Maybe the ladies under repair have fibromyalgia, another physical illness that certain psychiatrists who work for health insurance companies dismiss as 'all in the mind'?
Evidence of dysfunctional pain inhibition in Fibromyalgia reflected in rACC during provoked pain.
Pain. 2009 Apr 30. [Epub ahead of print]
Jensen KB, Kosek E, Petzke F, Carville S, Fransson P, Marcus H, Williams SC, Choy E, Giesecke T, Mainguy Y, Gracely R, Ingvar M.
Stockholm Brain Institute, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden.
PMID: 19410366
Over the years, many have viewed Fibromyalgia syndrome (FMS) as a so-called "functional disorder" and patients have experienced a concomitant lack of interest and legitimacy from the medical profession. The symptoms have not been explained by peripheral mechanisms alone nor by specific central nervous system mechanisms. In this study, we objectively evaluated the cerebral response to individually calibrated pain provocations of a pain-free body region (thumbnail).
The study comprised 16 female FMS patients and 16 individually age-matched controls. Brain activity was measured using functional magnetic resonance imaging (fMRI) during individually calibrated painful pressures representing 50mm on a visual analogue scale (VAS) ranging from 0 to 100mm.
Patients exhibited higher sensitivity to pain provocation than controls as they required less pressure to evoke equal pain magnitudes (U(A)=48, p<.002). Despite lower pressures applied in patients at VAS 50mm, the fMRI-analysis revealed no difference in activity in brain regions relating to attention and affect or regions with sensory projections from the stimulated body area. However, in the primary link in the descending pain regulating system (the rostral anterior cingulate cortex) the patients failed to respond to pain provocation. The attenuated response to pain in this brain region is the first demonstration of a specific brain region where the impairment of pain inhibition in FMS patients is expressed.
These results validate previous reports of dysfunctional endogenous pain inhibition in FMS and advance the understanding of the central pathophysiologic mechanisms, providing a new direction for the development of successful treatments in FMS.
1 comment:
Maybe the ladies under repair have fibromyalgia, another physical illness that certain psychiatrists who work for health insurance companies dismiss as 'all in the mind'?
Evidence of dysfunctional pain inhibition in Fibromyalgia reflected
in rACC during provoked pain.
Pain. 2009 Apr 30. [Epub ahead of print]
Jensen KB, Kosek E, Petzke F, Carville S, Fransson P, Marcus H,
Williams SC, Choy E, Giesecke T, Mainguy Y, Gracely R, Ingvar M.
Stockholm Brain Institute, Osher Center for Integrative Medicine,
Karolinska Institutet, Stockholm, Sweden.
PMID: 19410366
Over the years, many have viewed Fibromyalgia syndrome (FMS) as a
so-called "functional disorder" and patients have experienced a
concomitant lack of interest and legitimacy from the medical
profession. The symptoms have not been explained by peripheral
mechanisms alone nor by specific central nervous system mechanisms.
In this study, we objectively evaluated the cerebral response to
individually calibrated pain provocations of a pain-free body region
(thumbnail).
The study comprised 16 female FMS patients and 16 individually
age-matched controls. Brain activity was measured using functional
magnetic resonance imaging (fMRI) during individually calibrated
painful pressures representing 50mm on a visual analogue scale (VAS)
ranging from 0 to 100mm.
Patients exhibited higher sensitivity to pain provocation than
controls as they required less pressure to evoke equal pain
magnitudes (U(A)=48, p<.002). Despite lower pressures applied in
patients at VAS 50mm, the fMRI-analysis revealed no difference in
activity in brain regions relating to attention and affect or regions
with sensory projections from the stimulated body area. However, in
the primary link in the descending pain regulating system (the
rostral anterior cingulate cortex) the patients failed to respond to
pain provocation. The attenuated response to pain in this brain
region is the first demonstration of a specific brain region where
the impairment of pain inhibition in FMS patients is expressed.
These results validate previous reports of dysfunctional endogenous
pain inhibition in FMS and advance the understanding of the central
pathophysiologic mechanisms, providing a new direction for the
development of successful treatments in FMS.
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