Dr Nick Fallon PhD

Fibromyalgia syndrome (FMS) is a chronic pain disorder primarily associated with pain in deep tissues which particularly affects women of middle age. The syndrome is frequently comorbid with a variety of clinical, functional and psychological disorders and is therefore both challenging and costly to diagnose and treat. In spite of significant previous research, the underlying aetiology and pathophysiology of FMS is still not fully understood. Central mechanisms, including structural and functional brain alterations have been proposed as a casual or maintaining factor of the disorder. Several studies show augmented brain activity in response to tactile stimuli accompanied by reduced pain thresholds which have led many to report that FMS is a central sensitisation syndrome. However, the precise nature of how any such sensitisation occurs in the brain, and whether this could be related peripheral pathophysiology or affective and cognitive disturbances in FMS, is not fully understood.

Our research has shown that tactile sensations are amplified in the brain of FMS patients, causing patterns of brain activation similar to those seen when healthy people are in pain. Shape and volume alterations were also identified in the brainstem of patients, and these may relate to how this amplification process occurs. However, we have also revealed a powerful effect of FMS during on emotional processing of observed pain, and the importance of psychological factors cannot be discounted in this disorder. Our most recent work points to alterations in the resting brain activity of FMS patients, which have potential to be important as a predisposing factor for developing this problem.

Our findings have so far led to the publication of several articles in renowned scientific journals and have also been presented at international conferences. In future I would like to continue this line of work to shed further light on the mechanisms responsible for this debilitating and frustrating illness.

Following on from my experiences with central sensitisation disorders, I developed an interest in understanding the boundaries between our 'normal' sensory processing and pain, i.e., when does touch become pain? Likewise, can other sensory inputs become painful, some evidence from central sensitisation syndrome patients would suggest that even a bad smell can be interpreted as pain but can we model this in normal populations?

This led me to consider the dynamics of sensory processing for a range of inputs, but particular olfaction (smell) and tactile (touch) sensation. I am proud to be part of a successful collaboration with Unilever developed over a period of 5 years, encompassing multiple projects investigating sensory and psychological aspects of odour perception in the human brain. Now, I am embarking on a series of projects to investigate the neural dynamics of sensory processing in healthy people to better understand how the interactions physical, psychological and sensory processes can influence our feelings and behaviour. In future, we will expand to investigate clinical populations with the aim to improving our understanding of central sensitisation disorders to implement clinical change