Autonomic nervous system dysfunction may explain the multisystem features of fibromyalgia

Martı́nez-Lavı́n, Manuel; Hermosillo, Antonio G.

doi:10.1016/s0049-0172(00)80008-6

Cited by 185 publications

(116 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, when an acute stress is imposed on the system, notably under conditions in which the monoamine system is challenged, the COMT deficiency can be uncovered in a pattern consistent with gene-environment interaction. This might well be the case in fibromyalgia (Martinez-Lavin & Hermosillo, 2000;Martinez-Lavin et al, 2002).The COMT Val158Met polymorphism has been linked to a decrease in pain tolerance in healthy volunteers (Zubieta et al, 2003). Studies on healthy volunteers have also shown greater brain activation in the limbic region of Met/Met carriers in reaction to an emotionally challenging situation such as the presentation of unpleasant stimuli (Zubieta et al, 2003;Smolka et al, 2005Smolka et al, , 2007Drabant et al, 2006).…”

mentioning

confidence: 99%

Psychological distress in fibromyalgia patients: A role for catechol-O-methyl-transferase Val158met polymorphism.

Desmeules¹,

Piguet²,

Besson³

et al. 2012

Health Psychology

View full text Add to dashboard Cite

Objective: Fibromyalgia (FM) has been related to biochemical alterations, central pain sensitization and psychological distress. Among genetic and environmental hypotheses, a role was suggested for catechol-O-methyl-transferase (COMT), a modulator in the metabolism of monoaminergic neurotransmitters. Method: This study compared the COMT Val158Met enzyme polymorphism (rs4680) of 198 FM patients to 99 pain-free controls. Psychological and functional aspects were assessed through investigating anxiety, depression, catastrophizing, perceived health, and functional status. Results: The distribution of the COMT Val158Met polymorphism was similar in FM and controls. Out of 198 patients, 137 were able to stop medication before evaluation. In these patients, the COMT Val158Met genotype was associated with specific psychological profiles. The Met/Met subgroup scored systematically worse on all psychological and functional variables. All variables displayed a "genotype-trend effect" with the Met/Met and Val/Val subgroups at the two ends of the scores. Genotypes distribution in the 61 patients unable to stop medication was significantly different from that of patients able to stop medication and controls (p ϭ .002 and p ϭ .018, respectively) with an increase in the proportion of the Met/Met genotype associated to the lowest COMT activity. These results suggest a possible role of COMT Val158Met polymorphism in the psychological distress observed in FM. Conclusions: The association of COMT genotype with psychological distress may be of importance as identifying subgroups is a challenge in the diagnosis and treatment of fibromyalgia patients. This association may contribute to open new perspectives into the understanding of the pathophysiology of fibromyalgia and stress-related genes.

show abstract

mentioning

confidence: 99%

Psychological distress in fibromyalgia patients: A role for catechol-O-methyl-transferase Val158met polymorphism.

Desmeules¹,

Piguet²,

Besson³

et al. 2012

Health Psychology

View full text Add to dashboard Cite

show abstract

“…fibromyalgia; baroreflex; autonomic nervous system; modeling; causality FIBROMYALGIA SYNDROME (FMS) is a noninflammatory syndrome characterized by chronic diffuse musculoskeletal pain, stiffness, and pain hypersensitivity in 18 specific points located in muscles or tendon muscle insertion called tender points (27). Although the painful condition is the main characteristic of this syndrome, advancements regarding the etiology and pathophysiology of FMS have attributed an important role to dysautonomia (i.e., the autonomic nervous system dysfunction) (4,7,11,12,24,25).The dysautonomia has been widely demonstrated in patients with FMS. Thus, it is known that FMS patients present an alteration of the cardiac autonomic modulation characterized by a high cardiac sympathetic modulation and low cardiac parasympathetic modulation even at rest (4,7,11,12,24,25).…”

mentioning

confidence: 99%

“…Thus, it is known that FMS patients present an alteration of the cardiac autonomic modulation characterized by a high cardiac sympathetic modulation and low cardiac parasympathetic modulation even at rest (4,7,11,12,24,25). In addition, despite a normal baroreflex function, a lack of increased sympathetic discharge to vessels and decreased cardiac vagal activity has been reported during the orthostatic stimulus, which may account for the reduced orthostatic tolerance, commonly observed in these patients (7).Traditionally, the baroreflex sensitivity (BRS) in FMS patients has been studied through the computation of indices derived from spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities (4,7,11,12,24,25). However, these approaches to the quantification of BRS have many methodological drawbacks.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular control in women with fibromyalgia syndrome: do causal methods provide nonredundant information compared with more traditional approaches?

