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Updated: Jul 20, 2026
A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
Published on: January 5, 2024
99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia
Eric Guedj1, David Taieb, Serge Cammilleri
1Service Central de Biophysique et de Médecine Nucléaire, Assistance Publique des Hôpitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France. eric.guedj@ap-hm.fr
Fibromyalgia patients show altered brain blood flow, with sensory areas overactive and others underactive. This brain imaging study suggests SPECT scans can help personalize pain management strategies.
Area of Science:
- Neuroscience
- Medical Imaging
- Rheumatology
Background:
- Previous SPECT studies in fibromyalgia (FM) showed limited subcortical hypoperfusion.
- Technetium Tc 99m ethyl cysteinate dimer (99mTc-ECD) SPECT offers superior evaluation of high cerebral blood flow areas.
- Fibromyalgia is characterized by widespread hyperalgesia and complex pain processing.
Purpose of the Study:
- To investigate brain perfusion patterns in hyperalgesic FM patients using 99mTc-ECD SPECT.
- To identify brain regions associated with spontaneous pain processing in FM.
- To explore the utility of SPECT in guiding FM treatment.
Main Methods:
- Eighteen women with FM and ten healthy controls underwent 99mTc-ECD SPECT.
- Voxel-by-voxel group analysis was performed using SPM2 with correction for multiple comparisons.
- Pain intensity was assessed using the Visual Analogue Scale (VAS).
Main Results:
- FM patients exhibited significant hyperperfusion in the somatosensory cortex compared to controls.
- Hypoperfusion was observed in the frontal, cingulate, medial temporal, and cerebellar cortices of FM patients.
- These findings were confirmed by SPM2 analysis.
Conclusions:
- FM involves altered brain perfusion, with sensory pain processing regions showing hyperperfusion and affective-attentional regions showing hypoperfusion.
- 99mTc-ECD SPECT may serve as a valuable tool for tailoring therapeutic strategies in FM.
- SPECT imaging could provide objective follow-up for pain processing recovery during treatment.
