Brain Changes May Explain Chronic Pain Symptoms in Different Disorders, Study Suggests

Brain Changes May Explain Chronic Pain Symptoms in Different Disorders, Study Suggests

Even though fibromyalgia and urological chronic pelvic pain syndrome (UCPPS) are different disorders, new research suggests that patients suffering from these conditions may actually share alterations to the brain, perhaps explaining why certain UCPPS patients exhibit fibromyalgia characteristics, such as widespread pain.

The study “Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study” was published in the journal Pain.

Chronic pain is diagnosed and assessed via severity score scales, determining the intensity of the pain. However, current clinical practice disregards the pain’s spatial distribution in the body.

Now, a team of researchers at the University of Michigan asked how widespread pain is and what may underlie its wide distribution. They examined data from the brains of 1,709 participants in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network.

“Participants with a clinical diagnosis of UCPPS were compared to pain-free controls and patients with fibromyalgia, the prototypical centralized pain disorder,” researchers wrote. They also analyzed questionnaires where patients reported their levels of pain severity and function. Moreover, patients were asked to pinpoint, on a body map, the locations where they felt pain.

A subset of the study participants, which included 10 UCPPS, 23 fibromyalgia and 49 healthy controls subjects, underwent functional and structural magnetic resonance imaging (MRI) exams.

Patients with UCPPS reported experiencing localized pain in the pelvic area, but also throughout the body, i.e., a widespread pain. When researchers analyzed the brains of these patients they detected alterations, including increased gray matter volume and alterations to the brains’ connectivity circuits.

“What was surprising was these individuals with widespread pain, although they had the diagnosis of urological chronic pelvic pain, were actually identical to another chronic pain disorder: fibromyalgia,” Richard Harris, PhD, the study’s senior author and associate professor of anesthesiology and rheumatology at Michigan Medicine, said in a University’s press release written by Kylie Urban.

Most notably, the alterations to the brain’s gray matter volume and pattern of connectivity were similar to the ones seen in fibromyalgia patients, but were absent in the pain-free control group.

“This study represents the fact that pelvic pain patients, a subset of them, have characteristics of fibromyalgia. Not only do they have widespread pain, but also they have brain markers indistinguishable from fibromyalgia patients,” Harris said.

Widespread pain also was associated with impairments to physical and mental functions, independently of pain severity.

Overall, the results suggest that widespread pain is linked to brain alterations and highlights possible new ways for treating chronic pain. Moreover, it also suggests that despite diagnoses as different disorders in patients experiencing widespread pain, the symptoms may have a common source.

“We think that this type of study will help treat these patients because if they have a central nerve biological component to their disorder, they’re much more likely to benefit from targets that affect the central nervous system rather than from treatments that are aimed at the pelvic region,” Harris concluded.

 

14 comments

  1. Linda says:

    What kind medicine
    Will help for fibromyalgia . I try everything. Nothing works . I just saw on internet , there was article on Fibrolief that will help Fibromyalgia did anyone try that yet . Please let me know if anyone try any medicine that helps this disease please e-mail me. Best Wishes. Linda

    • Arlene says:

      Hi Linda. Unfortunely there is not cure for fibromyalgia. I have been suffering since 2013. There are so many theories out there and some sound plausible. What I have found ,which could be a placebo effect, but seems to work for me is to eat more vegetables and take gabapentin. I take 100mg three times daily and vitamin D. I can not work anymore because of the fatigue caused from the pain. I wish someone could get to the bottom of this and find a cure.

    • Sarah says:

      Kratom helps! I took Fibrolief too, but it turns out I got my methylation cycles tested and my body can’t activate b12 and folate, which increases many of my fibro symptoms. So I take specially activated vitamins with guidance from my functional MD. I really recommend looking into kratom. I’ve had fibro my entire life, since I was a little kid.

    • Betty says:

      Have you tried Gabapentin? I have found it takes some of the pain away. It does not help headaches, which was what Gabapentin was prescribed for, but surprisingly, it helped the fibromyalgia. Try it!

    • Ottilija says:

      I would look into medicinal cannabis.
      Actually I am looking into it for myself. I have been living with Fibromyalgia for 15 years.
      It takes a toll on a person.

    • Mary Martin says:

      I have tried Fibrolief and it did nothing for me. I take 5-HTP, SAM-E, magnesium, Vit. D, CoQ10. Melatonin and Trazodone for sleep. Also Celexa for depression & Tramadol for pain. Tramadol plus rest helps pain, Lidocaine patches for lower back pain. Water exercise helps with stiffness. There is no one magic therapy.😥

  2. Ellen Saville says:

    I have had Fifromyalgia for over 40 years, maybe longer. Three years ago I was diagnosed with interstitial cystitis. My complaint was I always had pelvic pain and couldn’t figure out why I could feel my bladder all the time. There is medication to help with this illness but my insurance does not cover it. I do take Norco for the Fibromyalgia. I find this article very interesting and exciting and so hope they continue to study which might lead to a medication for both. Good luck in you research.

  3. Lori says:

    I have chronic pain for other reasons, but was reading this article because I have family with Fibro. I have to say I agree with Sarah above! You have to at least give Kratom a shot. It’s no magic bullet but it absolutely takes the edge off and helps with the depression left in the wake on chronic pain.

  4. Martha Fink says:

    After being very sick/painful/bedridden for about 1 1/2 years, I was diagnosed via CDC approved labs with Lyme in 1989. When the doxy didn’t work, I was dismissed as having fibromyalgia. My research has led me to the conclusion that I have Lyme and who knows how many of the other vector-borne infections that are so easily transmitted to us without our even knowing it. I’ve been sick for 29 years now, with some periods of remission (thankfully). Do research on Lyme from ILADS and lymedisease.org. to give you a starting place.

  5. Rohr Richard says:

    Doctors at our allegedly Level 1 trauma center and Hospital/Clinic system in pain management will not give tramadol or Hydrocodone 10/325 acetaminophen anymore, and just use this invasive sort of procedure with injections into the spine or radio-ablation treatments, of which my wife has had at least 5 times, and it does no good. We are not going to continue this again. I don’t like burning nerve endings, which I consider a terrible thing to do, and far more problematic than any Class III opioid therapy that has worked with much success for years. Internal medicine used Norco 10mg/325 and their recommendation to control the chronic pain for the past 7 years, and now just stopped it cold turkey with recent CDC requirements to limit the use of Cl III pain killers like Norco, or Vicodin, so doctors here just quit the use of it entirely for outpatient therapy. Most people KNOW you don’t just quit prescribed hydrocodone therapy cold turkey, but I question the judgement of doctors who do this out of fear that they migh lose their licenses. So they look after their own interests, but some just have convictions in general without any real knowledge of the difference between addiction and real pain relief by non-addict patients whose only relief has been the very fine effects of opoiod therapy. So they should not assume that this CDC report is valid, as it has been questioned by authorities in the know that their study was flawed. So millions who suffer significant pain and misery every day are being treated malicialiously without caring how much they are making their patients suffer without adequate alternatives that have worked for 4-5 decades. It’s travesty to let patients suffer such abusive, and invasive burning of nerve endings to no good results. The Pain remains. Is there anybody in Texas who has better sense about the valid use of opioids for patients who have never abused them. The quality of life is the issue here, and they are making people suffer for it.

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