Image-based diagnosis for fibromyalgia on the horizon

Fibromyalgia is an oddity when it comes to musculoskeletal diseases. It’s considered an “arthritis-related condition," but it’s not truly a form of arthritis—it doesn’t cause muscle or joint inflammation. It’s tough to diagnose, problematic to treat and affects women at eight times the rate of men. However, researchers from the University of Colorado-Boulder have identified three neural networks on functional MRI (fMRI) that may represent the first image-based diagnostic method for fibromyalgia.

The causes of fibromyalgia are unknown. While there’s speculation it may be the way certain genes regulate the processing of pain stimuli, scientists aren’t yet sure. The lack of an identifiable cause means diagnoses are often made by ruling out other causes for a patient’s pain. These fMRI profiles may allow a quicker, more accurate diagnosis, which can expedite treatment and reduce uncertainty.   

The researchers identified three neural networks that exhibited consistent responses to painful pressure and multisensory stimuli: a pain network, a sensory processing network and a newly identified network termed “FM-pain.” The findings were published in the journal PAIN from the International Association for the Study of Pain.

Combined activity in all three sectors allowed researchers to separate over 90 percent of fibromyalgia patients from control subjects, providing a framework for assessing treatment and predicting response. While a cure for fibromyalgia may still be far off, this neurological profile will be a boon to researchers and clinicians alike.

"Though many pain specialists have established clinical procedures for diagnosing fibromyalgia, the clinical label does not explain what is happening neurologically and it does not reflect the full individuality of patients' suffering," said Tor Wager, director of the Cognitive and Affective Control Laboratory. "The potential for brain measures like the ones we developed here is that they can tell us something about the particular brain abnormalities that drive an individual's suffering. That can help us both recognize fibromyalgia for what it isa disorder of the central nervous system—and treat it more effectively."