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Hum Brain Mapp. 2016 May;37(5):1749-58. doi: 10.1002/hbm.23132. Epub 2016 Feb 11.

Coordinate-based (ALE) meta-analysis of brain activation in patients with fibromyalgia.

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Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany.
Department of Neurology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr Universität Bochum, Bochum, Germany.
Department of Clinical Radiology, University Hospital Münster, Münster, Germany.
Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Germany.
Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany.
Department of Anesthesiology, Pain Medicine, University Hospital Göttingen, Göttingen, Germany.
Department of Anesthesiology, Chronic Pain and Fatigue Research, University of Michigan, Michigan.
Research Institute of Health Sciences, University of Balearic Islands, Palma, Spain.


There are an increasing number of neuroimaging studies that allow a better understanding of symptoms, neural correlates and associated conditions of fibromyalgia. However, the results of these studies are difficult to compare, as they include a heterogeneous group of patients, use different stimulation paradigms, tasks, and the statistical evaluation of neuroimaging data shows high variability. Therefore, this meta-analytic approach aimed at evaluating potential alterations in neuronal brain activity or structure related to pain processing in fibromyalgia syndrome (FMS) patients, using quantitative coordinate-based "activation likelihood estimation" (ALE) meta-analysis. 37 FMS papers met the inclusion criteria for an ALE analysis (1,264 subjects, 274 activation foci). A pooled ALE analysis of different modalities of neuroimaging and additional analyses according functional and structural changes indicated differences between FMS patients and controls in the insula, amygdala, anterior/mid cingulate cortex, superior temporal gyrus, the primary and secondary somatosensory cortex, and lingual gyrus. Our analysis showed consistent results across FMS studies with potential abnormalities especially in pain-related brain areas. Given that similar alterations have already been demonstrated in patients with other chronic pain conditions and the lack of adequate control groups of chronic pain subjects in most FMS studies, it is not clear however, whether these findings are associated with chronic pain in general or are unique features of patients with FMS. Hum Brain Mapp 37:1749-1758, 2016.


activation likelihood analysis; brain imaging; descending pain modulation system; fibromyalgia; meta-analysis; pain

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