The Physiology of Stress Illness (3)

Evidence of abnormalities in the brain in stress-related illness continues to accumulate.  A recent paper * compared MRI scans in 14 Fibromyalgia (FM) patients and 14 healthy people and found reduced gray matter in pain-processing areas in the brain in the FM group.  The authors wondered whether this reduction in gray matter caused the chronic pain or whether it was a result of chronic pain.

In an attempt to answer this, the authors looked to see if FM patients with more years of pain had more reduction in gray matter than FM patients with fewer years of pain.  If they found this it would imply that FM caused the grey matter reduction.  However, they found no link between the duration of FM and the degree of grey matter reduction.  This suggests that the gray matter reduction could have come on before the FM (from some other cause) and later contributed to pain from FM.

If the FM wasn’t responsible for the the gray matter reduction, then what else might have caused it?  The authors point to other studies showing gray matter reduction in pain-processing areas of the brain in patients with post-traumatic stress disorder or Borderline Personality Disorder.  The implication is that life stresses could be responsible for the gray matter loss which would then lead to greater pain sensitivity in the brain which could then lead to FM (and possibly other forms of stress-related illness).

The number of patients in this study was small but the results are consistent with a growing body of evidence that life stresses may lead to greater sensitivity to pain in the brain and spinal cord and that this plays an important role in stress-related illnesses.

Burgmer, M et al. Decreased Gray Matter Volumes in the Cingulo-Frontal Cortex and the Amygdala in Patients with Fibromyalgia.  Psychosomatic Medicine 71:566-573, 2009.  From Munster, Germany.

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