Neurobiology underlying fibromyalgia symptoms.

Alan Edwards Centre for Research on Pain, McGill University, 3640 University Street, Room M19, Montreal, QC, H2A 1C1, Canada.
Pain research and treatment 01/2012; 2012:585419. DOI: 10.1155/2012/585419
Source: PubMed

ABSTRACT Fibromyalgia is characterized by chronic widespread pain, clinical symptoms that include cognitive and sleep disturbances, and other abnormalities such as increased sensitivity to painful stimuli, increased sensitivity to multiple sensory modalities, and altered pain modulatory mechanisms. Here we relate experimental findings of fibromyalgia symptoms to anatomical and functional brain changes. Neuroimaging studies show augmented sensory processing in pain-related areas, which, together with gray matter decreases and neurochemical abnormalities in areas related to pain modulation, supports the psychophysical evidence of altered pain perception and inhibition. Gray matter decreases in areas related to emotional decision making and working memory suggest that cognitive disturbances could be related to brain alterations. Altered levels of neurotransmitters involved in sleep regulation link disordered sleep to neurochemical abnormalities. Thus, current evidence supports the view that at least some fibromyalgia symptoms are associated with brain dysfunctions or alterations, giving the long-held "it is all in your head" view of the disorder a new meaning.

1 Bookmark
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Fibromyalgia (FM) is a prevalent, chronic and disabling disorder, which etiology is unknown. It is characterized by widespread pain, diffuse tenderness, and a plethora of other symptoms. It is also considered the coexistence of tender points – painful points when a digital palpation of 4 kg/A of force is exercised - through the body. Technically, it can be defined as a history of widespread pain for at least 3 months and the existence of pain at least in 11 of 18 tender points. Its manifestations are not homogenous, making the diagnosis difficult. It shows varying proportions of anxiety and depression as comorbidities, which depend on the psychological features of each patient. Therefore, the medical evaluation must not include only the presence/absence of widespread pain or painful tender points, but also the existence of mood changes. Some studies show that the patients with FM have high rates of alexithymia and rage, and link depression, work stress and childhood traumatic events as contributors to its etiology, therefore, antidepressants could be an effective therapeutic handling. On the other hand, researchers have identified the influence of social effort and emotional context under the pain threshold in FM. These and other results led to conclude that there is an intrinsic bind between depressive disorders and FM. Other studiers classified them in a same wide category of stress disturbances. Finally, depression is a frequent (present in 28,6 to 70% of the patients) comorbidity associated with fibromyalgia, and brings worsening to its natural history of disease.
    Fibromyalgia: Risk Factors, Symptoms and Treatment, 01/2013: chapter Fibromyalgia: The Role of Antidepressant Agents: pages 63-86; Nova Publishers., ISBN: 978-1-62257-678-4
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The purpose of this study is to explore how people use daytime naps and to determine the links between daytime napping and symptom severity in fibromyalgia syndrome. Methods: A community based sample of 1044 adults who had been diagnosed with fibromyalgia syndrome by a clinician completed an online questionnaire. Associations between napping behavior, sleep quality and fibromyalgia symptoms were explored using Spearman correlations, with possible predictors of napping behaviour entered into a logistic regression model. Differences between participants who napped on a daily basis and those who napped less regularly, as well as nap duration were explored. Results: Daytime napping was significantly associated with increased pain, depression, anxiety, fatigue, memory difficulties and sleep problems. Sleep problems and fatigue explained the greatest amount of variance in napping behaviour, p<0.010. Those who engaged in daytime naps for >30 minutes had higher memory difficulties (t=-3.45) and levels of depression (t = -2.50) than those who napped for shorter periods (<30mins) (p<0.010). Conclusions: Frequent use and longer duration of daytime napping was linked with greater symptom severity in people with fibromyalgia. Given the common use of daytime napping in people with fibromyalgia evidence based guidelines on the use of daytime napping in people with chronic pain are urgently needed.
    BMC Musculoskeletal Disorders 01/2015; accepted(1). · 1.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated whether the spinal or systemic treatment with the lipid resolution mediators resolvin D1 (RvD1), aspirin-triggered resolvin D1 (AT-RvD1) and resolvin D2 (RvD2) might interfere with behavioral and neurochemical changes in the mouse fibromyalgia-like model induced by reserpine. Acute administration of AT-RvD1 and RvD2 produced a significant inhibition of mechanical allodynia and thermal sensitization in reserpine-treated mice, whereas RvD1 was devoid of effects. A similar antinociceptive effect was obtained by acutely treating animals with the reference drug pregabalin. Noteworthy, the repeated administration of AT-RvD1 and RvD2 also prevented the depressive-like behavior in reserpine-treated animals, according to assessment of immobility time, although the chronic administration of pregabalin failed to affect this parameter. The induction of fibromyalgia by reserpine triggered a marked decrease of dopamine and serotonin (5-HT) levels, as examined in total brain, spinal cord, cortex and thalamus. Reserpine also elicited a reduction of glutamate levels in total brain, and a significant increase in the spinal cord and thalamus. Chronic treatment with RvD2 prevented 5-HT reduction in total brain, and reversed the glutamate increases in total brain and spinal cord. Otherwise, AT-RvD1 led to a recovery of dopamine levels in cortex, and 5-HT in thalamus, whilst it diminished brain glutamate contents. Concerning pregabalin, this drug prevented dopamine reduction in total brain, and inhibited glutamate increase in brain and spinal cord of reserpine-treated animals. Our data provide novel evidence, showing the ability of D-series resolvins AT-RvD1, and mainly RvD2, in reducing painful and depressive symptoms allied to fibromyalgia in mice.
    Neuropharmacology 06/2014; · 4.82 Impact Factor

Full-text (5 Sources)

Available from
May 15, 2014