Descending antinociception & fibromyalgia (FM)

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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