The effects of a 15-week physical exercise intervention on pain modulation in fibromyalgia : Increased pain-related processing within the cortico-striatal- occipital networks, but no improvement of exercise-induced hypoalgesia.

• Dysfunctional top-down pain modulation is a hallmark of fibromyalgia (FM) and physical exercise is a cornerstone in FM treatment. The aim of this study was to explore the effects of a 15-week intervention of strengthening exercises, twice per week, supervised by a physiotherapist, on exercise-induced hypoalgesia (EIH) and cerebral pain processing in FM patients and healthy controls (HC). FM patients (n = 59) and HC (n = 39) who completed the exercise intervention as part of a multicenter study were examined at baseline and following the intervention. Following the exercise intervention, FM patients reported a reduction of pain intensity, fibromyalgia severity and depression. Reduced EIH was seen in FM patients compared to HC at baseline and no improvement of EIH was seen following the 15-week resistance exercise intervention in either group. Furthermore, a subsample (Stockholm site: FM n = 18; HC n = 19) was also examined with functional magnetic resonance imaging (fMRI) during subjectively calibrated thumbnail pressure pain stimulations at baseline and following intervention. A significant main effect of exercise (post > pre) was observed both in FM patients and HC, in pain-related brain activation within left dorsolateral prefrontal cortex and caudate, as well as increased functional connectivity between caudate and occipital lobe bordering cerebellum (driven by the FM patients). In conclusion, the results indicate that 15-week resistance exercise affect pain-related processing within the cortico-striatal-occipital networks (involved in motor control and cognition), rather than directly influencing top-down descending pain inhibition. In alignment with this, exercise-induced hypoalgesia remained unaltered.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Physiotherapy (hsv//eng)

Nyckelord

AAL

Automated Anatomical Labeling

ACR

American College of Rheumatology

CNS

central nervous system

CPM

conditioned pain modulation

EIH

exercise-induced hypoalgesia

Exercise induced hypoalgesia

Exercise intervention

FD

Frame-wise displacement

FEW

family-wise error

FIQ

Fibromyalgia Impact Questionnaire

FM

fibromyalgia

FOV

field of view

FWHM

full-width-half-maximum

Fibromyalgia

Functional connectivity

Functional magnetic resonance imaging (fMRI)

GLM

general linear model

HADS

Hospital Anxiety and Depression Scale

HC

healthy controls

MNI

Montreal Neurological Institute

MVC

maximum voluntary contraction force

NSAIDs

non-steroidal anti-inflammatory drugs

P50

pressure stimuli corresponding to a pain rating of 50mm on a 100 mm VAS

PPI

psychophysiological interaction

PPTs

pressure pain thresholds

Pressure pain

RM

repetition maximum

SM

stimulation maximum

SPM

Statistical Parametric Mapping

T1

longitudinal relaxation time

T2

transverse relaxation time

TR/TE

time repetition/time echo

VAS

visual analogue scale

VOI

volume of interest

dlPFC

dorsolateral prefrontal cortex

fMRI

functional magnetic resonance imaging

rACC

rostral anterior cingulate cortex

Exercise induced hypoalgesia

Exercise intervention

Fibromyalgia

Functional connectivity

Functional magnetic resonance imaging (fMRI)

Pressure pain

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)