TY - JOUR
T1 - Differential Brain Perfusion Changes Following Two Mind–Body Interventions for Fibromyalgia Patients
T2 - an Arterial Spin Labelling fMRI Study
AU - Medina, Sonia
AU - O’Daly, Owen G.
AU - Howard, Matthew A.
AU - Feliu-Soler, Albert
AU - Luciano, Juan V.
N1 - Funding Information:
SM and MAH are funded by a Medical Research Council Experimental Medicine Challenge Grant (MR/N026969/1). SM, MAH and OOD are also supported by the NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Trust. AFS acknowledges the funding from the Serra Húnter program (Generalitat de Catalunya; reference number UAB-LE-8015). JVL has a “Miguel Servet” research contract from the ISCIII (CPII19/00003).
Publisher Copyright:
© 2021, Crown.
PY - 2022/2
Y1 - 2022/2
N2 - Objectives: Further mechanistic insight on mind–body techniques for fibromyalgia (FMS) is needed. Arterial spin labelling (ASL) imaging can capture changes in regional cerebral blood flow (rCBF) that relate to spontaneous pain. Methods: We recruited FMS patients undergoing either mindfulness-based stress reduction training (MBSR, n = 14) or a psychoeducational programme (FibroQoL, n = 18), and a control FMS group with no add-on treatment (n = 14). We acquired whole-brain rCBF maps and self-report measures at baseline and following treatment and explored interaction effects in brain perfusion between the treatment group and session with a focus on the amygdala, the insula and the anterior cingulate cortex (ACC). Results: We identified a significant interaction effect in the amygdala, which corresponded with rCBF decreases following FibroQoL specifically. At baseline, rCBF in the amygdala for the FibroQoL group correlated with pain catastrophizing and anxiety scores, but not after treatment, suggesting a decoupling between activity in the amygdala and negative emotional symptoms of FMS as a consequence of treatment. Baseline rCBF correlated positively with pain symptoms in the ACC and the anterior insula across all patients; moreover, the correlation between rCBF changes post intervention in the insula and pain improvement was negative for both treatments and significantly different from the control group. We suggest that there is disruption of the typical relationship between clinical pain and activity as a product of these two nonpharmacological therapies. Conclusions: We have demonstrated that different mind-to-body treatments correspond to differential changes in clinical symptoms and brain activity patterns, which encourages future research investigating predictors of treatment response. Trial Registration: NCT02561416.
AB - Objectives: Further mechanistic insight on mind–body techniques for fibromyalgia (FMS) is needed. Arterial spin labelling (ASL) imaging can capture changes in regional cerebral blood flow (rCBF) that relate to spontaneous pain. Methods: We recruited FMS patients undergoing either mindfulness-based stress reduction training (MBSR, n = 14) or a psychoeducational programme (FibroQoL, n = 18), and a control FMS group with no add-on treatment (n = 14). We acquired whole-brain rCBF maps and self-report measures at baseline and following treatment and explored interaction effects in brain perfusion between the treatment group and session with a focus on the amygdala, the insula and the anterior cingulate cortex (ACC). Results: We identified a significant interaction effect in the amygdala, which corresponded with rCBF decreases following FibroQoL specifically. At baseline, rCBF in the amygdala for the FibroQoL group correlated with pain catastrophizing and anxiety scores, but not after treatment, suggesting a decoupling between activity in the amygdala and negative emotional symptoms of FMS as a consequence of treatment. Baseline rCBF correlated positively with pain symptoms in the ACC and the anterior insula across all patients; moreover, the correlation between rCBF changes post intervention in the insula and pain improvement was negative for both treatments and significantly different from the control group. We suggest that there is disruption of the typical relationship between clinical pain and activity as a product of these two nonpharmacological therapies. Conclusions: We have demonstrated that different mind-to-body treatments correspond to differential changes in clinical symptoms and brain activity patterns, which encourages future research investigating predictors of treatment response. Trial Registration: NCT02561416.
KW - Fibromyalgia
KW - Meditation, pCASL fMRI
KW - Mindfulness
UR - http://www.scopus.com/inward/record.url?scp=85122304719&partnerID=8YFLogxK
U2 - 10.1007/s12671-021-01806-2
DO - 10.1007/s12671-021-01806-2
M3 - Article
AN - SCOPUS:85122304719
SN - 1868-8527
VL - 13
SP - 449
EP - 461
JO - Mindfulness
JF - Mindfulness
IS - 2
ER -