In a recent randomized clinical trial of patients with fibromyalgia, cognitive behavioral therapy (CBT), which uses structured techniques to alter distorted thoughts and negative moods, was superior to a combined educational treatment in reducing the interference effects of pain and other aspects of fibromyalgia in daily life.
Within the group that received CBT in the trial, published in Arthritis & Rheumatology , the improvements were, at least in part, attributable to reductions in what is known as catastrophizing , a state composed of cognitive and emotional processes such as helplessness, rumination, and magnification. from pain.
Neuroimaging evidence indicated that CBT exerts these effects by altering the connectivity of specific brain regions. Therefore, changes in brain circuits underlying catastrophic pain may support the benefits of CBT for patients with fibromyalgia, a condition characterized by function-altering symptoms such as widespread pain, fatigue, cognitive difficulties, and psychosocial distress.
"These findings contribute to a growing literature highlighting the benefits of non-pharmacological treatments, including CBT, for chronic pain conditions such as fibromyalgia," said corresponding author Jeungchan Lee, PhD, of Spaulding Rehabilitation Hospital and the School of Medicine. from Harvard. "Identifying the multiple biopsychosocial mechanisms through which these treatments help relieve pain may help facilitate the practice of precision pain medicine and improve treatment outcomes for the many patients suffering from chronic pain."
Conclusion Our results suggest clinically important and CBT-specific associations between somatosensory/motor and salience processing brain regions and the default mode network in chronic pain. These connectivity patterns may contribute to individual differences (and treatment-related changes) in somatic self-awareness. CBT appears to provide clinical benefits, at least partially, by reducing pain-related catastrophizing and producing adaptive alterations in default mode network functional connectivity. |
Reference: URL: https://onlinelibrary.wiley.com/doi/10.1002/art.42672
