Neuroimaging in Fibromyalgia Syndrome

Objectives: The objective of this review is to summarize findings from neuroimaging studies conducted in patients with fibromyalgia syndrome [FMS] and discuss their implications regarding pathophysiology and treatment. Findings: A variety of neuroimaging modalities have been used to explore abnormalities in brain structure and function associated with FMS. Single-photon-emission computerized tomography has been used to demonstrate abnormalities in regional cerebral blood flow and explore correlations between these findings and clinical parameters. Abnormalities in brain morphometry, tissue microstructure, and metabolite contents have been described using magnetic resonance imaging techniques. Evidence of central sensitization characterized by abnormal brain activation in response to stimulation has also been reported. Studies using positron emission tomography have shown abnormalities in dopaminergic neurotransmission and mu-opioid receptor binding. Conclusions: Fibromyalgia is associated with a variety of brain abnormalities demonstrable by neuroimaging that correlate with patients' symptoms. Future neuroimaging studies that take into account distinguishing characteristics among different populations of FMS patients may help to improve approaches to treatment and provide insight as to the pathophysiology of symptoms in addition to chronic widespread pain.