Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Fibromyalgia Is Associated with a Disruption of Emotional Modulation of Pain, but Not Emotional Modulation of Spinal Nociception.
DelVentura1, Jennifer L., Terry2, Ellen L., Bartley2, Emily J., Vincent2, Ashley, Olech3, Ewa, Rhudy2, Jamie L.
Fibromyalgia syndrome (FM) is a disorder of unknown etiology that is characterized by chronic, widespread musculoskeletal pain and hyperalgesia. Recent functional imaging research has shown that FM patients exhibit differing patterns of brain activation during anticipation of and experience of experimental pain, as compared with rheumatoid arthritis (RA) patients and healthy controls (HC). Therefore, FM-related hyperalgesia may be due to an amplification of the nociceptive signal via cognitive-emotional mechanisms at the supraspinal level. Indeed, individuals with FM tend to report increased negative affect and reduced positive affect; a finding consistent with their higher rates of anxiety and depressive disorders. Given that emotion modulates pain and nociception, such that negative emotions augment pain and positive emotions inhibit it, and that FM patients exhibit hyperalgesia and greater negative affect, the present study examined whether FM patients would show disrupted emotional modulation of pain and nociception relative to RA and HC.
Patients with physician-verified diagnoses of FM or RA, and HCs with no chronic pain were recruited (N=33; FM=11, RA=8, HC=14). Participants were shown pictures that varied in emotional content (mutilation, neutral, erotica). To elicit pain and the nociceptive flexion reflex (NFR, a physiological correlate of spinal nociception), suprathreshold electrocutaneous stimuli were delivered to the left ankle over the sural nerve pseudorandomly, during and in between pictures.
Pain and NFR during different picture contents were analyzed using a linear mixed model analysis. Results suggested that all groups exhibited emotional modulation of the NFRunpleasant pictures augmented NFR and pleasant pictures inhibited NFR. Conversely, emotional modulation of pain ratings was exhibited in the RA and HC groups, but not in the FM group. Average pain ratings were not significantly different between groups (p=.28).
Thus, only FM patients exhibited abnormal emotional modulation of pain, while cerebrospinal modulation of the NFR was similar across groups. These data support prior research indicating disrupted supraspinal processing of the pain signal in FM. This study was funded by NIAMS (grant number: 5R03AR054571).
To cite this abstract, please use the following information:
DelVentura, Jennifer L., Terry, Ellen L., Bartley, Emily J., Vincent, Ashley, Olech, Ewa, Rhudy, Jamie L.; Fibromyalgia Is Associated with a Disruption of Emotional Modulation of Pain, but Not Emotional Modulation of Spinal Nociception. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :101