Fm really does start in our heads after all. Those Drs. have been right all along
Brain Scan Proves What Sufferers Have Always Known
By Daniel DeNoon
WebMD Medical News Reviewed By Gary Vogin, MD
June 12, 2002 -- People with fibromyalgia (FM) know their pain is real. So do FM experts. And now there's proof that FM patients' extreme sensitivity to pain is no figment of their imaginations.
It's now possible to look at the brain and see exactly where it's active. This is done with a sophisticated brain scan called functional magnetic resonance imaging or fMRI. And these studies now are being done on FM patients.
In a study reported in the May issue of the journal Arthritis & Rheumatism, FM experts Richard H. Gracely, PhD, and Daniel J. Clauw, MD, gave fMRI scans to 16 FM patients and 16 healthy people. They did the scans under two conditions: first, when the person was feeling slight pressure on the thumb; and second, when the person was feeling moderately painful pressure on the thumb.
Healthy people's brains only became active when they felt the painful pinch. But the brains of the FM patients became highly active even when there was only slight pressure. This activity was very much like what happens in the brains of healthy people who are feeling pain.
"What it shows is that the brain response is consistent with what the patients report verbally," Gracely tells WebMD. "Being believed is an extremely important issue for these people. Now these physical findings are emerging, it is gratifying for these patients. We doctors aren't surprised because we already knew. But for the patient, it is just a terrible situation to be in. The general public doesn't really realize that pain can be very severe -- and sometimes untreatable -- in a person who does not seem to be injured."
I. John Russell, MD, PhD, is leading similar fMRI studies at University of Texas Health Science Center, San Antonio. Russell is director of the university's clinical research center.
"This helps the patient to see that their pain is different from the pain of others and that it is real," Russell tells WebMD. "Also, this gives us a window to look into the brain at the responsiveness to and effect of pain on mood in people with FM."
Russell notes that FM patients aren't just more sensitive to pain. Pain also affects the mood centers of their brains in ways that it doesn't affect healthy people.
Also impressed by the new research is Terence W. Starz, MD, an FM expert at the University of Pittsburgh Medical Center.
"These very, very sophisticated instruments may now help us describe different subsets of FM patients," Starz tells WebMD. "The brain's processing information from the senses is very complex. When one looks at fibromyalgia patients it is becoming increasingly clear that there are variations in the processing of sensory information."
Doctors have been slow to accept FM as a real disease -- but that quickly is changing.
"I've been in the pain field for 27 years," Gracely says. "Twenty years ago, pain medicine was like a poor stepchild. It was not taught in medical school. Today, the number of people in pain research is huge. FM has been a poor stepchild, too. It is like pain research was several years ago."
Gracely, formerly a researcher at the U.S. National Institutes of Health, and Clauw, formerly at Georgetown University in Washington, have moved their research to the University of Michigan, Ann Arbor.
so now it's yappy Happy!
