Correlation of Brain Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging with the Severity of Clinical Symptoms in Fibromyalgia Patients

Background: Fibromyalgia is recognized as a chronic pain syndrome. Widespread pain is a common symptom in fibromyalgia, indicating a potential dysfunction in the processing of painful sensations in the central nervous system. Objectives: This study aimed to investigate changes in the severity of clinical symptoms in fibromyalgia patients and to evaluate the apparent diffusion coefficients and metabolites in the brain of these patients. Patients and Methods: This cross-sectional study included 28 female outpatients with complaints of widespread pain, who were diagnosed with fibromyalgia syndrome. Magnetic resonance imaging, magnetic resonance spectroscopy, and diffusion tensor examinations were applied to evaluate patients diagnosed with fibromyalgia before treatment. Results: The mean age of the patients included in this study was 39.1 ± 8.6 years (range, 24 - 55 years). A statistically significant strong positive correlation was found between the scores of the visual analog scale and the fibromyalgia impact questionnaire. Besides, significant associations were found between the scores of the visual analog scale and fibromyalgia impact questionnaire and the results of fractional anisotropy, apparent diffusion coefficient, and peak values of some metabolites in spectroscopy. Conclusion: The results of this study suggest that metabolites play an inhibitory or excitatory role in the central pain mechanisms of fibromyalgia as a chronic pain syndrome.