Background and purpose: Fibromyalgia is a commonly observed pain disorder linked to cognitive impairments, encompassing challenges in attention, memory, and executive processing. It has been proposed that fibromyalgia may be caused by changes in attention network. However, the neural network mechanisms underlying the relationship between the intrinsic fluctuations of functional connectivity in the brain network and clinical symptoms remain unclear.
Methods: 46 fibromyalgia patients and 36 healthy controls underwent resting-state functional MRI (rs-fMRI). We employed static functional network connectivity (sFNC) and dynamic functional network connectivity (dFNC) to investigate the potential relationship between alterations in sensory integration and attention networks in fibromyalgia and clinical features.
Results: Patients with fibromyalgia had reduced functional connectivity within the visual network (VIN), the auditory network (AUN), the default mode network (DMN), and the sensorimotor network (SMN). The decrease in functional connectivity in VIN and DMN was correlated with pain levels, while an increase in functional connectivity between SMN and the posterior dorsal attention network (DAN) was associated with symptoms. dFNC further observed that patients in state 4 show increased functional coupling between the ventral attention network (VAN) and both SMN and DMN, and the number of transitions between states positively correlated with pain levels.
Conclusion: dFNC offered additional insights for understanding the pathophysiological mechanisms underlying fibromyalgia. Fibromyalgia patients exhibited increased in the attention network and reduced functionality in visual and auditory networks, which might contribute to the diminished attention towards external environmental stimuli and heightened sensitivity self-perception sensations observed in fibromyalgia.