Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients – Clin Rheumatol 2014 Dec – free full-text /PMC4348533/
Recent work has demonstrated that approximately 50 % of patients diagnosed with fibromyalgia have damage to their small unmyelinated nerve fibers
A skin punch biopsy is a sensitive and specific diagnostic test for this damage as a reduction in nerve fiber density allows for the diagnosis of small fiber neuropathy.
Small fiber neuropathy is a disease with symptoms similar to fibromyalgia, but it often has a definable etiology. Continue reading
Many Fibromyalgia Patients Have Small-Fiber Polyneuropathy – October 18, 2012 – medscape.com – Daniel M. Keller, PhD
In a small study of patients labeled as having fibromyalgia, almost half actually had small-fiber polyneuropathy (SFPN), a potentially treatable condition.
Dr. Oaklander noted that despite an emphasis on central mechanisms as the cause of fibromyalgia, these findings suggest that a specific — and sometimes treatable — type of peripheral neuropathy is a common cause of the condition.
It seems like quite a leap to assume the neuropathy is the *cause* of fibromyalgia. Another article from 4 years later (summarized below) suggests the opposite: that fibromyalgia is the cause of the peripheral neuropathy. Continue reading
Exercise Tests Suggest Autoimmunity Causes the Exertion Problems in Chronic Fatigue Syndrome, Fibromyalgia and POTS – Health Rising – by Cort Johnson | Aug 16, 2017
Researchers and doctors get interested in ME/CFS in different ways. Many have a personal connection, but for David Systrom, a pulmonologist, it was all about demand.
He didn’t seek chronic fatigue syndrome patients out – quite the contrary. When Systrom was given control of a clinical cardiopulmonary lab, he started doing invasive cardiopulmonary exercise tests (iCPET’s) on people with exercise intolerance.
Invasive Cardiopulmonary Exercise Testing (iCPET) Continue reading
Increased neural noise and impaired brain synchronization in fibromyalgia patients during cognitive interference | Scientific Reports | July 2017
Fibromyalgia (FM) and other chronic pain syndromes are associated with cognitive dysfunction and attentional deficits, but the neural basis of such alterations is poorly understood
Dyscognition may be related to high levels of neural noise, understood as increased random electrical fluctuations that impair neural communication; however, this hypothesis has not yet been tested in any chronic pain condition.
Here we compared electroencephalographic activity (EEG) in 18 FM patients -with high self-reported levels of cognitive dysfunction- and 22 controls during a cognitive control task. Continue reading
The Lyrica Effect: Lyrica Study Uncovers Key Brain Abnormalities in Fibromyalgia – Health Rising by Cort Johnson | Sep 30, 2013
Lyrica’s success – despite issues with side effects and efficacy in a significant number of fibromyalgia patients – highlights the tremendous need for drugs that relieve neuropathic pain.
Fifteen years in development, Lyrica was originally developed to reduce seizures by increasing GABA levels, but was later found to reduce glutamate, substance P and norepinephrine levels instead.
Researchers know the pharmacological effects Lyrica has, but they don’t know what parts of the brain it’s affecting. Continue reading
Connections: the Pain and Distress Circuit in Fibromyalgia Identified – Health Rising – by Cort Johnson | Feb 6, 2015
This article points out the further consequences of pain in Fibromyalgia patients, which are different than in normal people.
Fibromyalgia (FM), of course, is much more than about pain.
Called the “prototypical functional pain syndrome,” people with fibromyalgia often experience problems thinking (fibro-fog), sleep and autonomic nervous system problems, depression and catastrophizing.
The multidimensional aspects of fibromyalgia suggest that more than one part of the brain must be involved. Continue reading
Response to Pregabalin for Fibromyalgia-Related Pain in Patients Taking Antidepressants – Tori Rodriguez, MA, LPC– June 09, 2017
In a post hoc analysis of a pregabalin trial, researchers identified characteristics associated with pain improvement in patients with fibromyalgia who take antidepressant medications. Their findings were reported in Pain Medicine.
Alhough there is currently no gold-standard therapy for the treatment of fibromyalgia, a number of medications have shown modest efficacy in managing fibromyalgia-related pain, including
- milnacipran, and
However, these “do not necessarily provide a clinically meaningful improvement in FM-related pain for every patient, Continue reading
Fascia: A Hidden Piece of the Puzzle of Fibromyalgia Pain – Fibro News Daily | April 25, 2017 | By Ginevra Liptan, MD
Many studies have shown that the fibromyalgia nervous system has become sensitized and therefore has overactive responses resulting in pain.
This is the target of the three FDA approved medications for this illness, and these medications can indeed be helpful—usually resulting in about 30 percent reduction of pain.
In my experience, both as someone with the illness personally and as a physician treating fibromyalgia, utilizing these medications alone is inadequate. Continue reading
Study Suggests “Bad Energy” is Core Problem in Fibromyalgia and Chronic Fatigue Syndrome (ME/CFS) – Health Rising – by Cort Johnson | May 31, 2017
Lactate has become a big deal in both chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM). A by-product of anaerobic energy metabolism, lactate ordinarily gets pumped out of our cells in large amounts during exertion.
The lactate findings suggest that the energy needs of ME/CFS/FM patients are largely being addressed by glycolysis or anaerobic energy production.
Anaerobic energy production plays an important role in energy production, but when aerobic energy production is not available and it becomes the major source of energy it produces metabolites that produce the burning muscles, fatigue and other symptoms we associate with over-exercise. Continue reading
Study Reveals New Treatment Target for Fibromyalgia: Inflammation in the Brain – National Pain Report – April 11, 2017 – By Ginevra Liptan, MD
Scientists have long suspected that inflammation in the brain (neuroinflammation) could be the cause of the amplification of pain signals in the brain seen in fibromyalgia.
They can show this to be the case in lab animals, but this theory has been hard to prove in humans—mostly because researchers can’t very easily biopsy brain tissue of living people!
However, some very creative Swedish scientists figured out a different way assess levels of inflammation in the brain, by sampling the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord. Continue reading