Self-regulation of Real-time fMRI Brain Activity in Chronic Pain: A Potential Neurobiological Mechanism of Cognitive Behavioral Therapy
Brigham and Women's Hospital
Summary
This study aims to explore the usefulness of self-regulation of brain activity in patients with fibromyalgia. Patients will use real-time functional magnetic resonance imaging (fMRI) neurofeedback to observe and regulate their own brain activity while applying mental strategies to reduce fibromyalgia pain. The study consists of 2 magnetic resonance imaging (MRI) visits that involve brain neuroimaging for fMRI neurofeedback tasks, as well as 8 weekly intervention sessions with a pain psychologist. Patients will be randomized to either Cognitive Behavioral Therapy (CBT) or Fibromyalgia Education groups.
Description
Pain catastrophizing-a negative cognitive and emotional process that involves helplessness, rumination, and magnification of pain complaints-is the most consistent psychosocial factor predicting deleterious outcomes in chronic musculoskeletal pain, including fibromyalgia. We will use real-time functional magnetic resonance imaging (fMRI) neurofeedback as a research probe to elucidate the neurological mechanisms underlying self-regulation of pain catastrophizing in individuals with fibromyalgia. Investigators will recruit patients diagnosed with fibromyalgia. In the baseline magnetic resonance…
Eligibility
- Age range
- 18–65 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Aged 18-65 2. Meet the Wolfe et al 2011 research criteria for fibromyalgia for at least one year 3. On stable doses of medication prior to entering the study and agree not to change medications or dosages (or CAM treatments) during the trial 4. Baseline pain intensity of at least 4/10 on average and pain report for at least 50% of days 5. Able to provide written consent and fluent in English Exclusion Criteria: 1. Comorbid acute pain condition 2. Comorbid chronic pain condition that is rated by the subject as more painful than fibromyalgia 3. Stimulant medications for…
Interventions
- BehavioralCognitive Behavioral Therapy
Practicing certain cognitive and behavioral pain self-management strategies such as relaxation and changing negative thoughts about pain.
- BehavioralDisease Education
Providing information about fibromyalgia, including its potential causes and management approaches.
Location
- Athinoula A. Martinos Center for Biomedical ImagingBoston, Massachusetts