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[Fibromyalgia: a challenge for neuroscience].

J C Leza1

  • 1Universidad Complutense. Facultad de Medicina, Madrid, España. jcleza@med.ucm.es

Revista De Neurologia
|July 2, 2003
PubMed
Summary

Fibromyalgia is a complex chronic pain disorder. Current research suggests pain transmission issues and neurotransmitter imbalances, with serotonin and noradrenaline reuptake inhibitors showing therapeutic promise.

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Area of Science:

  • Neuroscience
  • Rheumatology
  • Pharmacology

Context:

  • Fibromyalgia is a poorly understood chronic disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and neuroendocrine issues.
  • Current understanding of fibromyalgia's physiopathology centers on disordered pain transmission within the dorsal horn of the spinal cord, leading to allodynia and hyperalgesia.

Purpose:

  • To review recent findings on the physiopathology of fibromyalgia.
  • To discuss current therapeutic guidelines for managing fibromyalgia symptoms.
  • To highlight the role of neurotransmitters and spinal cord pain pathways in fibromyalgia.

Summary:

  • Research indicates that altered pain signaling in the spinal cord, involving glutamate, substance P, serotonin (5HT), and noradrenaline, is central to fibromyalgia.
  • Patients often exhibit reduced 5HT activity and elevated substance P levels, contributing to pain perception and associated neuropsychiatric and sleep disorders.
  • Serotonin's role extends to regulating sleep, hormones, and mood, further implicating its dysfunction in fibromyalgia's multifaceted presentation.

Impact:

  • Fibromyalgia remains a significant challenge in modern medicine, necessitating a bedside-oriented scientific approach.
  • Classical antidepressants, specifically serotonin and noradrenaline reuptake inhibitors (SNRIs) at sub-antidepressant doses, are identified as the most effective therapeutic agents.
  • Further research is crucial for developing targeted pharmacological interventions to alleviate fibromyalgia symptoms.

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