Fibromyalgia has been a medical mystery for quite some time. Unlike other chronic medical conditions, there is no test or scan that can detect it; doctors can only make a diagnosis based on a patient’s reported symptoms.

However, a team of researchers at Mass General, in collaboration with a team form the Karolinska Institutet in Sweden, recently identified a pattern of inflammation in the brains of fibromyalgia patients that could be the key to diagnosing the elusive disorder.

Their insights could also provide much needed validation for fibromyalgia patients, who have often encountered skepticism about the legitimacy of their symptoms.

A Challenge to Diagnose

Patients with fibromyalgia often describe feeling pain throughout the body, fatigue, changes in mood, and difficulties with sleep and memory. These symptoms are said to come and go, as well as coexist with symptoms of other diseases, making a clear diagnosis difficult.

It is this elusive nature that has caused fibromyalgia to have a credibility issue. People experiencing fibromyalgia feel intense pain, but when doctors have tried to find the source they come up empty handed.

Keys goals of this recent research project were to find a scientifically validated way to diagnose fibromyalgia, track its progression, and find new potential targets for treatment. 

Targeting Brain Inflammation

Using a strategy that had previously been successful in identifying brain inflammation associated with chronic back pain, the team—led by Marco Loggia, PhD—used PET brain imaging technology to measure the activity levels of a key protein in astrocytes and microglia, two types of brain cells known as glial cells.

By comparing the imaging results of fibromyalgia patients to healthy controls, they found that fibromyalgia patients had increased inflammatory activity in several regions of the brain. Researchers suspect that this widespread inflammation could explain the complexity of fibromyalgia symptoms.

Furthermore, the levels of glial activation corresponded with patient-reported levels of fatigue. The higher the reported fatigue, the higher the levels of inflammation.

The researchers believe that this inflammation may increase the sensitivity of receptors related to pain and fatigue.

The discovery could also give researchers a way to measure the effectiveness of new therapies by measuring how inflammation levels change in response to treatment.

“Demonstrating inflammation in the brain of patients suffering from fibromyalgia has two implications.

“First, by showing that objective neurochemical changes can be observed, we provide validation to these patients that ‘their condition is real,’ a claim that is often met with skepticism and stigma by society and even some clinicians.

“Second, our results identify in neuroinflammation a novel therapeutic target, paving the way for novel treatments for this poorly-understood and difficult-to-treat condition.”

Marco Loggia, PhD
Martinos Center for Biomedical Imaging

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
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