Huijin Song1, JeeHye Seo1, Seonguk Jin1, Hee-Kyung Kim1, Moon-jung Hwang2, Kyung Jin Suh3, Yongmin Chang4
1Medical & Biological Engineering, Kyungpook National University, Daegu, Korea, Republic of; 2GE healthcare, Seoul, Korea, Republic of; 3Radiology, College of Medicine, Dongguk University, Gyungju, Korea, Republic of; 4Medical & Biological Engineering, Diagnostic Radiology, molecular medicine, Kyungpook National University, Daegu, Korea, Republic of
Fibromyalgia(FM) is disorder of unknown etiology1, characterized by chronic widespread pain and are often accompanied by symptoms of sleep disturbance, anxiety, memory problems, fatigue, and exhaustion. Previous functional imaging studies of FM mainly focused on pain by physical stimuli or functional connectivity. However, there is no emotional and cognitive effective connectivity study with FM. Therefore, the aim of this study investigates the effective connectivity using dynamic causal modeling and difference of pain network between FM patient and healthy controls in the empathy for pain stimuli. Based on our finding that the DLPFC delivers controlled pain information and intensity to insula, and insula assesses the information and perceives the pain intensity with ACC. In this study, in patients with FM, the effective connectivity between DLPFC and insula was decreased, but effective connectivity between insula and ACC was increased. Therefore, the role of DLPFC in emotional pain processing is associated with control of pain intensity and inhibitory system. If the DLPFC has a deficit or a dysfunction, patients under chronic pain perceive the more pain intensity than normal.