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.

Altered Resting Connectivity between Individuals with Fibromyalgia and Healthy Controls.

Schmidt-Wilcke2,  Tobias, Bhavsar2,  Rupal, Clauw1,  Daniel J., Williams1,  David A.

University of Michigan, Ann Arbor, MI
University of Michigan


Fibromyalgia (FM) is a chronic pain condition characterized by widespread pain in addition to fatigue, disturbed mood, non-restorative sleep, and dyscognition. fMRI studies investigating brain activity in response to pressure and heat pain in FM have identified augmented activation of pain processing regions when exposed to these experimental pain stimuli. The use of functional connectivity (fc) to analyze "resting state" imaging data holds promise for revealing differences between FM and HC with regards to how brain regions differentially communicate with one another under conditions of spontaneous (i.e., chronic) pain versus these other studies which use experimentally-induced pain. Specifically, we were interested in whether individuals with FM differed from healthy controls (HCs) in resting state connectivity in the insular cortex (IC), a region that plays a critical role in pain perception and modulation and other regions associated with affect, cognition, and sensory experiences.


Using SPM8 and the SPM-based connectivity toolbox Conn, functional connectivity from resting state fMRI scans of 17 individuals with FM and 8 HCs used seed regions in the anterior, middle and posterior IC. After pre-procecessing (e.g., realignment, normalisation and smoothing) connectivity maps were generated indicating the temporal correlation of a given voxel with a seed region in the IC (i.e., in total, 6 connectivity maps). After Fisher z-transformation one and two sample t-tests were performed to determine IC connectivity both within and between groups.


Highly correlated, low-frequency oscillations (< 0.1 Hz) between specific IC and cingulate cortex (CC) subdivisons were identified in both groups. Group differences were found in the connectivity of the left posterior IC and the left thalamus (i.e., hyperconnectivity in FM patients), the right IC and posterior mid-cingulate cortex/posterior cingulate cortex (i.e., hyperconnectivity in FM patients) and the right anterior IC and right middle frontal gyrus (hypoconnectivity in FM patients).


These data suggest that at rest, individuals with FM have stronger concurrent activations between brain regions known to participate in pain perception and modulation than do HCs. These data also add further support to the notion that central mechanisms play a critical role in the pain experience of individuals with FM.

To cite this abstract, please use the following information:
Schmidt-Wilcke, Tobias, Bhavsar, Rupal, Clauw, Daniel J., Williams, David A.; Altered Resting Connectivity between Individuals with Fibromyalgia and Healthy Controls. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :650
DOI: 10.1002/art.28418

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