Abstract

Abnormal functional connectivity (FC) and structure in the brain are found in fibromyalgia (FM) patients. This study investigated FC and structural alterations of the visual cortical system, the emerging contributor to pain processing, in FM patients. Thirty pain-free participants and twenty-six patients with FM were enrolled. Clinical characteristics were evaluated using standardized scales. Structural and resting-state functional MRI were conducted. Seed-based FC analyses, voxel-based morphometry, and surface-based morphometry were performed. The FC and cortical structure of the visual system were compared between the two groups. The correlation between functional and structural changes in visual cortical system with clinical presentation in the FM group was analyzed. The FM patients showed increased FCs within visual networks, of which the FC between the visual medial network (VMN) and the right lingual gyrus (LG) was positively correlated with the fibromyalgia impact questionnaire (FIQ) score. However, the FM group showed decreased FCs from the visual occipital network (VON) to several regions, of which the FCs from VON to bilateral frontal orbital cortices (FOrb) were negatively correlated with FIQ and Pittsburgh Sleep Quality Index (PSQI) scores. Cortical thickness of the lateral occipital cortex, LG, and pericalcarine in FM tended to increase. Altered FCs and structure in the visual cortical system might be involved in pathomechanisms and clinical presentation in FM. The findings could potentially support further studies that seek to find the diagnosis methods and mechanism-based therapies in patients with FM.

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