Universität zu Köln

Jensen, Karin B., Petzke, Frank, Carville, Serena, Choy, Ernest, Fransson, Peter ORCID: 0000-0002-1305-9875, Gracely, Richard H., Vitton, Olivier, Marcus, Hanke, Williams, Steven C. R., Ingvar, Martin ORCID: 0000-0002-9041-5714 and Kosek, Eva (2014). Segregating the Cerebral Mechanisms of Antidepressants and Placebo in Fibromyalgia. J. Pain, 15 (12). S. 1328 - 1338. EDINBURGH: CHURCHILL LIVINGSTONE. ISSN 1526-5900

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Abstract

Antidepressant drugs are commonly used to treat fibromyalgia, but there is little knowledge about their mechanisms of action. The aim of this study was to compare the cerebral and behavioral response to positive treatment effects of antidepressants or placebo. Ninety-two fibromyalgia patients participated in a 12-week, double-blind, placebo-controlled clinical trial with milnacipran, a serotonin-norepinephrine reuptake inhibitor. Before and after treatment, measures of cerebral pain processing were obtained using functional magnetic resonance imaging. Also, there were stimulus response assessments of pressure pain, measures of weekly pain, and fibromyalgia impact. Following treatment, milnacipran responders exhibited significantly higher activity in the posterior cingulum compared with placebo responders. The mere exposure to milnacipran did not explain our findings because milnacipran responders exhibited increased activity also in comparison to milnacipran nonresponders. Stimulus response assessments revealed specific antihyperalgesic effects in milnacipran responders, which was also correlated with reduced clinical pain and with increased activation of the posterior cingulum. A short history of pain predicted positive treatment response to milnacipran. We report segregated neural mechanisms for positive responses to treatment with milnacipran and placebo, reflected in the posterior cingulum. The increase of pain-evoked activation in the posterior cingulum may reflect a normalization of altered default mode network processing, an alteration implicated in fibromyalgia pathophysiology. Perspective: This study presents neural and psychophysical correlates to positive treatment responses in patients with fibromyalgia, treated with either milnacipran or placebo. The comparison between placebo responders and milnacipran responders may shed light on the specific mechanisms involved in antidepressant treatment of chronic pain. (C) 2014 by the American Pain Society

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jensen, Karin B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Petzke, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Carville, Serena UNSPECIFIED UNSPECIFIED UNSPECIFIED Choy, Ernest UNSPECIFIED UNSPECIFIED UNSPECIFIED Fransson, Peter UNSPECIFIED orcid.org/0000-0002-1305-9875 UNSPECIFIED Gracely, Richard H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vitton, Olivier UNSPECIFIED UNSPECIFIED UNSPECIFIED Marcus, Hanke UNSPECIFIED UNSPECIFIED UNSPECIFIED Williams, Steven C. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ingvar, Martin UNSPECIFIED orcid.org/0000-0002-9041-5714 UNSPECIFIED Kosek, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-422650
DOI:	10.1016/j.jpain.2014.09.011
Journal or Publication Title:	J. Pain
Volume:	15
Number:	12
Page Range:	S. 1328 - 1338
Date:	2014
Publisher:	CHURCHILL LIVINGSTONE
Place of Publication:	EDINBURGH
ISSN:	1526-5900
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEFAULT-MODE NETWORK; DOUBLE-BLIND; PAIN MODULATION; BRAIN; DULOXETINE; OSTEOARTHRITIS; SENSITIVITY; MILNACIPRAN; EFFICACY Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42265