Zamunér

Porta

Andrade

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

View full text Add to dashboard Cite

-The cardiovascular autonomic control and the baroreflex sensitivity (BRS) have been widely studied in fibromyalgia syndrome (FMS) patients through the computation of linear indices of spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities. However, there are many methodological difficulties regarding the quantification of BRS by the traditional indices especially in relation to the issue of causality. This difficulty has been directly tackled via a model-based approach describing the closed-loop HP-SAP interactions and the exogenous influences of respiration. Therefore, we aimed to assess whether the BRS assessed by the model-based causal closed-loop approach during supine and active standing in patients with FMS could provide complementary information to those obtained by traditional indices based on time and frequency domains. The findings of this study revealed that, at difference with the traditional methods to quantify BRS, the causality analysis applied to the HP, SAP, and respiratory series, through the model-based closed-loop approach, detected lower BRS in supine position, as well as a blunted response to the orthostatic stimulus in patients with FMS compared with healthy control subjects. Also, the strength of the causal relation from SAP to HP (i.e., along the cardiac baroreflex) increased during the active standing only in the control subjects. The model-based closed-loop approach proved to provide important complementary information about the cardiovascular autonomic control in patients with FMS. fibromyalgia; baroreflex; autonomic nervous system; modeling; causality FIBROMYALGIA SYNDROME (FMS) is a noninflammatory syndrome characterized by chronic diffuse musculoskeletal pain, stiffness, and pain hypersensitivity in 18 specific points located in muscles or tendon muscle insertion called tender points (27). Although the painful condition is the main characteristic of this syndrome, advancements regarding the etiology and pathophysiology of FMS have attributed an important role to dysautonomia (i.e., the autonomic nervous system dysfunction) (4,7,11,12,24,25).The dysautonomia has been widely demonstrated in patients with FMS. Thus, it is known that FMS patients present an alteration of the cardiac autonomic modulation characterized by a high cardiac sympathetic modulation and low cardiac parasympathetic modulation even at rest (4,7,11,12,24,25). In addition, despite a normal baroreflex function, a lack of increased sympathetic discharge to vessels and decreased cardiac vagal activity has been reported during the orthostatic stimulus, which may account for the reduced orthostatic tolerance, commonly observed in these patients (7).Traditionally, the baroreflex sensitivity (BRS) in FMS patients has been studied through the computation of indices derived from spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities (4,7,11,12,24,25). However, these approaches to the quantification of BRS have many methodological drawbacks. The most relevant one is the in...

show abstract

“…Studies of the stress axes, including the hypothalamic-pituitary-adrenal axis, show functional abnormalities in many individuals with FMS (9). Change in NE output is reflected in altered sympathetic activity in FMS that is thought to be associated with stress (10).…”

Section: Control Systemsmentioning

confidence: 99%

Balanced treatments for fibromyalgia

Littlejohn

2004

Arthritis & Rheumatism

View full text Add to dashboard Cite

It has been more than 25 years since Smythe and Moldofsky refocused attention on the fibromyalgia syndrome (FMS) (1). Their observations clearly characterized the predictable clinical features of this common pain syndrome and initiated new enquiry into an enigmatic disorder. The core characteristic of widespread pain was seen to occur in conjunction with the presence of widespread tenderness, implying complex changes to the neurophysiologic activities of the pain system. Smythe and Moldofsky emphasized the intimate link between the "physical" symptoms and signs of fibromyalgia, on the one hand, and the presence of a number of personal and emotional factors, on the other hand. Importantly, these investigators delineated abnormalities of sleep architecture, an early indication of the mind and body interactions in this disorder.As time has passed, research has identified significant biologic, psychological, and social abnormalities and effects in FMS. It has taken some time for this jigsaw of observations to form a coherent picture of the nature of FMS. As a consequence, it has also taken a long time to establish effective management strategies for this important clinical and societal problem. Understanding FMS symptomsMany of the initial advances in the understanding of FMS have come from simple clinical observations. For instance, the generalized tenderness in FMS patients, more obvious in some sites than in others, has subsequently been shown to be due to the fundamental biologic process of sensitization as it pertains to the pain system (2,3). The stimulus threshold required to translate an otherwise innocuous sensory input, such as pressure, into pain is significantly lowered in FMS. This ubiquitous neurobiologic process is common to many different parts of the nervous system and translates otherwise subclinical information into perceived sensations, often resulting in unpleasant symptoms. Sensitization is an important function of the pain system after tissue damage, seen both peripherally and centrally, but it is also prominent in pain conditions without obvious tissue damage-induced pain generation, such as FMS. Consideration of this sensitization process in the dorsal horn of the spinal cord can be seen as a useful starting point in the understanding of FMS.Activity within both the unmyelinated C fibers, with related neuropeptide functions including those of substance P, and the faster-transmitting myelinated A-delta fibers is increased in FMS (4,5). These key nociceptor fiber types principally connect to nociceptivespecific projection neurons in the superficial layers of the dorsal horn (Figure 1). A minority of these fiber types also connect to the wide-dynamic range projection neurons, responsive to a broader range of input stimuli and usually more deeply placed in the dorsal horn.Perhaps even more important from the point of view of FMS is the input from the mechanoreceptors, the A-beta fiber system, that predominantly provides sensory proprioceptive information. Although most of this information is rel...

show abstract

Autonomic nervous system dysfunction may explain the multisystem features of fibromyalgia

Cited by 185 publications

References 10 publications

Psychological distress in fibromyalgia patients: A role for catechol-O-methyl-transferase Val158met polymorphism.

Psychological distress in fibromyalgia patients: A role for catechol-O-methyl-transferase Val158met polymorphism.

Cardiovascular control in women with fibromyalgia syndrome: do causal methods provide nonredundant information compared with more traditional approaches?

Balanced treatments for fibromyalgia

Contact Info

Product

Resources

About