Explosive Synchronization: Could It Be Causing Your Fibromyalgia Pain?

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We've known for a long time that fibromyalgia involves abnormal hypersensitivity. The most obvious thing we're hypersensitive to is pain, but it doesn't stop there—heat, coldnoise, lightssmells, crowds, motion, chaos also cause discomfort.

Hypersensitivity in fibromyalgia isn't the same things as being "too sensitive" in the way people usually mean when they throw that phrase around. It's not that we're emotionally fragile, it's that our physiological response is bigger than most people's, and over the years researchers have learned more about how the brains of people with fibromyalgia respond—or rather, over-respond—to changes going on around us.

This hyper-responsiveness, when it has to do with pain, is called hyperalgesia. Conditions that include this feature have recently been classified under the umbrella of central sensitivity syndromes since the symptom stems from dysfunction in the central nervous system.

Ongoing research gives us insight into why and how we have this exaggerated response. Researchers from the University of Michigan and South Korea's Pohang University of Science and Technology say they've found evidence of something called "explosive synchronization" in the brains of people with fibromyalgia.

What Is Explosive Synchronization?

Explosive synchronization (ES) is something that's found in some natural networks. Until recently, it was the domain of physicists, not medical doctors. This research, published in the journal Scientific Reports, documents only the second discovery of this phenomenon in the human brain.

In ES, even little things can lead to a dramatic reaction throughout the network, which in this case is the brain. Other examples are a power grid, where everything can be shut down rapidly, or seizures, in which multiple areas of the brain turn on rapidly.

Typically, the brain responds in a more gradual way, with electrical impulses moving from one region to another, rather than multiple regions responding at once like they do in ES.

While the importance of this might not be immediately recognized by most of us, the researchers say this avenue of research could help them determine how someone develops this condition. That could lead to new treatment options that target ES, as well.

"As opposed to the normal process of gradually linking up different centers in the brain after a stimulus, chronic pain patients have conditions that predispose them to link up in an abrupt, explosive manner," said the study's first author UnCheol Lee, Ph.D., of the University of Michigan medical school.

The Study

This was a small study, involving only ten women with fibromyalgia. (However, it's normal for initial studies to be small and, if promising, they can lead to larger studies down the road.)

Electroencephalogram, a type of brain scan, showed hypersensitive and unstable networks in the brain, researchers said. They also noted that the more pain the participant was in at the time of testing, the greater the ES was in their brains.

They used the data to create a computer model of fibromyalgia brain activity so they could compare it to that of a normal brain. They found that the fibromyalgia model was more sensitive to electrical stimulation than other models, which is what they expected based on their earlier findings.

The computer modeling allows doctors to do extensive testing to determine what regions of the brain are most responsible for the ES. Then, those regions could be targeted in people using noninvasive brain modulation therapies.

“This study represents an exciting collaboration of physicists, neuroscientists, and anesthesiologists. The network-based approach, which can combine individual patient brain data and computer simulation, heralds the possibility of a personalized approach to chronic pain treatment,” said George Mashour, M.D., Ph.D., who was a co-senior author of the paper.

The Underlying Mechanism

When doctors set out to understand a condition, the "underlying mechanism" of that condition is an important thing to figure out. It's the answer to why the body is behaving as it is.

Without understanding the underlying mechanism, it's like trying to repair a broken car without knowing which part is broken. If ES is the underlying mechanism behind the hypersensitivity of fibromyalgia, then treating ES would be far more effective than using drugs to dull the pain—it could, finally, be the thing that goes beyond the symptoms and corrects the physiology that's gone awry.

Of course, one small study is never conclusive. It'll take years of work to know for sure whether this theory is accurate, and then more time to figure out the best ways to treat it. However, if these researchers are right, this could be a crucial first step toward better outcomes for people with fibromyalgia.

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