Andy
Retired committee member
Abstract
Objective
Juvenile fibromyalgia (JFM) is a prevalent chronic pain condition affecting children and adolescents worldwide during a critical period of brain development. To date, no published studies have addressed the pathophysiology of JFM. Here we characterize gray matter volume (GMV) alterations in JFM patients for the first time and investigate their functional and clinical relevance.
Methods
34 female adolescents with JFM and 38 healthy adolescents underwent a structural magnetic resonance imaging examination and completed questionnaires assessing core JFM symptoms. Using voxel-based morphometry, we assessed between-group GMV differences and associations between GMV and functional disability, fatigue, and pain interference in JFM. We also studied whether validated brain patterns predicting pain, cognitive control, or negative emotion were amplified/attenuated in JFM patients and whether structural alterations reported in adult fibromyalgia replicated in adolescents with JFM.
Results
Compared to controls, JFM patients showed GMV reductions in the anterior-midcingulate cortex (MCC) region associated with pain. Within the JFM group, patients reporting higher functional disability had larger GMV in inferior frontal regions linked to affective, self-referential, and language-related processing. Last, GMV reductions in JFM showed partial overlap with findings in adult fibromyalgia, specifically for the anterior/posterior cingulate cortices.
Conclusion
Pain-related MCC reductions may be a structural hallmark of JFM, whereas alterations in regions involved in emotional, self-referential, and language-related processes may predict disease impact on patients’ well-being. The partial overlap between juvenile and adult fibromyalgia findings strengthens the importance of early symptom identification and intervention to prevent the transition to adult forms of the disease.
Paywall, https://onlinelibrary.wiley.com/doi/10.1002/art.42073
Objective
Juvenile fibromyalgia (JFM) is a prevalent chronic pain condition affecting children and adolescents worldwide during a critical period of brain development. To date, no published studies have addressed the pathophysiology of JFM. Here we characterize gray matter volume (GMV) alterations in JFM patients for the first time and investigate their functional and clinical relevance.
Methods
34 female adolescents with JFM and 38 healthy adolescents underwent a structural magnetic resonance imaging examination and completed questionnaires assessing core JFM symptoms. Using voxel-based morphometry, we assessed between-group GMV differences and associations between GMV and functional disability, fatigue, and pain interference in JFM. We also studied whether validated brain patterns predicting pain, cognitive control, or negative emotion were amplified/attenuated in JFM patients and whether structural alterations reported in adult fibromyalgia replicated in adolescents with JFM.
Results
Compared to controls, JFM patients showed GMV reductions in the anterior-midcingulate cortex (MCC) region associated with pain. Within the JFM group, patients reporting higher functional disability had larger GMV in inferior frontal regions linked to affective, self-referential, and language-related processing. Last, GMV reductions in JFM showed partial overlap with findings in adult fibromyalgia, specifically for the anterior/posterior cingulate cortices.
Conclusion
Pain-related MCC reductions may be a structural hallmark of JFM, whereas alterations in regions involved in emotional, self-referential, and language-related processes may predict disease impact on patients’ well-being. The partial overlap between juvenile and adult fibromyalgia findings strengthens the importance of early symptom identification and intervention to prevent the transition to adult forms of the disease.
Paywall, https://onlinelibrary.wiley.com/doi/10.1002/art.42073
