Self-perspective leads to increased activation of pain processing brain regions in fibromyalgia.

BACKGROUND: Dysfunction of central nervous pain processing is assumed to play a key role in primary fibromyalgia (FM) syndrome. This pilot study examined differences of pain processing associated with adopting different interpersonal perspectives. METHODS: Eleven FM patients and 11 healthy controls (HC) were scanned with functional magnetic resonance imaging. Participants were trained to take either a self-perspective or another person's perspective when viewing the visual stimuli. Stimuli showed body parts in painful situations of varying intensity (low, medium, and high) and visually similar but neutral situations. RESULTS: Patients with FM showed a higher increase in blood oxygen level dependent (BOLD) response, particularly in the supplementary motor area (SMA). All pain-related regions of interest (anterior insula, somatosensory cortices, anterior cingulate cortex, and SMA) showed stronger modulation of BOLD responses in FM patients in the self-perspective. In contrast to pain processing regions, perspective-related regions (e.g. temporoparietal junction) did not differ between FM and HC. CONCLUSIONS: The stronger response of all four pain processing cerebral regions during self-perspective is discussed in the light of disturbed bottom-up processing. Furthermore, the results confirm earlier reports of augmented pain processing in FM, and provide evidence for sensitization of central nervous pain processing.

Multi-delay coherence imaging spectroscopy optimized for ion temperature measurements in the divertor plasma of the Wendelstein 7-X stellarator.

A new coherence imaging spectroscopy (CIS) diagnostic optimized to measure the C2+ impurity ion temperature Ti spatial distribution in the divertor plasma of the W7-X stellarator is designed, tested, and validated. Using CIS to obtain Ti in the edge of magnetically confined plasmas has historically been challenging because Doppler broadening and Zeeman splitting have comparable effects on the shape of spectral emission lines. To distinguish between these two mechanisms, a novel approach to birefringent crystal design is employed to minimize the diagnostic's sensitivity to Zeeman splitting. The recently developed pixelated multi-delay CIS approach is also used to obtain four times as much spectral information as traditional CIS approaches. The Ti-optimized CIS diagnostic is validated in a long-pulse W7-X plasma by comparison with a high-resolution spectrometer whose sightlines overlap with the CIS field of view. The CIS and spectrometer Ti profiles have the same shape and agree to within 10% on average and 25% in the worst case. Images of the Ti distribution near the divertor show toroidally elongated bands aligned with the magnetic field, with Ti ranging between 10 and 40 eV.

Coherence imaging spectroscopy at Wendelstein 7-X for impurity flow measurements.

In the last decade, Coherence Imaging Spectroscopy (CIS) has shown distinctive results in measuring ion flow velocities in the edge of magnetically confined plasma devices. Its 2D spatially resolved measurement capabilities and its high optical throughput are ideal for investigating the impurity behavior in the complex 3D magnetic island topology edge of Wendelstein 7-X (W7-X). However, a highly precise and stable calibration method is required for a reliable diagnostic operation. A new level of precision and stability has been achieved for the two CIS systems installed at W7-X with the use of a new calibration source, a continuous tunable laser commercially available only since 2015. A specific prototype model was successfully adapted to the challenging requirements of W7-X, granting high accuracy (±0.01 pm) and flexibility (spectral range: 450-650 nm) in the wavelength calibration required for measuring low-Z impurity ion flow velocities. These features opened up new investigation possibilities on temperature stability and wavelength response of the CIS components, allowing to fully characterize and validate the W7-X systems. The CIS diagnostic was operational throughout the last W7-X experimental campaign. Measured velocities on the order of ∼20-30 km/s were observed, corroborated by comparisons with measurements with Mach probes.

Infrared imaging systems for wall protection in the W7-X stellarator (invited).

Wendelstein 7-X aims at quasi-steady state operation with up to 10 MW of heating power for 30 min. Power exhaust will be handled predominantly via 10 actively water cooled CFC (carbon-fiber-reinforced carbon) based divertor units designed to withstand power loads of 10 MW/m2 locally in steady state. If local loads exceed this value, a risk of local delamination of the CFC and failure of entire divertor modules arises. Infrared endoscopes to monitor all main plasma facing components are being prepared, and near real time software tools are under development to identify areas of excessive temperature rise, to distinguish them from non-critical events, and to trigger alarms. Tests with different cameras were made in the recent campaign. Long pulse operation enforces additional diagnostic design constraints: for example, the optics need to be thermally decoupled from the endoscope housing. In the upcoming experimental campaign, a graphite scraper element, in front of the island divertor throat, will be tested as a possible means to protect the divertor pumping gap edges during the transient discharge evolution.

Is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial.

OBJECTIVE: There are no studies investigating the efficacy of short-term psychodynamic psychotherapy in primary fibromyalgia syndrome (FMS). We conducted a randomized controlled trial evaluating an adapted form of individual short-term psychodynamic psychotherapy (ASTPP) versus primary care management (TAU). The study focused on FMS patients with psychiatric comorbidity. METHODS: Forty-six female patients with FMS and an International Classification of Diseases, 10th Revision diagnosis of a comorbid depression or anxiety disorder were recruited in a hospital setting. Participants were randomized to receive either ASTPP (25 sessions, 1 session/week) or TAU (4 consultations/6 months). Outcome measures included the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Pain Disability Index, the Symptom Checklist 27 and the health-related quality of life. Primary endpoints of the outcome assessment were the FIQ total score and the HADS depression scale at 12-month follow-up. RESULTS: Both treatments were effective in reducing the FIQ total score (ES=0.56 and ES=0.75, respectively). Intent-to-treat analyses failed to provide evidence suggesting a marked superiority of individual psychodynamic psychotherapy as compared to TAU. CONCLUSIONS: A high-standard routine treatment focusing on the improvement of health behavior and including antidepressant and analgesic medication is equally effective as a short-term individual psychodynamic psychotherapy in improving fibromyalgia-related symptoms.