Rahm Benjamin, Lacour Michael, Decety Jean, Müller Juliane, Scheidt Carl-Eduard, Bauer Joachim, König Ralf, Wirsching Michael, Glauche Volkmar, Ohlendorf Sabine, Unterbrink Thomas, Hartmann Armin, Joos Andreas A
Medical Psychology and Medical Sociology, Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Medical Center, Mainz, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Freiburg, Germany.
Compr Psychiatry. 2015 May;59:80-90. doi: 10.1016/j.comppsych.2015.02.005. Epub 2015 Feb 18.
Dysfunction of central nervous pain processing is assumed to play a key role in primary fibromyalgia (FM) syndrome. This pilot study examined differences of pain processing associated with adopting different interpersonal perspectives.
Eleven FM patients and 11 healthy controls (HC) were scanned with functional magnetic resonance imaging. Participants were trained to take either a self-perspective or another person's perspective when viewing the visual stimuli. Stimuli showed body parts in painful situations of varying intensity (low, medium, and high) and visually similar but neutral situations.
Patients with FM showed a higher increase in blood oxygen level dependent (BOLD) response, particularly in the supplementary motor area (SMA). All pain-related regions of interest (anterior insula, somatosensory cortices, anterior cingulate cortex, and SMA) showed stronger modulation of BOLD responses in FM patients in the self-perspective. In contrast to pain processing regions, perspective-related regions (e.g. temporoparietal junction) did not differ between FM and HC.
The stronger response of all four pain processing cerebral regions during self-perspective is discussed in the light of disturbed bottom-up processing. Furthermore, the results confirm earlier reports of augmented pain processing in FM, and provide evidence for sensitization of central nervous pain processing.
中枢神经疼痛处理功能障碍被认为在原发性纤维肌痛（FM）综合征中起关键作用。这项初步研究考察了采用不同人际视角时疼痛处理的差异。
对11名FM患者和11名健康对照者（HC）进行功能磁共振成像扫描。参与者在观看视觉刺激时接受训练，采取自我视角或他人视角。刺激呈现不同强度（低、中、高）疼痛情境下的身体部位以及视觉上相似但为中性的情境。
FM患者的血氧水平依赖（BOLD）反应增加更为明显，尤其是在辅助运动区（SMA）。所有与疼痛相关的感兴趣区域（前脑岛、体感皮层、前扣带回皮层和SMA）在FM患者采取自我视角时对BOLD反应的调节更强。与疼痛处理区域不同，FM患者和HC在与视角相关的区域（如颞顶联合区）没有差异。
鉴于自下而上处理过程受到干扰，讨论了在自我视角下所有四个疼痛处理脑区更强的反应。此外，研究结果证实了先前关于FM中疼痛处理增强的报道，并为中枢神经疼痛处理的敏化提供了证据。
