Research teams find widespread inflammation in the brains of fibromyalgia patients

A study by Massachusetts General Hospital (MGH) researchers – collaborating with a team at the Karolinska Institutet in Sweden – has documented for the first time widespread inflammation in the brains of patients with the poorly understood condition called fibromyalgia. Their report has been published online in the journal Brain, Behavior and Immunity.

“We don’t have good treatment options for fibromyalgia, so identifying a potential treatment target could lead to the development of innovative, more effective therapies,” says Marco Loggia, PhD, of the MGH-based Martinos Center for Biomedical Imaging, co-senior author of the report. “And finding objective neurochemical changes in the brains of patients with fibromyalgia should help reduce the persistent stigma that many patients face, often being told their symptoms are imaginary and there’s nothing really wrong with them.”

Characterized by symptoms including chronic widespread pain, sleep problems, fatigue, and problems with thinking and memory, fibromyalgia affects around 4 million adults in the U.S., according to the Centers for Disease Control and Prevention. Previous research from the Karolinska group led by Eva Kosek, MD, PhD, co-senior author of the current study, suggested a potential role for neuroinflammation in the condition – including elevated levels of inflammatory proteins in the cerebrospinal fluid – but no previous study has directly visualized neuroinflammation in fibromyalgia patients.

A 2015 study by Loggia’s team used combined MR/PET scanning to document neuroinflammation – specifically activation of glial cells – in the brains of patients with chronic back pain. Hypothesizing that similar glial activation might be found in fibromyalgia patients as well, his team used the same PET radiopharmaceutical, which binds to the translocator protein (TSPO) that is overexpressed by activated glial cells, in their study enrolling 20 fibromyalgia patients and 14 control volunteers.

At the same time, Kosek’s team at Karolinska had enrolled a group of 11 patients and an equal number of control participants for a similar study with the TSPO-binding PET tracer. Since that radiopharmaceutical binds to two types of glial cells – microglia and astrocytes – they also imaged 11 patients, 6 who had the TSPO imaging and 5 others, and another 11 controls with a PET tracer that is thought to bind preferentially to astrocytes and not to microglia. At both centers, participants with fibromyalgia completed questionnaires to assess their symptoms. When the MGH team became aware of the similar investigation the Karolinska group had underway, the teams decided to combine their data into a single study.

The results from both centers found that glial activation in several regions of the brains of fibromyalgia patients was significantly greater than it was in control participants. Compared to the MGH team’s chronic back pain study, TSPO elevations were more widespread throughout the brain, which Loggia indicates corresponds to the more complex symptom patterns of fibromyalgia. TSPO levels in a structure called the cingulate gyrus – an area associated with emotional processing where neuroinflammation has been reported in patients with chronic fatigue syndrome – corresponded with patients reported levels of fatigue. The Karolinska team’s studies with the astrocyte-binding tracer found little difference between patients and controls, suggesting that microglia were primarily responsible for the increased neuro-inflammation in fibromyalgia patients.

“The activation of glial cells we observed in our studies releases inflammatory mediators that are thought to sensitize pain pathways and contribute to symptoms such as fatigue,” says Loggia, an assistant professor of Radiology at Harvard Medical School. “The ability to join forces with our colleagues at Karolinska was fantastic, because combining our data and seeing similar results at both sites gives confidence to the reliability of our results.”

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Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life
  • Abril M.D., Andy (Author)
  • English (Publication Language)
  • 272 Pages - 09/24/2019 (Publication Date) - Mayo Clinic Press (Publisher)

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Concussion and Fibromyalgia: Is There A Link?

Fibromyalgia is an insidious disease. It’s challenging to diagnose with a host of complicated and differed symptoms, much of which can be attributed to other problems. These consist of, yet are not restricted to, increased sensitivity to pain, fatigue, memory loss and concerns with concentration, and also headaches. The specific root cause of fibromyalgia is unknown, yet study suggests it relates to chemical inequalities in the brain as well as, subsequently, exactly how the central nerves refines discomfort. Usually it’s thought to be triggered by a literally or emotionally traumatic event like the loss of a close friend or relative, giving birth, a severe medical procedure, or an injury. Such as, as an example, a terrible brain injury, also referred to as a concussion.

As we remain to learn more about fibromyalgia as well as its causes, so, as well, does the clinical area considerably discover more concerning concussion and traumatic brain injuries (TBI). Both are mostly misunderstood conditions, linked by injury to the brain as well as the nervous system. Thus, there are theories that head injury might result in fibromyalgia. But why? Just how does bumping your head after a fall link to a long-term incapacitating persistent pain condition? In the end, it’s all in your head!

