Fibromyalgia and Loss of Grey Matter

How my brain feels after writing a blog post!

According to a recent review of studies called Relations between brain alterations and clinical pain measures in chronic musculoskeletal pain: A systematic review, based on patients suffering widespread chronic musculoskeletal pain (MSKP);

Moderate evidence demonstrates that higher pain intensity and pressure pain sensitivity are related to decreased regional grey matter (GM) volume in brain regions encompassing the cingulate cortex, the insula and the superior frontal and temporal gyrus. Further, some evidence exists that longer disease duration in fibromyalgia is correlated with decreased total GM volume. Yet, inconclusive evidence exists regarding the association of longer disease duration with decreased or increased regional GM volume in other chronic MSKP conditions. Inconclusive evidence was found regarding the direction of the relation of pain intensity and pressure pain sensitivity with microstructural white matter and functional connectivity alterations

These differences were found through the use of MRI imaging. Since all that is available of this review is the abstract which lacks any concrete details about the particular studies reviewed such as the number of patients included in the study, the criteria on which patients were chosen, use of controls, and specific data points, it’s difficult to make any point by point comparisons. Of course, the biggest flaw, which the review authors point to, is  whether or not the loss in GM is definitively correlated to the clinical pain measures itself;

…preliminary to moderate evidence demonstrates relations between clinical pain measures, and structural and functional connectivity alterations within brain regions involved in somatosensory, affective and cognitive processing of pain in chronic MSKP. Nevertheless, inconclusive results exist regarding the direction of these relations. Further research is warranted to unravel whether these brain alterations are positively or negatively correlated to clinical pain measures.

Given that the brain is what translates what the body feels, it’s impossible for it not to be related, so to speak. Even Jarred Younger points this out in his video, here.  But they are right, that doesn’t necessarily mean that there is an absolute cause and effect relationship between pain, pain levels and the grey matter loss experienced in patients. It is important to know that it’s happening though, and whether or not it’s progressive with the length and/or severity of the disease.

I am very intrigued by the results and its many possible implications. First of all, grey matter loss can contribute to a number of symptoms; pretty much if you can name them, you can blame them on grey matter loss, most especially the cognitive dysfunction and memory loss that I seem to have at a stellar level. My MRI from 2.5 years ago was clear, but who knows now?

This could also indicate that fibromyalgia and myalgic encephalomyelitis are two separate illnesses, as grey matter volume seems only to decrease in some ME/CFS patients and not others and perhaps only after a certain duration or length of severity, from what I’ve read, though admittedly I’m not expert and I’ve certainly not read every study out there.

I do wish those who had reduced grey matter in such studies had been tested for fibromyalgia. Based on the recent microglia discoveries through PET observations made by Fukuda, the primary enemy in ME/CFS seems largely to be brain inflammation (or perhaps whatever is causing that inflammation).  I myself have seen a significant decrease in symptoms by controlling that inflammation with curcumin, though there’s certainly still room for improvement.

Finally, this grey matter shrinkage should also be of great concern because of the connection between it and Alzheimer’s disease. We should be asking ourselves and most certainly asking the powers that be why there haven’t been more questions raised about the similarities between these two diseases.

Since there are a number of patients like myself who are eventually diagnosed with both illnesses based on distinct and separate criteria, one must wonder if the effects of one might possibly “kick off” the other, or if perhaps there is something in the patient’s genetics, environment (viral, chemical or otherwise) that creates the perfect conditions for development of both of these neurological diseases. My mother and my former partner were both diagnosed with fibromyalgia as well as myself. Can it really just be a coincidence?

So many questions. So few answers. I’d be scratching my head, but it’s throbbing too much after all this thinking and writing!

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