Mudanças comportamentais e alterações de espessura cortical em longo prazo em mulheres com fibromialgia

Abstract

Introduction: Fibromyalgia is a chronic pain syndrome of central origin, characterized by widespread musculoskeletal pain, fatigue, cognitive alterations, and sleep disturbances. Classified as a nociplastic condition, the syndrome does not result from inflammatory processes or structural lesions, but rather from dysfunctions in central pain modulation mechanisms. In addition, studies indicate that emotional and cognitive factors, such as attention, motivation, and catastrophizing, modulate the pain experience in these patients. Objectives: The aim of this study was to examine long-term brain and behavioral alterations in patients with fibromyalgia (FM) compared to healthy individuals. Methods: Data from 33 female volunteers with FM and 33 age- and education-matched healthy women were analyzed to assess cortical thickness using high-resolution T1-weighted magnetic resonance imaging (MRI) acquired on a 3T scanner. Furthermore, the Toronto Alexithymia Scale, the Positive and Negative Affect Schedule (PANAS), the Emotion Regulation Questionnaire (ERQ), and the Hamilton Depression and Anxiety Rating Scales were used to evaluate behavioral alterations. Results: The findings indicated significant differences in cortical structure in the right cerebral hemisphere between groups, specifically in the anterior insular cortex, precentral gyrus, and postcentral gyrus (p<0.001). No differences were found in the left hemisphere. The FM group scored higher in alexithymia (p<0.01), negative affect (p<0.01), anxiety symptoms (p<0.01), and depression (p<0.01), and lower in positive affect (p<0.01). Moreover, a negative correlation was observed between the right anterior insular cortex and the Toronto Alexithymia Scale (p<0.001). Conclusion: This study demonstrated long-term brain and behavioral alterations in FM patients, suggesting notable neurophysiological changes associated with this chronic pain condition. The study provides new insights into how FM may affect brain health and highlights potential biomarkers for the condition.