MRI scans could be used in fibromyalgia diagnosis, study finds

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Previous studies have identified hypersensitivity and an altered brain response in people suffering from fibromyalgia.

Doctors may one day be able to diagnose fibromyalgia by means of a simple MRI scan. A study published in the journal Pain has, for the first time, identified a different brain response to pain and non-pain stimuli in people suffering from this chronic inflammatory disease.

Specialists have defined specific clinical procedures currently used to diagnose fibromyalgia, notably by assessing 12 tender points on the body. However, this doesn’t explain what’s going on at a neurological level in fibromyalgia patients or reflect individual levels of suffering.

Fibromyalgia is characterized by chronic widespread musculoskeletal pain, accompanied by symptoms such as fatigue, anxiety, and mood and sleep disorders. It is difficult to diagnose and treat since it shares many symptoms with other common chronic conditions. It affects 2 to 6% of the population.

Several research teams are working to develop new tests to diagnose the condition, including genetic tests, ophthalmic tests and medical imaging. The aim is to improve fibromyalgia treatment by developing a more personalized therapeutic approach in response to the disease’s highly diverse manifestations.

Previous studies have identified hypersensitivity and an altered brain response in people suffering from fibromyalgia.

Researchers at the University of Colorado Boulder, in the USA, have explored the potential analysis of these brain responses as a means of diagnosis. Scientists studied the brain activity of 37 people with fibromyalgia and 35 control patients using fMRI scans (functional Magnetic Resonance Imaging). They also used “multisensory” machine-learning techniques to identify brain-based fibromyalgia signs and non-painful sensory stimulation. Both groups were exposed to various non-painful visual, auditory and tactile cues as well as painful pressure.

During the tests, the scientists identified a series of three sub-markers, or “neurological patterns,” correlating with the hypersensitivity to pain that characterizes the condition.

“The novelty of this study is that it provides potential neuroimaging-based tools that can be used with new patients to inform about the degree of certain neural pathology underlying their pain symptoms,” said Marina López-Solà, the study’s lead author. “The set of tools may be helpful to identify patient subtypes, which may be important for adjusting treatment selection on an individualized basis.”

According to the study, the tests were 93% accurate.

The researchers hope that this new brain imaging technique could one day help evaluate the degree of patients’ individual pain symptoms. It could help doctors establish a neurological road map to brain activity to inform diagnosis and treatment for the condition.

The study is available here:  http://journals.lww.com/pain/Abstract/publishahead/Towards_a_neurophysiological_signature_for.99428.aspx

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