Reduced Resting-State Connectivity in Sensory Regions in Juvenile Fibromyalgia

Abstract

Juvenile fibromyalgia (JFM) is a chronic pain condition affecting predominantly female adolescents. Although JFM pathophysiology has not been addressed, a study found reduced resting-state functional connectivity (rs-FC) in the primary somatosensory system of children with chronic pain. This finding concurs with rs-FC reductions in somatosensory areas described in adults with fibromyalgia. In adults, such rs-FC alterations extended beyond the somatosensory domain and implicated other sensory modalities (3), which may suggest that fibromyalgia patients experience a weakening of sensory integration. Whether this phenomenon replicates in JFM remains to be elucidated. This research aimed to evaluate rs-FC alterations in adolescents with JFM for the first time. We evaluated 37 female adolescents with JFM and 43 matched controls. All participants underwent a resting-state functional magnetic resonance imaging examination. Using an Intrinsic Connectivity Contrast approach, we computed whole-brain, voxel-wise rs-FC and assessed between-group differences via t-tests. Significant clusters were used as seeds of interest in post-hoc seed-to-voxel analyses. The statistical threshold of all analyses was set at family-wise error-corrected p<.05. Compared to controls, JFM patients had decreased whole-brain rs-FC in the primary somatosensory cortex (SI) and the midcingulate cortex, involved in pain processing and response selection. Seed-to-voxel analyses revealed that JFM patients had reduced rs-FC within these regions and between the midcingulate cortex and the bilateral supplementary motor area, posterior insula and parietal operculum (SII), and auditory cortices, thus, areas mediating somatomotor and sensory processing. In contrast, JFM participants showed increased rs-FC between SI and the thalamus, potentially reflecting increased coupling between subcortical and cortical relays of nociceptive processing, and between SI and the ventral anterior insula, involved in affective and visceral processing. Our findings suggest an overall reduction of cortico-cortical integration of sensory signal and an augmented cross-talk between primary sensory and affective-visceral processing regions in adolescents with JFM. This work was funded by NIH/NIAMS Grants R01 AR074795 and P30 AR076316.