Research articles from June

Some of the most interesting research relevant to Fibromyalgia Syndrome (Fibro) that has been published over the last month and discussed in the FibroAction Research section is summarised here.

Fibromyalgia and normalising behaviours

At the end of May, FibroAction discussed a study that suggested Fibro patients may not seek help to manage their symptoms because the symptoms seem normal to them. A problem with invisible illnesses, such as Fibro, which have no outward sign of illness, is that even the patient can doubt whether the symptoms are really there. Fibro patients may also try to lead a normal life for some time after the onset of the condition, maintaining careers, relationships and lifestyles as far as possible for as long as they physically can, despite the immense struggle this can be. According to the study, this "normalization" contributes to Fibro patients not seeking medical attention.

The role of central dopamine

Dr Patrick Wood MD had an article published in which he discusses the role of the neurotransmitter dopamine in pain and analgesia. Dr Wood is a respected authority on the cause and treatment of Fibro and the originator of the Dopamine Theory of Fibromyalgia. He spearheaded the use of advanced imaging technologies to investigate fundamental changes within the central nervous system relating to Fibro. In the article, Dr Wood says that dopamine has an important role within the brain in dealing with how our brains perceive pain and also with natural pain-relief. Studies carried out by Dr Wood and his colleagues in the past have shown that people with Fibro have both reduced dopamine activity in the central nervous system and an abnormal response to pain, where dopamine is not released in response to pain, meaning that pain stimuli are felt as being more painful. Dr Wood says that several new classes of medication with analgesic properties have an effect on dopamine. The role of dopamine in Fibro, the potential treatments relating to that and the knowledge that is being discovered in these studies is extremely exciting and could lead to more effective use of medications to treat Fibro. Some doctors are already using medications that affect dopamine - such as Acupan (Nefopam) and Mirapex (Pramipexole) to treat Fibro, with a promising level of success.

City of Hope Fibro Study

Preliminary results from the City of Hope Fibromyalgia Study were e-published this month. The "City of Hope Fibromyalgia Study" is a three-year investigation taking place at City of Hope Hospital in California, USA, involving patients of Dr R Paul St Amand, the originator of the Guaifenesin Protocol for Fibro. The purpose of the City of Hope study is to look for links between Fibro and autoimmune, inflammatory and genetic factors. The study found that people with Fibro, whether they were on the Guaifenesin protocol or not, had high levels of substances that are usually associated with autoimmune and inflammatory conditions, suggesting that they may be an inflammatory or autoimmune connection with Fibro. Family members of the Fibro patients also had raised levels of some of these substances, suggesting that Fibro might have a family or genetic link. Dr St Amand has suggested that the particularly raised levels of one of the immune system substances found in the patients on the Guaifenesin Protocol may be of significance for the validity of the Guaifenesin Protocol. However, there were some flaws in the study and possibly in the conclusions drawn. The study remains a very interesting piece of research, but its significance may unfortunately be diluted by the flaws in the study and its significance to proponents of the Guaifenesin Protocol as evidence of the protocol is debatable.

Fibrofog mimics 20 years of aging

An article has been published recently suggesting that the cognitive problems associated with Fibrofog mimic around 20 years of aging. The article says that the difficulties with memory and concentration associated with "Fibrofog" have been shown in studies, and that the problems associated with Fibro with specific types of memory mimic the effects of around 20 years of aging. According to the article, the cognitive difficulties associated with Fibro may be exacerbated by the presence of depression, anxiety, sleep problems, hormonal disturbances and pain.

Sleep disturbances and Fibro

A recent article discusses a study that looked at the relationship between sleep problems, pain, depression, and physical functioning in Fibro patients. The study highlights how often Fibro patients have sleep problems and it also suggests that, over a period of 1 year, poor sleep could contribute to more pain, more pain could contribute to poorer physical functioning, and poorer physical functioning could contribute to depression. It is often thought that many Fibro patients have symptoms of depression, but it is not always considered whether problems due to the Fibro were the direct cause of the depression. This study suggests that this is so, corroborating many anecdotal reports that depression is a result of Fibro.