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Descending antinociception & fibromyalgia (FM)

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By Mense S • • April 15, 1998

The hypothesis is discussed that a dysfunction of the
descending antinociceptive system may underly the pain of
fibromyalgia. Data from animal experimentation show that an
interruption of the system by spinal cord cooling leads to (1)
increase in ongoing activity, (2) lowering in stimulation
threshold, and (3) increase in response magnitude in
nociceptive dorsal horn neurons. The influence of the
descending system was stronger on the responses to input from
deep nociceptors than to input from cutaneous nociceptors. If
similar changes occur also in patients, an impairment of the
tonicly active descending system should be followed by (1)
spontaneous pain (ongoing activity), (2) tenderness (lowering
in mechanical threshold), and (3) hyperalgesia (increased
responses to noxious stimuli). These changes should affect
mainly deep pain, because the antinociceptive system
influences predominantly input from deep nociceptors.

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