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. Author manuscript; available in PMC: 2020 Oct 1.
Published in final edited form as: Curr Opin Physiol. 2019 Jun 18;11:67–74. doi: 10.1016/j.cophys.2019.06.006

Figure 2.

Figure 2.

(A) Higher degree of intrinsic connectivity is seen between the default mode network (DMN) and the insula in people with fibromyalgia (FM). Intrinsic DMN connectivity to the right (R) anterior and middle insula was correlated greater spontaneous pain intensity on a visual analog scale (VAS) at the time of the fMRI. Red circles represent individuals with FM. Reproduced with permission(73). (B) Increased activity in the anterior and posterior middle cingulate cortex (MCC) measured by standardized uptake value ratio (SUVR) was found for individuals with FM reporting higher levels of fatigue on the American College of Rheumatology (ACR) fibromyalgia diagnostic criteria. There were no other significant associations between SUVR at these cortical sites and any other clinical variable. Reproduced with permission from(83). (C) Blockade of the serotonin transporter by 20 nmol of fluoxetine injected in the rostral ventromedial medulla (RVM) 24 hours after the second acid injection resulted in a reversal of hyperalgesia measured by muscle withdrawal thresholds in the acid hyperalgesic priming model. Reproduced from(103). Immunohistochemical staining of SERT in the nucleus raphe obscurus (NRO), nucleus raphe pallidus (NRP) and nucleus raphe magnus (NRM) in naïve and WT mice 24 hours after induction of activity-induced hyperalgesia priming model. There was an increase in the SERT immunoreactivity in the NRO, NRM and NRP of the RVM in WT mice following induction of the model. Reproduced with permission from(104). (D) Blockade of ERK with the MEK inhibitor during the priming injection prevented development of hyperalgesia after the second injection. Photomicrographs show immunohistochemical staining for phosphorylated extracellular signal-related kinases (pERK) in the dorsal horn of the spinal cord 2 hours after the acid priming injection. The bar graphs show a significant increase in the number of cells labeled with p-ERK after the first priming injection compared to pH 7.2 injection. Reproduced with permission from(107).