PET Scans Reveal Neurochemical Changes in Fibromyalgia Patients

Fibromyalgia is a condition where you feel almost constant pain caused by inflammation all over the body, including joints, organs, and skin. Now brain scans and an advanced imaging test called positron emission tomography, or PET, show that there is a neurochemical change in the brains of those who have fibromyalgia.

"Finding an objective neurochemical change in the brains of people who are used to being told that their problems are imaginary is pretty important," Marco Loggia, study author, explained. He is an associate director of the Center for Integrative Pain Neuroimaging at Harvard Medical School.

Chronic pain conditions cause those who suffer from the condition to experience mental and physical pain. You don’t look like you are in pain when you have fibromyalgia and when you complain, people are skeptical. Dr. Harry Gewanter,  master of the American College of Rheumatology, states, "There's a heck of a lot of stigma associated with chronic pain conditions like fibromyalgia. I think it's going to make a lot of people feel much better knowing that there are physiologic changes you can find.”

Those who have fibromyalgia and have chronic and often untreated pain are in danger of other health and mental issues. One of the bodies alarm signals, pain, requires attention. It doesn’t matter if you cannot “see” the pain or if it only lasts for short period of time, a response to help relieve the pain is needed.

Those who suffer from chronic pain know pain negatively affects sleep, cognitive process and brain function, mental health, moods, cardiovascular health and your overall quality of life.

Pain management for fibromyalgia requires expert care and pain management programs. These programs often combine drug, physical and mental therapies tailored to an individual patient’s needs.

With the persistent pain of fibromyalgia, there is a warning signal that a possible life-threatening levy is being taken on the human mind and body. Studies are always ongoing to discover why fibromyalgia causes pain and what can be done about it.

Study Using Positron Emission Tomography (PET)

Fibromyalgia affects almost 4 million Americans, reports the Center for Disease Control and Prevention. The condition also causes fatigue, difficulty with thinking and memory and sleep problems. The exact cause of fibromyalgia is not known, but it may be a disease of the central nervous system.

There are medications and lifestyle modifications that can help you manage fibromyalgia; knowing you do not imagine the pain and fatigue is a great help.

In a study using 31 people with fibromyalgia and 27 health “controls” from Boston and Stockholm, participants underwent PET scans on their brains. Researchers compared the scans of those with fibromyalgia with those who were healthy. The results proved those with fibromyalgia had more inflammation in their brains cells than those who did not have fibromyalgia.

It’s exciting to realize that these studies and tests might lead investigators to discover the cause of fibromyalgia. PET scans are a new roadmap to finding fibromyalgia cures and treatments. One map is to follow treatments to see how well the therapies work, and another way is to find new treatments.

Treatments for chronic pain and fibromyalgia focus on medication and lifestyle changes. The CDC encourages those with fibromyalgia to exercise at least 30 minutes a day as many days of the week as they can. Regular sleeping habits need to be established, and stress reduction therapies are encouraged.

With PET, a new diagnostic tool, it is possible to see that there are definite neuroinflammation agents in fibromyalgia and elevated levels of inflammatory proteins in the cerebrospinal fluid.

A similar test was conducted on those patients with chronic back pain. TSPO elevations in fibromyalgia patients, however, were more widespread throughout the brain than the back pain patients. To the study team, these scans proved that fibromyalgia is very specific and real condition.

Different Studies for Reducing Fibromyalgia Pain

Further studies have found there are higher lactate levels in the brains of those with fibromyalgia. Elevated levels of lactate are relatedto decreased oxygen levels in the tissues. Cells that don’t receive enough oxygen to power aerobic energy production,energy processes turn to anaerobic energy to produce energy.

“During anaerobic energy production pyruvate is broken down into lactate, which then fuels the energy production process. This kind of energy production only works for short periods – two to three minutes in fit people – before fatigue and pain set in.”

This conclusion leads to a suggestion that reductions in brain lactate levels might reduce pain levels further and if researchers can figure out how to minimize brain lactate levels, the pain in people living with fibromyalgia could be significantly reduced.

Another study proposes that the pain of fibromyalgia is low blood flow. Researchers have suggested that high levels of oxidative stress produced elevated levels of free radicals or isoprostanes in the brains of fibromyalgia patients.

Oxidative stress might result from glia cell activation or low antioxidant levels. The research behind this study indicates that isoprostanes reduce blood flow and oxygen delivery to the brain. Blood vessels constricting in the brain cause reductions.

The conclusion to this study indicates that fibromyalgia may be a neuroinflammatory disorder, and some antidepressants might reduce inflammation in the brain and lower pain throughout the body.

Antidepressants for Fibromyalgia

The goal of all the ongoing testing for fibromyalgia leads back to controlling the pain. If you control the pain of fibromyalgia, it is possible to carry on a healthier lifestyle. Some medications help manage the debilitating pain, and these medications also help with fatigue, muscle spasms, and depression.

Antidepressants are by far the most used medications for treating fibromyalgia pain. Antidepressants help block pain signals to the brain. Two antidepressant drugs approved by the FDA for treatment of fibromyalgia are duloxetine and milnacipran. Other selective serotonin reuptake inhibitors or SSRIs like Prozac or Paxil also seem to work when blocking pain receptors to the brain.

Alternative Treatments for Fibromyalgia

Studies pointingto the brain region named the amygdala with neurofeedback seemed to improve your quality of sleep and reduce anxiety and depressionlinkedin fibromyalgia patients. The study was published in the journal Neuroimage and states that chronic pain in fibromyalgia is a multistep process involving impaired mood regulation, sleep quality, and other neural and physiological changes.

The amygdala plays a role in regulating sleep emotion and pain, and fibromyalgia patients show there is altered function going on in the limbic system Scientists in different studies have theorized that neurofeedback aimed at limbic activity might help fibromyalgia patients decrease their pain.

A study in Israel included 10 neurofeedback sessions, and each session used an auditory interface, an animated scenario, or both. Biofeedback is a mind-body technique where individuals modify their physiology to improve physical, mental, emotional and spiritual health. Biofeedback requires participation by the patients and regular practice between sessions. Research has shown that biofeedback interventions are useful in treating many medical problems including pain. Conclusions with using biofeedback demonstrate that an economical mechanism-based EEG- or neurofeedback treatment can be clinically used in treating fibromyalgia patients. This finding alone carries a significant hope that pain can be better managed without using drugs with negative side effects or treatments that don’t work.