Fibromyalgia Feeling Catastrophic about Fibromyalgia? Here's Why

Cort

Founder of Health Rising and Phoenix Rising
Staff member
This interesting study suggests that the seat of catastrophizing and negative emotions in FM - lie in inactivation of a particular region of the brain ( a part of the prefrontal cortex.) Essentially the anticipation of pain should trigger a pain inhibitory circuit to kick in the PFC.

Unfortunately, that area of the brain stays pretty much inactive in FM. The failure of that part of the brain allows other parts of the brain to rachet up the anticipation of pain leading to "catastrophic thoughts" (a normal reaction in this circumstance) and ultimately emotional distress and increased pain.

They recommend neurofeedback to try and control that.
J Pain. 2015 Apr 30. pii: S1526-5900(15)00639-2. doi: 10.1016/j.jpain.2015.04.003. [Epub ahead of print] The lateral prefrontal cortex mediates the hyperalgesic effects of negative cognitions in chronic pain patients. Loggia ML1, Berna C2, Kim J3, Cahalan CM4, Martel MO4, Gollub RL5, Wasan AD6, Napadow V7, Edwards RR4.
Abstract

While high levels of negative affect and cognitions have been associated in chronic pain conditions with greater pain sensitivity, the neural mechanisms mediating the hyperalgesic effect of psychological factors in patients with pain disorders are largely unknown. In this cross-sectional study, we hypothesized that 1) catastrophizing modulates brain responses to pain anticipation, and that 2) anticipatory brain activity mediates the hyperalgesic effect of different levels of catastrophizing, in fibromyalgia (FM) patients. Using functional Magnetic Resonance Imaging, we scanned the brains of 31 FM patients exposed to visual cues anticipating the onset of moderately intense deep-tissue pain stimuli.

Our results indicated the existence of a negative association between catastrophizing and pain-anticipatory brain activity, including in the right lateral prefrontal cortex (lPFC). A bootstrapped mediation analysis revealed that pain-anticipatory activity in lateral prefrontal cortex (lPFC) mediates the association between catastrophizing and pain sensitivity.

These findings highlight the role of lPFC in the pathophysiology of FM related hyperalgesia, and suggest that deficits in the recruitment of pain-inhibitory brain circuitry during pain-anticipatory periods may play an important contributory role in the association between various degrees of widespread hyperalgesia in FM and levels of catastrophizing, a well validated measure of negative cognitions and psychological distress.
PERSPECTIVE:

This article highlights the presence of alterations in pain-anticipatory brain activity in FM. These findings provide the rationale for the development of psychological or neurofeedback-based techniques aimed at modifying patients' negative affect and cognitions towards pain.

Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.
 

Abby

New Member
Good to know it's not my fault, nor my choice. Just my brain's chemistry, I've always wondered.....
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Good to know it's not my fault, nor my choice. Just my brain's chemistry, I've always wondered.....
It's got to be brain chemistry - I think anyway....Which doesn't mean we can't tame it to some extent anyway.
 

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