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Updated: Aug 22, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Disrupted White Matter Microstructure in Patients With Fibromyalgia Owing Predominantly to Psychological Factors: A
Ye Tu1, Jihong Wang1, Fei Xiong2
1Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background:
Neuroimaging investigations have already uncovered alterations to cerebral microstructural integrity in patients with fibromyalgia (FM). In the meantime, these patients commonly suffer from depression and anxiety.
Objective:
In this study, microstructure changes within white matter were examined in patients with FM with consideration of concurrent physiological factors.
Study Design:
A cross-sectional case-control study.
Setting:
A university hospital.
Methods:
Diffusion tensor imaging was performed on 20 patients with FM and 20 healthy controls. The 4 diffusional indices, namely, fractional anisotropy (FA), mean, radial, and axial diffusivity (MD, RD, AD) were calculated using tract-based spatial statistics. The relationships between the diffusional parameters and pain scales were also examined.
Results:
The patients with FM exhibited enhanced FA, reduced MD, RD, and AD in numerous white matter tracts, including the corpus callosum, corona radiata, internal capsule, corticospinal tract, posterior thalamic radiation, cerebellar peduncle, sagittal stratum, and superior fronto-occipital fasciculus. When depression and anxiety were added as covariates, most between-group diffusional difference disappeared except for AD reduction in the corona radiate, internal capsule, and cerebellar peduncle (P < 0.05, threshold-free cluster enhancement corrected). The diffusion tensor imaging measures were not correlated with clinical variables.
Limitation:
A relatively small sample size.
Conclusion:
Our results demonstrate that disrupted white matter microstructure in patients with FM is mainly restricted to tracts associated with pain sensory processing and motor control, adjusting for psychosocial factors. A considerable degree of difference in white matter characteristics may be explained by the patients with FM group's greater level of psychological distress.
Insights
Fibromyalgia patients show altered white matter integrity, particularly in sensory and motor pathways. Psychological distress significantly explains these neuroimaging differences, not clinical pain levels.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Neuroimaging studies reveal cerebral microstructural integrity alterations in fibromyalgia (FM) patients.
- Fibromyalgia is frequently accompanied by depression and anxiety.
Purpose of the Study:
- To investigate white matter microstructure changes in FM patients.
- To assess the influence of concurrent psychological factors on these changes.
Main Methods:
- Diffusion tensor imaging (DTI) was used on 20 FM patients and 20 healthy controls.
- Calculated fractional anisotropy (FA), mean, radial, and axial diffusivity (MD, RD, AD) using tract-based spatial statistics.
- Examined relationships between diffusion parameters and pain scales.
Main Results:
- FM patients displayed altered FA, MD, RD, and AD in multiple white matter tracts.
- Most differences diminished when accounting for depression and anxiety, except for axial diffusivity (AD) reduction in specific tracts.
- DTI measures did not correlate with clinical variables.
Conclusions:
- Disrupted white matter microstructure in FM is primarily linked to pain processing and motor control tracts, independent of psychosocial factors.
- Psychological distress significantly contributes to observed white matter differences in FM patients.
