer
Guiseppe Esposito
Frances Atkins
Joseph Bleiberg
Gregory Foster
Arthur Weinstein
Publication date
01-09-2007
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 11/2007
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-007-0405-7

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