Accelerated Brain Gray Matter Loss in Fibromyalgia Patients: Premature Aging of the Brain?Anil Kuchinad1,2, Petra Schweinhardt1, David A. Seminowicz1, Patrick B. Wood1, Boris A. Chizh4, and M. Catherine Bushnell1,2,3+Show AffiliationsThe Journal of Neuroscience, 11 April 2007, 27(15): 4004-4007; doi: 10.1523/JNEUROSCI.0098-07.2007AbstractFull TextFull Text (PDF) Next SectionAbstractFibromyalgia is an intractable widespread pain disorder that is most frequently diagnosed in women. It has traditionally been classified as either a musculoskeletal disease or a psychological disorder. Accumulating evidence now suggests that fibromyalgia may be associated with CNS dysfunction. In this study, we investigate anatomical changes in the brain associated with fibromyalgia. Using voxel-based morphometric analysis of magnetic resonance brain images, we examined the brains of 10 female fibromyalgia patients and 10 healthy controls. We found that fibromyalgia patients had significantly less total gray matter volume and showed a 3.3 times greater age-associated decrease in gray matter than healthy controls. The longer the individuals had had fibromyalgia, the greater the gray matter loss, with each year of fibromyalgia being equivalent to 9.5 times the loss in normal aging. In addition, fibromyalgia patients demonstrated significantly less gray matter density than healthy controls in several brain regions, including the cingulate, insular and medial frontal cortices, and parahippocampal gyri. The neuroanatomical changes that we see in fibromyalgia patients contribute additional evidence of CNS involvement in fibromyalgia. In particular, fibromyalgia appears to be associated with an acceleration of age-related changes in the very substance of the brain. Moreover, the regions in which we demonstrate objective changes may be functionally linked to core features of the disorder including affective disturbances and chronic widespread pain.pain fibromyalgia functional disorders voxel-based morphometry brain anatomy agingPrevious SectionNext SectionIntroductionFibromyalgia is a disorder of unknown etiology that is characterized by chronic widespread pain and often accompanied by a variety of other symptoms, including sleep impairment, chronic fatigue, affective disturbances and altered stress responses (Wolfe et al., 1990). Although the disorder has been dismissed by many physicians as purely psychological, recent neuroimaging studies show alterations in sensory processing (Gracely et al., 2002) and neurochemical abnormalities (Wood et al., 2006), indicating that fibromyalgia is associated with alterations in the brain’s neural functioning.Changes in brain morphology have been described in chronic pain conditions (Apkarian et al., 2004; Schmidt-Wilcke et al., 2005, 2006), chronic fatigue syndrome (Okada et al., 2004; de Lange et al., 2005), and posttraumatic stress disorder (Villarreal et al., 2002; Corbo et al., 2005; Chen et al., 2006). Because fibromyalgia shares commonalities with these disorders, we hypothesized that fibromyalgia might be associated with neuroanatomical abnormalities as well. Specifically, we sought to determine whether fibromyalgia patients have demonstrable reductions in brain gray matter, particularly in regions involved in pain perception, pain modulation, and stress.