Functional connectivity of music-induced analgesia in fibromyalgia

Listening to self-chosen, pleasant and relaxing music reduces pain in fibromyalgia (FM), a chronic central pain condition. However, the neural correlates of this effect are fairly unknown and could be regarded as a more direct measure of analgesia. In our study, we wished to investigate the neural correlates of music-induced analgesia (MIA) in fibromyalgia patients. To do this, we studied 20 FM patients and 20 matched healthy controls (HC) acquiring rs-fMRI with a 3T MRI scanner, and pain data before and after two 5-min auditory conditions: music and noise. We performed resting state functional connectivity (rs-FC) seed-based correlation analyses (SCA) using pain and analgesia-related ROIs to determine the effects before and after the music intervention in FM and HC, and its correlation with pain reports. We found significant differences in baseline rs-FC between FM and HC. Both groups showed changes in rs-FC in several ROIs after the music condition between different areas, that were left lateralized in FM and right lateralized in HC. FM patients reported MIA that was significantly correlated with rs-FC decrease between the angular gyrus, posterior cingulate cortex and precuneus, and rs-FC increase between amygdala and middle frontal gyrus. These areas are related to autobiographical and limbic processes, and auditory attention, suggesting MIA may arise as a consequence of top-down modulation, probably originated by distraction, relaxation, positive emotion, or a combination of these mechanisms.