Sensitization, Glutamate, and the Link Between Migraine and Fibromyalgia – Source: Current Pain and Headache Reports, Oct 2007

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Recent advances have shed insight on the pathophysiologic mechanisms of Fibromyalgia and migraine, especially in the chronic form.

A growing body of evidence supports the involvement of peripheral and central sensitization disturbances of pain-related processes underlying both disorders. They involve increased glutamate transmission through interaction with its ionotropic and metabotropic receptors. [Glutamate is the principal ‘excitatory’ neurotransmitter in the brain/central nervous system.]

Few studies supporting the implication of this excitatory amino acid in chronic migraine and primary Fibromyalgia demonstrated increased levels of glutamate in the cerebrospinal fluid of affected patients.

These findings have implications for future therapies directed against glutamate receptors (in particular, N-methyl-D-aspartate receptors). Limited clinical experience in this regard, although promising, does not exclude additional mechanisms contributing to the maintenance of pain, which can be the target of therapeutic approaches in both disorders.

Source: Current Pain and Headache Reports. Oct 2007, Vol 11, No. 5:343-351. ISSN 1531-3433, by Sarchielli P, Di Filippo M, Nardi K, Calabresi P. Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia; Ospedale Santa Maria della Misericordia, Perugia, Italy. [E-mail: neuro.pg@tiscalinet.it]

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