Subtle changes of gray matter volume in fibromyalgia reflect chronic musculoskeletal pain rather than disease‐specific effects

Fibromyalgia syndrome (FMS) is a chronic pain syndrome. Neuroimaging studies provided evidence of altered gray matter volume (GMV) in FMS but, similarly, in chronic pain of other origin as well. Therefore, the purpose of this study was to evaluate the disease specificity of GMV alterations in FMS by direct comparison. Structural MRI data of the brain were acquired in 25 females with FMS and two different control groups: 21 healthy subjects and 23 patients with osteoarthritis. Regional GMVs were compared by voxel‐based morphometry and additional ROI‐analyses. In conclusion, we did not identify significant GMV alterations in either FMS or OA patients compared to healthy controls when adopting a conservative statistical approach with multiple comparison correction. However, even under a more liberal approach no FMS‐specific GMV changes were found because both pain groups presented increased gray matter volumes in the precentral gyrus and decreased GMV in the angular gyrus/middle occipital gyrus and middle temporal gyrus in comparison with healthy controls. Since no differences between both pain groups could be detected cortical GMV changes in FMS should not be interpreted as FMS‐specific but might rather reflect changes in chronic pain in general. This previously held notion is confirmed in this study by direct comparison with a control group consisting of another pain disorder. In fibromyalgia syndrome (FMS), altered gray matter volume (GMV) has been shown but with missing disease specificity. Regional voxel‐based morphometry showed increased GMV in the precentral gyrus and decreased GMV in the angular and middle temporal gyrus in patients with FMS and another pain group in comparison with healthy controls. Since no GMV differences between both pain groups were obvious, cortical changes in FMS are not disease‐specific but reflect alterations of chronic pain in general.