Regional cerebral blood flow changes in women with fibromyalgia in relation to depression scores

Objectives Different changes in regional cerebral blood flow (rCBF) have been reported in Fibromyalgia (FM). A relation between FM and depression has been sugested. Objective is to assess the presence rCBF changes in female patients with FM related and non related to depression scores using a voxel based method.

Methods 30 female patients (26-56 years) that fulfilled ACR criteria for FM were studied with 99mTc-ECD SPECT and compared to 20 normal female controls (26-59 years). None of them was under antidepressant/antiepileptic treatment. Results were analyzed by SPM5. Beck Depression Inventory (BDI) was applied to 23 of these patients and introduced as a covariate in a new analysis.

Results SPM5 detected bilateral thalamic hypoperfusion (p = 0.038 uncorrected cluster-level, p < 0.01 voxel-level with p < 0.001 for right thalamus). Analyzing only patients with BDI scores the same cluster was detected with a p value of 0.057. When introducing BDI as a covariate no significant clusters were detected but thalamic hypoperfusion disappeared with BDI as a nuisance variable.

Conclusions We found bilateral thalamic hypoperfusion in women with FM, probably related to alterations of sensorial/pain central processing pathways and consistent with some previous reports. Disappearance of thalamic hypoperfusion when controlling for BDI influence suggest the existence of a relation between brain disfunction in FM and depression