Gut Microbiota and Psychological Distress in Fibromyalgia: A Systematic Review

Area of Science:

• Gastroenterology
• Psychiatry
• Microbiology

Background:

• Fibromyalgia (FM) is a chronic pain condition often accompanied by psychological distress.
• The gut microbiota plays a crucial role in regulating physiological and psychological functions.
• Emerging evidence suggests a connection between the gut microbiota and FM pathophysiology.

Purpose of the Study:

• To systematically review recent evidence on the relationship between gut microbiota and psychological distress in fibromyalgia patients.
• To synthesize findings on microbiome alterations and their association with psychological symptoms in FM.
• To explore the implications for the gut-brain axis in fibromyalgia.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Scopus, EBSCO, WOS, Cochrane) following PRISMA guidelines.
• Search terms included combinations of 'microbiota', 'psychological distress', and 'fibromyalgia'.
• Ten English-language studies with human participants meeting inclusion criteria were analyzed, including case-control, randomized controlled trials, and observational designs.

Main Results:

• Most studies reported gut microbial imbalances (dysbiosis) and differences in microbiome composition or diversity between FM patients and healthy controls.
• Increased gut permeability was observed in FM patients.
• Intestinal dysbiosis and gut permeability were associated with higher levels of psychological distress, including emotional, cognitive, and somatic symptoms.

Conclusions:

• Alterations in the gut microbiota of FM patients support the hypothesis of impaired gut-brain axis regulation in this condition.
• The findings suggest that the gut microbiota may be a contributing factor to the pathophysiology of fibromyalgia.
• Further research is necessary to fully elucidate the role of the microbiota-gut-brain axis in fibromyalgia and its associated psychological distress.