Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia

Andrea Truini, Emanuele Tinelli, Maria C hiara Gerardi, Valentina Calistri, Cristina Iannuccelli, Silvia La Cesa, Lorenzo Tarsitani, Caterina Mainero, Piercarlo Sarzi-Puttini, Giorgio Cruccu, Francesca Caramia, Manuela Di Franco

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Abstract

OBJECTIVES: Emerging evidence associates chronic pain syndrome, such as fibromyalgia, with endogenous pain modulatory system dysfunction, leading to an impaired descending pain inhibition. In this study, using resting-state functional magnetic resonance imaging (fMRI), we aimed at seeking possible functional connectivity changes of the periaqueductal gray (PAG), a brainstem area that belongs to the endogenous pain modulatory system, in patients with fibromyalgia.

METHODS: In 20 patients with fibromyalgia and 15 healthy subjects, we investigated PAG functional connectivity using resting-state fMRI. We also analysed the correlation between clinical variables, such as pain severity, disease duration, and depressive personality traits with PAG functional connectivity.

RESULTS: Compared with control subjects, we identified that patients with fibromyalgia had an increased PAG connectivity with insula, anterior cingulate cortex, and anterior prefrontal cortex. The functional connectivity between PAG and the rostral ventral medulla, however, was not concordantly increased. PAG functional connectivity correlated with pain severity, disease duration, and the depressive personality trait rating.

CONCLUSIONS: Our fMRI study showing abnormal resting state functional connectivity of the PAG suggests that patients with fibromyalgia have an endogenous pain modulatory system dysfunction, possibly causing an impaired descending pain inhibition. This abnormal PAG functioning might underlay the chronic pain these patients suffer from.

Original languageEnglish
Pages (from-to)S129-S133
JournalClinical and Experimental Rheumatology
Volume34
Issue number2
StatePublished - 1 Mar 2016

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Periaqueductal Gray
Fibromyalgia
Pain
Magnetic Resonance Imaging
Chronic Pain
Personality
Inhibition (Psychology)
Gyrus Cinguli
Prefrontal Cortex
Brain Stem
Healthy Volunteers

ASJC Scopus subject areas

  • Medicine(all)

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Truini, A., Tinelli, E., Gerardi, M. C. H., Calistri, V., Iannuccelli, C., La Cesa, S., ... Di Franco, M. (2016). Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia. Clinical and Experimental Rheumatology, 34(2), S129-S133.

Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia. / Truini, Andrea; Tinelli, Emanuele; Gerardi, Maria C hiara; Calistri, Valentina; Iannuccelli, Cristina; La Cesa, Silvia; Tarsitani, Lorenzo; Mainero, Caterina; Sarzi-Puttini, Piercarlo; Cruccu, Giorgio; Caramia, Francesca; Di Franco, Manuela.

In: Clinical and Experimental Rheumatology, Vol. 34, No. 2, 01.03.2016, p. S129-S133.

Research output: Contribution to journalArticle

Truini, A, Tinelli, E, Gerardi, MCH, Calistri, V, Iannuccelli, C, La Cesa, S, Tarsitani, L, Mainero, C, Sarzi-Puttini, P, Cruccu, G, Caramia, F & Di Franco, M 2016, 'Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia' Clinical and Experimental Rheumatology, vol 34, no. 2, pp. S129-S133.
Truini A, Tinelli E, Gerardi MCH, Calistri V, Iannuccelli C, La Cesa S et al. Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia. Clinical and Experimental Rheumatology. 2016 Mar 1;34(2):S129-S133.

Truini, Andrea; Tinelli, Emanuele; Gerardi, Maria C hiara; Calistri, Valentina; Iannuccelli, Cristina; La Cesa, Silvia; Tarsitani, Lorenzo; Mainero, Caterina; Sarzi-Puttini, Piercarlo; Cruccu, Giorgio; Caramia, Francesca; Di Franco, Manuela / Abnormal resting state functional connectivity of the periaqueductal grey in patients with fibromyalgia.

In: Clinical and Experimental Rheumatology, Vol. 34, No. 2, 01.03.2016, p. S129-S133.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES: Emerging evidence associates chronic pain syndrome, such as fibromyalgia, with endogenous pain modulatory system dysfunction, leading to an impaired descending pain inhibition. In this study, using resting-state functional magnetic resonance imaging (fMRI), we aimed at seeking possible functional connectivity changes of the periaqueductal gray (PAG), a brainstem area that belongs to the endogenous pain modulatory system, in patients with fibromyalgia.METHODS: In 20 patients with fibromyalgia and 15 healthy subjects, we investigated PAG functional connectivity using resting-state fMRI. We also analysed the correlation between clinical variables, such as pain severity, disease duration, and depressive personality traits with PAG functional connectivity.RESULTS: Compared with control subjects, we identified that patients with fibromyalgia had an increased PAG connectivity with insula, anterior cingulate cortex, and anterior prefrontal cortex. The functional connectivity between PAG and the rostral ventral medulla, however, was not concordantly increased. PAG functional connectivity correlated with pain severity, disease duration, and the depressive personality trait rating.CONCLUSIONS: Our fMRI study showing abnormal resting state functional connectivity of the PAG suggests that patients with fibromyalgia have an endogenous pain modulatory system dysfunction, possibly causing an impaired descending pain inhibition. This abnormal PAG functioning might underlay the chronic pain these patients suffer from.",
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