Addiction Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 48109, USA.
J Pain. 2011 Dec;12(12):1219-29. doi: 10.1016/j.jpain.2011.06.007. Epub 2011 Sep 25.
The primary symptom of fibromyalgia (FM) is chronic, widespread pain; however, patients report additional symptoms including decreased concentration and memory. Performance-based deficits are seen mainly in tests of working memory and executive function. Neural correlates of executive function were investigated in 18 FM patients and 14 age-matched healthy controls during a simple Go/No-Go task (response inhibition) while they underwent functional magnetic resonance imaging (fMRI). Performance was not different between FM and healthy control, in either reaction time or accuracy. However, fMRI revealed that FM patients had lower activation in the right premotor cortex, supplementary motor area, midcingulate cortex, putamen and, after controlling for anxiety, in the right insular cortex and right inferior frontal gyrus. A hyperactivation in FM patients was seen in the right inferior temporal gyrus/fusiform gyrus. Despite the same reaction times and accuracy, FM patients show less brain activation in cortical structures in the inhibition network (specifically in areas involved in response selection/motor preparation) and the attention network along with increased activation in brain areas not normally part of the inhibition network. We hypothesize that response inhibition and pain perception may rely on partially overlapping networks, and that in chronic pain patients, resources taken up by pain processing may not be available for executive functioning tasks such as response inhibition. Compensatory cortical plasticity may be required to achieve performance on a par with control groups.
Neural activation (fMRI) during response inhibition was measured in fibromyalgia patients and controls. FM patients show lower activation in the inhibition and attention networks and increased activation in other areas. Inhibition and pain perception may use overlapping networks: resources taken up by pain processing may be unavailable for other processes.
纤维肌痛（FM）的主要症状是慢性、广泛的疼痛；然而，患者还报告了其他症状，包括注意力和记忆力下降。在执行功能的工作记忆和执行功能测试中主要观察到基于表现的缺陷。在一项简单的 Go/No-Go 任务（反应抑制）中，在功能磁共振成像（fMRI）期间，研究了 18 名 FM 患者和 14 名年龄匹配的健康对照者的执行功能的神经相关性。在反应时间或准确性方面，FM 患者和健康对照组之间的表现没有差异。然而，fMRI 显示，FM 患者的右侧运动前皮质、辅助运动区、中扣带皮质、壳核以及在控制焦虑后右侧岛叶皮质和右侧额下回的激活程度较低。FM 患者的右侧颞下回/梭状回呈超激活状态。尽管反应时间和准确性相同，但 FM 患者在抑制网络（特别是涉及反应选择/运动准备的区域）和注意力网络中的皮质结构中的大脑激活较少，而在通常不属于抑制网络的大脑区域中的激活增加。我们假设，反应抑制和疼痛感知可能依赖于部分重叠的网络，并且在慢性疼痛患者中，用于疼痛处理的资源可能无法用于执行功能任务，例如反应抑制。可能需要补偿性皮质可塑性来达到与对照组相当的表现。
在纤维肌痛患者和对照组中测量了反应抑制期间的神经激活（fMRI）。FM 患者在抑制和注意力网络中显示出较低的激活，而在其他区域则显示出较高的激活。抑制和疼痛感知可能使用重叠的网络：用于疼痛处理的资源可能无法用于其他过程。
