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Fibromyalgia: A Disorder of the Brain? – Source: Neuroscientist, Feb 12, 2008

  [ 135 votes ]   [ 5 Comments ]
By Catherine Bushnell, et al. • • February 15, 2008

This article presents evidence that Fibromyalgia patients have alterations in CNS [central nervous system] anatomy, physiology, and chemistry that potentially contribute to the symptoms experienced by these patients.

n There is substantial psychophysical evidence that Fibromyalgia patients perceive pain and other noxious stimuli differently than healthy individuals and that normal pain modulatory systems, such as diffuse noxious inhibitory control mechanisms, are compromised in Fibromyalgia.

n Furthermore, functional brain imaging studies revealing enhanced pain-related activations corroborate the patients' reports of increased pain.

n Neurotransmitter studies show that Fibromyalgia patients have abnormalities in dopaminergic, opioidergic, and serotoninergic systems.

n Finally, studies of brain anatomy show structural differences between the brains of Fibromyalgia patients and healthy individuals. The cerebral alterations offer a compelling explanation for the multiple symptoms of Fibromyalgia, including widespread pain and affective disturbances.

The frequent comorbidity of Fibromyalgia with stress-related disorders, such as chronic fatigue, posttraumatic stress disorder, irritable bowel syndrome, and depression, as well as the similarity of many CNS abnormalities, suggests at least a partial common substrate for these disorders.

Despite the numerous cerebral alterations, Fibromyalgia might not be a primary disorder of the brain but may be a consequence of early life stress or prolonged or severe stress, affecting brain modulatory circuitry of pain and emotions in genetically susceptible individuals.

Source: Neuroscientist. 2008 Feb 12 [Epub ahead of print] PMID: 18270311, by Schweinhardt P, Sauro KM, Bushnell MC. Center for Research on Pain, McGill University, Montreal, Quebec, Canada. [E-mail:]

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Article Comments Post a Comment

Fibromyalgia: A Disorder of the Brain?
Posted by: linda_angel
Feb 18, 2008
..."There is substantial psychophysical evidence that Fibromyalgia patients perceive pain and other noxious stimuli differently than healthy individuals and that normal pain modulatory systems, such as diffuse noxious inhibitory control mechanisms, are compromised in Fibromyalgia..." Is this to say that those who suffer with Fibromyalgia have a lower pain tolerance? In my case I seem to have a HIGHER level of tolerance. For example: I have had several infertility surgeries and a full abdominal hysterectomy and was advised that my recovery period was to be six to eight weeks. I felt as if I was always ready to go back to my "normal" work and every day activities in 3-4 weeks if not for the fatigue. Also, I have had several injuries, including broken several bones and most people are astonished that my recovery period from these have always been so short. This includes a fractured vertebra which I thought was only a "sore back" from a horse back riding fall. I do contend however that I feel the flu like aches and fatigue that most speak of when referring to their Fibromyalgia symptoms and I have frequent and very painful "shooting pains" that seem to have gotten worse as I have aged.
Reply Reply

Fibromyalgia: A Disorder of the Brain?
Posted by: pearls
Mar 5, 2008
As a person with fibromyalgia, it is always heartening to see an article that validates the problem as real. However, it would have been much more valuable had the author listed sources for her points. Further, could it be that fibromyalgia patients have had a neurological event with multiple causes? Could it be that an FMS person's brain is in some way susceptible to such an event, and that it was precipitated by such things as prolonged stress, an accident, an infection, etc. or even a combination of those things? As for a lower threshold, this seems true in many, though perhaps not all, respects. We seem to sense things going on in our bodies as pain, burning, numbness, cold, and so forth which might not be perceptible otherwise. They fall below the pain threshold for most people and are not noticed at all. But for people with fibromyalgia, these perceptions can be debilitating. We also seem to have more muscle spasms, which can cause severe pain. But ordinary pain caused by accidents like running into things, or getting cut doesn't seem any worse than before, at least to me. Pearl S.
Reply Reply

FM can be a descriptive term for Lyme disease
Posted by: munch1958
Mar 6, 2008
I'm not saying "ALL" cases of "FM" are Lyme but some are! The majority of LD patients WERE diagnosed with CFS or FM before getting Lyme diagnoses. For 27 years, I thought it was CFS and FM. Check out the journal articles on the left side toolbar.
Reply Reply

relationship of "emotions" in FMS
Posted by: robingers
Mar 7, 2008
I find this article to be contradictory. In the beginning, the author lists all the diagnostic tests that show that people with FMS have "physical" abnormalities. Then, she proceeds to fall back to the explanation that "stress" or an emotional trauma could be what caused the disorder. I believe this type of explanation is hurting the validation of FMS, because it suggests that the afflicted person was weak and somehow responsible for bringing on the disease. It is so absurd to me that we never blame stress for causing diseases like cancer, heart disease, MS, Parkinson's, etc. Instead we use an arsenal of medications and surgeries and treat the person from a "physical" perspective. Haven't we learned anything from medical history? Whenever a new disorder appears, until we understand the anatomy of it, we always assume there is a psychological origin. We did this with diabetes, Rheumatoid Arthritis, hypothyroidism, etc... Of course stress and emotions contribute to FMS, just like they do with all diseases. But they are not the main cause. Like most diseases, Fibromyalgia is probably a combination of genetics, poor immune system (via unhealthy diets, bacterial/viral infections), chronic toxic chemical exposure (via food, air, water), and stress. And until we stop searching for a psychological connection, Fibromyalgia will not get the medical (including alternative modalities) and physical treatment it requires. Frustrated, Yet Hopeful, Robin
Reply Reply

Brain overload
Posted by: Svette_Palme
Apr 18, 2008
Yup, I like it!! Brain overload, from the same input as other people have. Thats what our problem is, and it does NOT mean we are "not dealing with it well" - it means we have "too much sensory input to deal with". YA!! This is going to be understood someday... [please see my comment on the "Psychophysical Study of Auditory and Pressure Sensitivity" article too!]
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