Fibromyalgia: Imaging Studies Find Cognitive Behavioral Therapy Reduces Pain Catastrophizing Interview with:
Jeungchan Lee, Ph.D.,
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129

Jeungchan Lee, Ph.D.,
Postdoctoral Research Fellow
MGH/HST Athinoula A. Martinos Center for Biomedical ImagingSpaulding Rehabilitation Hospital
Harvard Medical School
Charlestown, MA 024129 What is the background for this study?

Response: Cognitive behavioral therapy (CBT) has shown promise in alleviating fibromyalgia (FM) symptoms by targeting pain-related catastrophizing, which comprises negative cognitive and emotional processes amplifying pain perception.

However, the neurological mechanisms underlying CBT’s impact on pain catastrophizing in FM patients have remained unclear. What are the main findings?

Response: In this randomized controlled neuroimaging trial, Cognitive behavioral therapy demonstrated its superiority over an education-based treatment in reducing pain interference and improving the functional impact of fibromyalgia. Within the CBT group, these improvements were partly attributed to reductions in catastrophizing, a cognitive distortion associated with pain perception.

Additionally, Cognitive behavioral therapy treatment led to changes in the connectivity of the Default Mode Network (DMN) with pain-related brain circuitry, possibly indicating shifts in somatic self-awareness. What should readers take away from your report?

Response: Cognitive behavioral therapy (CBT) appears to yield clinical benefits by reducing pain-related catastrophizing and inducing adaptive changes in the functional connectivity of the default mode network in the brain. What recommendations do you have for future research as a result of this study?

Response: Future studies could enhance their methodology by incorporating long-term post-treatment neuroimaging assessments to better understand the underlying mechanisms of benefits and therapeutic components of cognitive behavioral therapy (CBT). Moreover, catastrophizing may serve as a vital phenotyping variable to guide treatment selection and as a crucial process variable for investigating brain activity and connectivity during the pain catastrophizing experiences that play a pivotal role in shaping long-term pain-related outcomes.

No potential conflicts of interest


Lee, J., Lazaridou, A., Paschali, M., Loggia, M.L., Berry, M.P., Ellingsen, D.-M., Isenburg, K., Anzolin, A., Grahl, A., Wasan, A.D., Napadow, V. and Edwards, R.R. (2023), A Randomized, Controlled Neuroimaging Trial of Cognitive-Behavioral Therapy for Fibromyalgia Pain. Arthritis Rheumatol. Accepted Author Manuscript.

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Last Updated on September 21, 2023 by