AN ELEPHANT AMONG US: THE ROLE OF DOPAMINE IN THE PATHOPHYSIOLOGY OF FIBROMYALGIA

From the  Fibromyalgia Global News Desk of Jeanne Hambleton

Source:The Journal of Rheumatology, Feb 2009

by Patrick B Wood, MD, and Andrew J. Holman, MD – February 13, 2009

 

 

Exploration of the pathophysiology underlying fibromyalgia (FM) has become an exciting field of inquiry as we strive to improve our understanding of this enigmatic disorder.

While evidence of a neuro-dysregulatory state mounts and insights are gained as to potential contribution of specific neurotransmitters, a review of recent literature demonstrates that not all relevant neurotransmitters are being considered equally or with disinterest. Specifically:

• The potential contribution of serotonin and norepinephrine has been emphasized, ostensibly due in part to the qualified success of trials of serotonin-norepinephrine reuptake inhibitors,

• While a general awareness of the potential contribution of dopamine-related dysfunction lags. 

Indeed, the text of recent reviews, and even peer-reviewed continuing medical education test articles, have contained either scant reference or, in a majority of cases, conspicuous neglect regarding the question of dopamine’s role in FM.

Despite the recent European League Against Rheumatism consensus recommendation to consider a dopamine agonist for treatment of FM, most clinicians and even medical authorities in the field routinely fail to acknowledge the mounting evidence for a role for dopamine in the pathogenesis of FM. 

The proposition that a disruption of normal dopaminergic neurotransmission may make a substantial contribution to the pathophysiology of FM was initially based on 3 key observations:

1. FM has been characterized as a “stress-related” disorder due to its frequent onset and apparent exacerbation of symptoms in the context of stressful events;

2. The experience of chronic stress results in disruption of dopaminergic activity in otherwise healthy organisms; and

3. Dopamine plays a dominant role in natural analgesia within multiple brain centers. 

The first hint in the medical literature of a connection between FM and dopamine was provided by Russell, et al, who in 1992 reported lower concentrations of metabolites of dopamine, norepinephrine, and serotonin … 

 

[Note: to read the free full text of this article by the originators of the Dopamine Theory of Fibromyalgia, click here.]

Source: The Journal of Rheumatology, Feb 2009. 36(2). PMID: 19208556, by Wood, PB, Holman AJ. Angler Biomedical Technologies, LLC, Jonestown, Texas; Pacific Rheumatology Research, Inc., Renton, Washington, USA. [E-mail:pwood@anglerbiomedical.com]

Courtesy ProHealth.com

http://www.prohealth.com/library/showarticle.cfm?libid=14320

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About jeanne hambleton

Journalist-wordsmith, former reporter, columnist, film critic, editor, Town Clerk and then fibromite and eventer with 5 conferences done and dusted. Interested in all health and well being issues, passionate about research to find a cure and cause for fibromyalgia. Member LinkedIn. Worked for 4 years with FMA UK as Regional Coordinator for SW and SE,and Chair for FMS SAS the Sussex and Surrey FM umbrella charity and Chair Folly Pogs Fibromyalgia Research UK - finding funding for our "cause for a cure" and President and co ordinator of National FM Conferences. Just finished last national annual Fibromyalgia Conference Weekend. This was another success with speakers from the States . Next year's conference in Chichester Park Hotel, West Sussex, will be April 24/27 2015 and bookings are coming in from those who raved about the event every year. I am very busy but happy to produce articles for publication. News Editor of FMS Global News on line but a bit behind due to conference. A workaholic beyond redemption! The future - who knows? Open to offers with payment. Versatile and looking for a regular paid column - you call the tune and I will play the pipes.
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