Fibromyalgia (FM) is a chronic, wi
desprea
d musculoskeletal pain
disor
der that is very prevalent in the general population (approximately 5 % ). Accumulating evi
dence suggests that FM is associate
d with central pain processing abnormalities, ie, central sensitization. Several previous stu
dies of chronic pain patients, inclu
ding FM, have shown gray matter atrophy of brain areas associate
d with sensory an
d affective pain processing. These fin
dings, however, have not been confirme
d in all FM stu
dies. In this stu
dy, we investigate
d gray matter volumes of brain areas associate
d with pain-relate
d areas of FM patients i
dentifie
d by functional brain imaging. Using voxel-base
d morphometric (VBM) analysis of magnetic resonance brain images, we compare
d 19 pain-relate
d brain areas of 14 female FM patients an
d 11 healthy controls (NC). We foun
d that FM patients ha
d significantly less gray matter volumes than NC in 3 of these brain regions, inclu
ding the anterior an
d mi
d-cingulate, as well as mi
d-insular cortices. Importantly, FM patients
demonstrate
d neither global gray matter atrophy nor gray matter changes associate
d with
depression, as shown in some stu
dies. Using a more stringent analysis than other VBM stu
dies, we provi
de evi
dence for
decrease
d gray matter volumes in a number of pain-relate
d brain areas in FM. Although the mechanisms for these gray matter changes are presently unclear, they may contribute to some of the core features of this chronic
disor
der inclu
ding affective
disturbances an
d chronic wi
desprea
d pain.
Perspective
Increasing evidence supports the association of chronic pain with accelerated gray matter atrophy in pain disorders like low back pain, IBS, and FM syndrome. However, cause-effect relationships between chronic pain and decreased gray matter volumes have not been established yet and will require future prospective studies.