Differential dopamine function in fibromyalgia
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Approximately 30 % of Americans suffer from chronic pain disorders, such as fibromyalgia (FM), which can cause debilitating pain. Many pain-killing drugs prescribed for chronic pain disorders are highly addictive, have limited clinical efficacy, and do not treat the cognitive symptoms reported by many patients. The neurobiological substrates of chronic pain are largely unknown, but evidence points to altered dopaminergic transmission in aberrant pain perception. We sought to characterize the dopamine (DA) system in individuals with FM. Positron emission tomography (PET) with [18F]fallypride (FAL) was used to assess changes in DA during a working memory challenge relative to a baseline task, and to test for associations between baseline D2/D3 availability and experimental pain measures. Twelve female subjects with FM and 11 female controls completed study procedures. Subjects received one FAL PET scan while performing a “2-back” task, and one while performing a “0-back” (attentional control, “baseline”) task. FM subjects had lower baseline FAL binding potential (BP) in several cortical regions relative to controls, including anterior cingulate cortex. In FM subjects, self-reported spontaneous pain negatively correlated with FAL BP in the left orbitofrontal cortex and parahippocampal gyrus. Baseline BP was significantly negatively correlated with experimental pain sensitivity and tolerance in both FM and CON subjects, although spatial patterns of these associations differed between groups. The data suggest that abnormal DA function may be associated with differential processing of pain perception in FM. Further studies are needed to explore the functional significance of DA in nociception and cognitive processing in chronic pain.
KeywordsDopamine Positron emission tomography Pain Fallypride Fibromyalgia Imaging Chronic pain
This study was supported by R03DA024774 (KKY). The authors thank Christine Herring, Lauren Federici, and James Walters for assistance with data collection; Kevin Perry for acquisition of PET data; Michele Beal and Courtney Robbins for assistance with MR scanning; and Dr. Bruce Mock, Dr. Clive Brown-Proctor, Dr. Qi-Huang Zheng, Barbara Glick-Wilson, and Brandon Steele for [18F]fallypride synthesis. Dr. Brenna McDonald provided consultation for scoring and interpretation of the neuropsychological assessments and working memory task.
Compliance with ethical standards
This study was supported by the National Institute on Drug Abuse R03DA024774 (KKY).
Conflict of interest
D.S. Albrecht, P.J. MacKie, D.A. Kareken, G.D. Hutchins, E.J. Chumin, B.T. Christian, and K.K. Yoder declare that they have no conflict of interest.
All study procedures were approved by the Indiana University Institutional Review Board, and as such, were in accordance with the ethical standards of the Belmont Report (1974; National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research). Written informed consent was obtained from all patients prior to participation in the study.
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