Widespread muscle and tissue pain, tenderness, and fatigue are well-documented symptoms of fibromyalgia, a chronic condition that affects up to an estimated 6% of the U.S. population. The underlying pathology of the pain disease is unknown. A new study featuring proton MR spectroscopy, however, has found a key linkage between the pain and a specific brain molecule.
Widespread muscle and tissue pain, tenderness, and fatigue are well-documented symptoms of fibromyalgia, a chronic condition that affects up to an estimated 6% of the U.S. population. The underlying pathology of the pain disease is unknown. A new study featuring proton MR spectroscopy, however, has found a key linkage between the pain and a specific brain molecule.
Researchers at the University of Michigan Health System found pain in patients with fibromyalgia decreased when levels of glutamate went down. The main strength of the study was a novel approach using proton MR spectroscopy (H1-MRS) to obtain insight into brain metabolism.
"No one has used the intervention that we used,'' said lead author Richard E. Harris, Ph.D., a research assistant professor in the rheumatology division of the U-M Medical School's internal medicine department. "It gives you an idea of a specific molecule in the brain being involved in a pathology of the disease, and that's information we didn't have before."
The results of the study, published in Arthritis and Rheumatism, could be useful to researchers looking for new drugs that treat fibromyalgia. Dr. Daniel J. Clauw, director of the U-M Chronic Pain and Fatigue Research Center, was senior author of the study.
"It's possible that specialists might be able to use glutamate as a biomarker for this condition for clinical research purposes," Harris said. "Glutamate might be able to be combined with PET or functional MRI, where you use the level of neurotransmitter concentration in individuals as a covariate of other imaging results."
Glutamate was suspected to play a role in fibromyalgia because previous studies had shown that some brain regions, particularly the insula, appear to be highly excited. In previous fMRI studies, researchers had shown that the insula displays augmented activity in fibromyalgia. Harris's team hypothesized that more activity among these neurons might be related to the level of glutamate in this region.
To gauge the linkage between pain and glutamate, the researchers used H1-MRS on 21 patients with fibromyalgia and 27 healthy controls. The use of 2D chemical shift imaging H1-MRS, as opposed to single-voxel methods, allowed the team to simultaneously assess a greater number of brain regions, the report said.
H1-MRS was performed once before and once following a four-week course of acupuncture or "sham" acupuncture to reduce pain symptoms. Following the four weeks of treatment, patients reported reductions in both clinical and experimental pain.
The outcome was linked with reductions in glutamate levels in the insula: Patients with greater reductions in pain showed greater reductions in glutamate.
For more information from the Diagnostic Imaging archives:
Proton MR spectroscopy monitors neural progenitor cells in human brain
Report from SIR: fMRI predicts response to treatment for liver cancer
Stay at the forefront of radiology with the Diagnostic Imaging newsletter, delivering the latest news, clinical insights, and imaging advancements for today’s radiologists.
The Reading Room Podcast: A Closer Look at Remote MRI Safety, Part 2
July 25th 2025In the second of a multi-part podcast episode, Emanuel Kanal, M.D. and Tobias Gilk, MRSO, MRSE, share their perspectives on remote MRI safety protocols for ensuring screening accuracy and adherence to conditional implant guidelines as well as a rapid and effective response to adverse events.
Study Reveals Significant Prevalence of Abnormal PET/MRI and Dual-Energy CT Findings with Long Covid
July 22nd 2025In a prospective study involving nearly 100 patients with Long Covid, 57 percent of patients had PET/MRI abnormalities and 90 percent of the cohort had abnormalities on dual-energy CT scans.
The Reading Room Podcast: Current and Emerging Insights on Abbreviated Breast MRI, Part 2
July 23rd 2025In the second part of a multi-part podcast episode, Stamatia Destounis, MD, Emily Conant, MD and Habib Rahbar, MD, discuss key sequences for abbreviated breast MRI and how it stacks up to other breast cancer screening modalities.
Stroke MRI Study Assesses Impact of Motion Artifacts Upon AI and Radiologist Lesion Detection
July 16th 2025Noting a 7.4 percent incidence of motion artifacts on brain MRI scans for suspected stroke patients, the authors of a new study found that motion artifacts can reduce radiologist and AI accuracy for detecting hemorrhagic lesions.