Cook Dane B, Stegner Aaron J, McLoughlin Michael J
William S. Middleton Memorial Veterans Hospital, Madison, WI 53706, USA.
Curr Pain Headache Rep. 2007 Jun;11(3):190-200. doi: 10.1007/s11916-007-0190-8.
Brain imaging studies have provided objective evidence of abnormal central regulation of pain in fibromyalgia (FM). Resting brain blood flow studies have reported mixed findings for several brain regions, whereas decreased thalamic blood flow has been noted by several investigators. Studies examining the function of the nociceptive system in FM have reported augmented brain responses to both painful and non-painful stimuli that may be influenced by psychologic dispositions such as depressed mood and catastrophizing. Treatment approaches are beginning to demonstrate the potential for brain imaging to improve our understanding of pain-alleviating mechanisms. Data from other chronic conditions suggest that idiopathic pain may be maintained by similar central abnormalities as in FM, whereas chronic pain conditions with a known nociceptive source may not be. Future neuroimaging research in FM is clearly warranted and should continue to improve our understanding of factors involved in pain maintenance and symptom exacerbation.
脑成像研究为纤维肌痛（FM）患者疼痛的中枢调节异常提供了客观证据。静息脑血流研究对多个脑区的结果不一，不过有多位研究者发现丘脑血流减少。对FM患者伤害感受系统功能的研究报告称，大脑对疼痛和非疼痛刺激的反应增强，这可能受到诸如情绪低落和灾难化等心理状态的影响。治疗方法开始显示出脑成像在增进我们对疼痛缓解机制理解方面的潜力。来自其他慢性疾病的数据表明，特发性疼痛可能由与FM类似的中枢异常维持，而具有已知伤害性刺激源的慢性疼痛疾病可能并非如此。显然有必要对FM开展未来的神经影像学研究，这应该会继续增进我们对疼痛维持和症状加重相关因素的理解。
