Flippy - I Rant, You Read
Sunday, March 08, 2009
late morning
Scary Fibromyalgia Study - Accelerated Brain Gray Matter Loss
Firstly, here’s a link to the full study, and then I’ll quote some of the easier to understand (for me, too) parts.
Fibromyalgia patients have abnormal brain gray matter loss These findings reveal for the first time that patients with fibromyalgia have brain gray matter atrophy. Interestingly, the normal age-related decrease in gray matter was accelerated in fibromyalgia patients and related to disease duration. The patients, who ranged from 27 to 61 years of age, demonstrated a yearly decrease in gray matter volume more than three times that of age-matched controls. The age-related decrease was even greater than that observed by Resnick et al. (2003) in a much older group of healthy adults (59–85 years), with the fibromyalgia patients in our study showing a decrease of 3.7 cm3/year and the older healthy subjects showing a decrease of 2.4 cm3/year. Although menopausal status can clearly have an effect on gray matter volume, the fact that more fibromyalgia patients than healthy controls in our sample were not cycling normally is not likely to account for our findings, because the postmenopausal fibromyalgia patients in our study had less gray matter than the postmenopausal healthy controls. The reduced gray matter was even observed in the two patients who were on HRT, which Erikson et al. (2005) showed increases gray matter volumes in postmenopausal women. Structural brain changes related to chronic pain and stress disorders Accumulating evidence now indicates that a number of chronic pain and stress-related disorders, including chronic low back pain, tension-type headache, chronic fatigue syndrome, and posttraumatic stress disorder, are characterized by gray matter reductions, although the specific regions involved differ among syndromes (Villarreal et al., 2002; Apkarian et al., 2004; Okada et al., 2004; de Lange et al., 2005; Schmidt-Wilcke et al., 2005; Chen et al., 2006). The extensive comorbidity among these disorders suggests that mechanistic similarities may underlie brain atrophy, whereas the regional differences in gray matter decline could explain differences in symptoms. Mechanisms and implications of gray matter loss A possible explanation for the decreased gray matter density in these disorders might be atrophy secondary to excitotoxicity and/or exposure to inflammation-related agents, such as cytokines (Apkarian et al., 2004). It is noteworthy that in fibromyalgia patients, gray matter loss occurred mainly in regions related to stress [parahippocampal gyrus (Herman et al., 2005)] and pain processing [cingulate, insular, and prefrontal cortices (Apkarian et al., 2005)], which might reflect their long-term experience of these symptoms. Because cingulate and prefrontal cortices are particularly implicated in pain modulation (Apkarian et al., 2005) (i.e., inhibition and facilitation of pain), structural changes in these systems could contribute to the maintenance of pain and symptom chronification in fibromyalgia. Furthermore, gray matter atrophy in areas such as parahippocampal and frontal cortices also appears consistent with cognitive deficits characteristic of fibromyalgia (Park et al., 2001). Longitudinal studies are indicated to determine whether the observed structural changes are the cause or the consequence of the disorder. If confirmed, these findings may provide a rationale for exploring neuroprotective approaches in fibromyalgia aimed at symptom treatment or indeed at their reversal.
But, but, but, I don’t want to lose my gray matter, although it’s probably already too late.
