Neurophysiological correlates of disorder-specific autobiographical memories in patients with fibromyalgia syndrome

Summary

In addition to disorder etiology, an understanding of maintaining mechanisms is central to the treatment of mental disorders. While numerous studies are available on physical, cognitive, and emotional aspects of the fibromyalgia syndrome (FMS), research is still needed regarding the interplay of these factors. The proposed study will examine whether chronic pain in FMS has an affect-regulation function by decreasing access to emotionally distressing memory material. Previous research has shown that the experience of acute pain is associated with a preference for negative memories, which in turn could exacerbate and maintain pain. To date, only one study has examined autobiographical memory in patients with FMS and found that patients retrieved fewer specific autobiographical memories with increased negative emotional valence compared with healthy women. Moreover, the memories retrieved by patients hardly referred to pain, suggesting functional avoidance in terms of affective dysregulation. Therefore, non-specific memories generated in response to disorder-related stimuli might be a promising pathophysiological concept in FMS fostering the chronification of pain. Non-specific memories could also trigger increased stress or represent an underlying mechanism for cognitive dysfunction. Therefore, the study of non-specific memories in FMS may provide an opportunity to better understand the relationship between pain, cognitive function, and non-specific memories. A cross-sectional fMRI (functional magnetic resonance imaging) will be performed in n = 55 female patients with FMS and compared with n = 55 healthy women in order to investigate the neural activation patterns generated during retrieval of pain-related memories. The study tests the hypotheses that FMS patients report a lower number of autobiographical memories, (1) which are less specific during pain-related memories compared to healthy women, (2) and which trigger reduced self-referential neural processing in fMRI, characterized by hyperactive emotional processing as well as impaired connectivity. Furthermore, Ecological Momentary Assessment (EMA) is used (3) to explore a relationship between specificity of pain-related memory retrieval and chronicity/severity of pain in FMS patients, with neural processing during memory retrieval acting as a mediating factor.