When you strike your head, your brain tissue is wounded. This is, essentially, what a concussion is. Depending upon the level of seriousness of the injury, and exactly how treatment and recovery are approached, you can, in theory, be back up as well as running within a week or so. Nevertheless, most cases of TBI’s aren’t dealt with very carefully enough and result in long-lasting signs frequently characterized as post-concussion syndrome (PCS). Without appropriate therapy and also rest, concussions can end up being a months-long recovery process, and PCS can take anywhere up to a year to get over. This prolonged healing time implies that your brain is distressed for the duration, attempting to recoup however not able to heal from its preliminary contusion made considerably even worse by overuse.

It’s consequently medical experts are beginning to speculate a direct relationship between traumas, concussion, and fibromyalgia. Research studies on the cognitive function of clients with fibromyalgia lend really certain understandings into how the brain reacts to the problem. Evidence of declined handling speed, memory lapses, as well as fogginess are lastly being connected to the lasting effect of a concussion and also PCS, including enhanced recognizing to the consequences of fibromyalgia.

So what does this mean for people that have recuperated from a concussion? Are they imminently at risk of creating fibromyalgia? Should they rush to their doctors for an examination? No, not always. But what this does imply is, if you have actually experienced a concussion eventually in your life, and also you begin to discover some similar signs and symptoms resurfacing unexpectedly together with chronic, mysterious discomfort, it would concern discuss your previous TBI to your doctor or group of experts. Keeping a comprehensive medical history is essential, and can aid with future diagnoses. If you or someone you understand has actually suffered a concussion, take the needed time to rest and recoup to prevent long-term damage or PCS.

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Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life
  • Abril M.D., Andy (Author)
  • English (Publication Language)
  • 272 Pages - 09/24/2019 (Publication Date) - Mayo Clinic Press (Publisher)

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Does insulin resistance cause fibromyalgia?

GALVESTON, Texas – Researchers led by a team from The University of Texas Medical Branch at Galveston were able to dramatically reduce the pain of fibromyalgia patients with medication that targeted insulin resistance.

This discovery could dramatically alter the way that chronic pain can be identified and managed. Dr. Miguel Pappolla, UTMB professor of neurology, said that although the discovery is very preliminary, it may lead to a revolutionary shift on how fibromyalgia and related forms of chronic pain are treated. The new approach has the potential to save billions of dollars to the health care system and decrease many peoples’ dependence on opiates for pain management.

The UTMB team of researchers, along with collaborators from across the U.S., including the National Institutes of Health, were able for the first time, to separate patients with fibromyalgia from normal individuals using a common blood test for insulin resistance, or pre-diabetes. They then treated the fibromyalgia patients with a medication targeting insulin resistance, which dramatically reduced their pain levels. The study was recently published in PlosOne.

Fibromyalgia is one of the most common conditions causing chronic pain and disability. The global economic impact of fibromyalgia is enormous – in the U.S. alone and related health care costs are about $100 billion each year. Despite extensive research the cause of fibromyalgia is unknown, so there’s no specific diagnostics or therapies for this condition other than pain-reducing drugs.

“Earlier studies discovered that insulin resistance causes dysfunction within the brain’s small blood vessels. Since this issue is also present in fibromyalgia, we investigated whether insulin resistance is the missing link in this disorder,” Pappolla said. “We showed that most – if not all – patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past two to three months.”

Pre-diabetics with slightly elevated A1c values carry a higher risk of developing central (brain) pain, a hallmark of fibromyalgia and other chronic pain disorders.”

The researchers identified patients who were referred to a subspecialty pain medicine clinic to be treated for widespread muscular/connective tissue pain. All patients who met the criteria for fibromyalgia were separated into smaller groups by age. When compared with age-matched controls, the A1c levels of the fibromyalgia patients were significantly higher.

“Considering the extensive research on fibromyalgia, we were puzzled that prior studies had overlooked this simple connection,” said Pappolla. “The main reason for this oversight is that about half of fibromyalgia patients have A1c values currently considered within the normal range. However, this is the first study to analyze these levels normalized for the person’s age, as optimal A1c levels do vary throughout life. Adjustment for the patients’ age was critical in highlighting the differences between patients and control subjects.”

For the fibromyalgia patients, metformin, a drug developed to combat insulin resistance was added to their current medications. They showed dramatic reductions in their pain levels.

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Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life
  • Abril M.D., Andy (Author)
  • English (Publication Language)
  • 272 Pages - 09/24/2019 (Publication Date) - Mayo Clinic Press (Publisher)

I get commissions for purchases made through links on this website. As an Amazon Associate I earn from qualifying purchases.