CBTs provided a small incremental benefit over control interventions in reducing pain , negative mood and disability at the end of treatment and at long-term follow-up .
The dropout rates due to any reason did not differ between CBTs and controls
BACKGROUND Fibromyalgia ( FM ) is a clinical ly well-defined chronic condition of unknown aetiology characterized by chronic widespread pain that often co-exists with sleep disturbances , cognitive dysfunction and fatigue .
Patients often report high disability levels and negative mood .
Psychotherapies focus on reducing key symptoms , improving daily functioning , mood and sense of personal control over pain .
OBJECTIVES To assess the benefits and harms of cognitive behavioural therapies ( CBTs ) for treating FM at end of treatment and at long-term ( at least six months ) follow-up .
Cognitive Behavioral Therapy increases pain-evoked activation of the prefrontal cortex in patients with fibromyalgeia
Summary Treatment with Cognitive Behavioral Therapy leads to clinical improvements in fibromyalgia patients , paired with increased activity and connectivity in the brain ’s pain modulatory regions . ABSTRACT Interventions based on Cognitive Behavioral Therapy ( CBT ) are widely used to treat chronic pain , but the brain mechanisms responsible for these treatment effects are poorly understood . The aim of this study was to vali date the relevance of the cortical control theory in response to an exposure‐based form of CBT , Acceptance and Commitment Therapy , in patients with chronic pain . Forty‐three female patients diagnosed with fibromyalgia syndrome were enrolled in a r and omized , 12‐week , waiting‐list controlled clinical trial  ( CBT n = 25 ; controls n = 18 ) . CBT was administered in groups of six patients during 12 weekly sessions . Functional magnetic resonance imaging ( fMRI ) during pressure‐evoked pain was assessed before and after treatment or the 12‐week period .  Self‐report question  naires of depression and anxiety  were administered pre‐ and posttreatment as well as 3 months following end of treatment . Patients treated with CBT reported larger improvement of fibromyalgia on the Patient Global Impression of Change measure , and improved depression and anxiety symptoms , compared to the waiting‐list controls . However , there were no effects on clinical pain or pain sensitivity measures . An analysis of fMRI scans revealed that CBT led to increased activations in the ventrolateral prefrontal/lateral orbitofrontal cortex ; regions associated with executive cognitive control . We suggest that CBT changes the brain ’s processing of pain through an altered cerebral loop between pain signals , emotions , and cognitions ; leading to increased access to executive regions for re appraisal of pain . Our data thereby support our hypothesis about the activation of a cortical control mechanism in response to CBT treatment in chronic pain
CBTs provided a small incremental benefit over control interventions in reducing pain , negative mood and disability at the end of treatment and at long-term follow-up .
The dropout rates due to any reason did not differ between CBTs and controls
BACKGROUND Fibromyalgia ( FM ) is a clinical ly well-defined chronic condition of unknown aetiology characterized by chronic widespread pain that often co-exists with sleep disturbances , cognitive dysfunction and fatigue .
Patients often report high disability levels and negative mood .
Psychotherapies focus on reducing key symptoms , improving daily functioning , mood and sense of personal control over pain .
OBJECTIVES To assess the benefits and harms of cognitive behavioural therapies ( CBTs ) for treating FM at end of treatment and at long-term ( at least six months ) follow-up .