Sawaddiruk Passakorn, Paiboonworachat Sahattaya, Chattipakorn Nipon, Chattipakorn Siriporn C
Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Clin Neurosci. 2017 Apr;38:13-22. doi: 10.1016/j.jocn.2016.12.014. Epub 2017 Jan 10.
Fibromyalgia is a chronic pain syndrome, characterized by widespread musculoskeletal pain with diffuse tenderness at multiple tender points. Despite intense investigations, the pathophysiology of fibromyalgia remains elusive. Evidence shows that it could be due to changes in either the peripheral or central nervous system (CNS). For the CNS changes, alterations in the high brain area of fibromyalgia patients have been investigated but the definite mechanisms are still unclear. Magnetic Resonance Imaging (MRI) and Functional Magnetic Resonance (fMRI) have been used to gather evidence regarding the changes of brain morphologies and activities in fibromyalgia patients. Nevertheless, due to few studies, limited knowledge for alterations in brain activities in fibromyalgia is currently available. In this review, the changes in brain activity in various brain areas obtained from reports in fibromyalgia patients are comprehensively summarized. Changes of the grey matter in multiple regions such as the superior temporal gyrus, posterior thalamus, amygdala, basal ganglia, cerebellum, cingulate cortex, SII, caudate and putamen from the MRI as well as the increase of brain activities in the cerebellum, prefrontal cortex, anterior cingulate cortex, thalamus, somatosensory cortex, insula in fMRI studies are presented and discussed. Moreover, evidence from pharmacological interventions offering benefits for fibromyalgia patients by reducing brain activity is presented. Because of limited knowledge regarding the roles of brain activity alterations in fibromyalgia, this summarized review will encourage more future studies to elucidate the underlying mechanisms involved in the brains of these patients.
纤维肌痛是一种慢性疼痛综合征，其特征为广泛的肌肉骨骼疼痛，并伴有多个压痛点的弥漫性压痛。尽管进行了深入研究，但纤维肌痛的病理生理学仍然难以捉摸。有证据表明，这可能是由于外周或中枢神经系统（CNS）的变化所致。对于中枢神经系统的变化，已经对纤维肌痛患者大脑高级区域的改变进行了研究，但确切机制仍不清楚。磁共振成像（MRI）和功能磁共振成像（fMRI）已被用于收集有关纤维肌痛患者大脑形态和活动变化的证据。然而，由于研究较少，目前关于纤维肌痛患者大脑活动改变的知识有限。在本综述中，全面总结了纤维肌痛患者报告中各脑区大脑活动的变化。介绍并讨论了MRI显示的多个区域灰质的变化，如颞上回、丘脑后部、杏仁核、基底神经节、小脑、扣带回皮质、第二躯体感觉区、尾状核和壳核，以及fMRI研究中显示的小脑、前额叶皮质、前扣带回皮质、丘脑、躯体感觉皮质、岛叶大脑活动的增加。此外，还介绍了药物干预通过降低大脑活动为纤维肌痛患者带来益处的证据。由于关于纤维肌痛中大脑活动改变作用的知识有限，本综述将鼓励未来进行更多研究，以阐明这些患者大脑中涉及的潜在机制。
