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In controls, stronger BOLD responses were observed in the left primary somatosensory and motor cortices (sensorimotor representation of the leg), superior parietal lobule, dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, and operculo-insular cortices compared to patients. In the whole-brain analyses, FM patients did not exhibit a stronger BOLD response to the expectancy of pain relief cue in any region compared to controls. No group differences reached statistical significance for the nucleus accumbens in the direct searches. In the right ventral tegmental area, a voxelwise direct search revealed group differences in all 3 statistical comparisons (Figure 5). Healthy controls exhibited an increase in BOLD signal during pain anticipation http://www.selleckchem.com/products/chir-99021-ct99021-hcl.html and pain stimulation, but a decrease during relief anticipation. In FM patients, however, these responses were either significantly reduced (pain), or null (pain anticipation and relief anticipation) (Figure 5B). Similar results were observed in http://www.selleck.cn/products/pexidartinib-plx3397.html ROI analyses that averaged the values from all voxels in the right ventral tegmental area mask. Compared to FM patients, control subjects exhibited stronger activations during pain anticipation (P 0.6). However, the left ventral tegmental area did reveal a statistically significant difference in the BOLD signal between FM patients and controls in regard to pain anticipation (i.e., control subjects had a stronger BOLD signal) (P http://www.selleckchem.com/products/Y-27632.html correlated with responses in the ventral tegmental area to relief anticipation in the control subjects (r = 0.76, P = 0.002), but not in the FM patients (r = ?0.12, P = 0.52) (Figure 5C). Our evidence indicates differences between FM patients and controls in brain processing during pain, as well as during anticipation of pain and of pain relief. During pain anticipation (Figure 2), multiple regions were activated in healthy controls, (including the anterior cingulate cortex, the periaqueductal gray, the thalamus, the premotor cortex, and the ventral tegmental area, i.e.