Motor Cortex Function in Fibromyalgia: A Study by Functional Near-Infrared Spectroscopy.

Marina de Tommaso,Filippo Brighina,Eleonora Gentile,Katia Ricci,Marianna Delussi

doi:10.1155/2019/2623161

Abstract

Previous studies indicated changes of motor cortex excitability in fibromyalgia (FM) patients and the positive results of transcranial stimulation techniques. The present study aimed to explore the metabolism of motor cortex in FM patients, in resting state and during slow and fast finger tapping, using functional Near-Infrared Spectroscopy (fNIRS), an optical method which detects in real time the metabolism changes in the cortical tissue. We studied 24 FM patients and 24 healthy subjects. We found a significant slowness of motor speed in FM patients compared to controls. During resting state and slow movement conditions, the metabolism of the motor areas was similar between groups. The oxyhemoglobin concentrations were significantly lower in patients than in control group during the fast movement task. This abnormality was independent from FM severity and duration. The activation of motor cortex areas is dysfunctional in FM patients, thus supporting the rationale for the therapeutic role of motor cortex modulation in this disabling disorder.

Highlights

Fibromyalgia (FM) is a disabling disease with widespread muscle pain, associated with fatigue, sleep disorders, cognitive impairment, and a number of other physic and psychopathological symptoms [1]
Exclusion criteria were less than 8 years of education; any peripheral or central nervous system (CNS) disease, including spinal cord diseases and radiculopathies; psychiatric disease; diabetes; active and/or positive history for thyroid insufficiency; renal failure; autoimmune diseases; inflammatory arthritis; systemic connective tissue disease; present or previous history of cancer; and use of drugs acting on the CNS or chronic opioid therapy
In view of the correlation between functional Near-Infrared Spectroscopy (f NIRS) and clinical data, we considered the Wide Pain Index (WPI) according to the recent ACR diagnostic criteria (2010) [1]

Summary

Introduction

Fibromyalgia (FM) is a disabling disease with widespread muscle pain, associated with fatigue, sleep disorders, cognitive impairment, and a number of other physic and psychopathological symptoms [1]. It is a complex and often poorly curable syndrome, with unclear pathophysiological mechanisms. Increasing evidence is in favor of the pivotal role of the motor function in contributing to pain syndrome outcomes [5]. The possible basal condition of motor cortex inhibition and the benefit of its recovery in pain control may explain the often-reported success of excitatory neuromodulation of M1 in patients with fibromyalgia [8,9,10]

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