TY  - JOUR
A1  - Üçeyler, Nurcan
A1  - Kewenig, Susanne
A1  - Kittel-Schneider, Sarah
A1  - Fallgatter, Andreas J.
A1  - Sommer, Claudia
T1  - Increased cortical activation upon painful stimulation in fibromyalgia syndrome
JF  - BMC Neurology
N2  - Background
Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain and associated symptoms. We investigated cerebral activation in FMS patients by functional near-infrared spectroscopy (fNIRS).

Methods
Two stimulation paradigms were applied: a) painful pressure stimulation at the dorsal forearm; b) verbal fluency test (VFT). We prospectively recruited 25 FMS patients, ten patients with unipolar major depression (MD) without pain, and 35 healthy controls. All patients underwent neurological examination and all subjects were investigated with questionnaires (pain, depression, FMS, empathy).

Results
FMS patients had lower pressure pain thresholds than patients with MD and controls (p < 0.001) and reported higher pain intensity (p < 0.001). Upon unilateral pressure pain stimulation fNIRS recordings revealed increased bilateral cortical activation in FMS patients compared to controls (p < 0.05). FMS patients also displayed a stronger contralateral activity over the dorsolateral prefrontal cortex in direct comparison to patients with MD (p < 0.05). While all three groups performed equally well in the VFT, a frontal deficit in cortical activation was only found in patients with depression (p < 0.05). Performance and cortical activation correlated negatively in FMS patients (p < 0.05) and positively in patients with MD (p < 0.05).

Conclusion
Our data give further evidence for altered central nervous processing in patients with FMS and the distinction between FMS and MD.
KW  - fibromyalgia syndrome
KW  - depression
KW  - cortical activation
KW  - pain
KW  - near-infrared spectroscopy
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125230
VL  - 15
IS  - 210
ER  - 
TY  - JOUR
A1  - Üçeyler, Nurcan
A1  - Schließer, Mira
A1  - Evdokimov, Dimitar
A1  - Radziwon, Jakub
A1  - Feulner, Betty
A1  - Unterecker, Stefan
A1  - Rimmele, Florian
A1  - Walter, Uwe
T1  - Reduced midbrain raphe echogenicity in patients with fibromyalgia syndrome
JF  - PloS One
N2  - Objectives
The pathogenesis of fibromyalgia syndrome (FMS) is unclear. Transcranial ultrasonography revealed anechoic alteration of midbrain raphe in depression and anxiety disorders, suggesting affection of the central serotonergic system. Here, we assessed midbrain raphe echogenicity in FMS.

Methods
Sixty-six patients underwent transcranial sonography, of whom 53 were patients with FMS (27 women, 26 men), 13 patients with major depression and physical pain (all women), and 14 healthy controls (11 women, 3 men). Raphe echogenicity was graded visually as normal or hypoechogenic, and quantified by digitized image analysis, each by investigators blinded to the clinical diagnosis.

Results
Quantitative midbrain raphe echogenicity was lower in patients with FMS compared to healthy controls (p<0.05), but not different from that of patients with depression and accompanying physical pain. Pain and FMS symptom burden did not correlate with midbrain raphe echogenicity as well as the presence and severity of depressive symptoms.

Conclusion
We found reduced echogenicity of the midbrain raphe area in patients with FMS and in patients with depression and physical pain, independent of the presence or severity of pain, FMS, and depressive symptoms. Further exploration of this sonographic finding is necessary before this objective technique may enter diagnostic algorithms in FMS and depression.
KW  - midbrain
KW  - fibromyalgia
KW  - depression
KW  - pain
KW  - ultrasound imaging
KW  - neuropathic pain
KW  - diagnostic medicine
KW  - migraine
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300639
VL  - 17
IS  - 11
ER  -