Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia

Martı́nez-Lavı́n, Manuel

doi:10.1186/ar2146

Cited by 200 publications

(185 citation statements)

References 32 publications

(29 reference statements)

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“…Dysfunctional ARs may provide a biologic explanation for some "somatization" symptoms. Different stress tests have shown that FM patients have orthostatic intolerance (3). Other studies have confirmed the relationship between low blood pressure and pain sensitivity (14,15).…”

Section: Discussionmentioning

confidence: 73%

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Association of adrenergic receptor gene polymorphisms with different fibromyalgia syndrome domains

Vargas‐Alarcón

Fragoso

Cruz-Robles

et al. 2009

Arthritis & Rheumatism

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Objective. Fibromyalgia (FM) patients have signs of relentless sympathetic hyperactivity associated with hyporeactivity to stress. Adrenergic receptors (ARs) are parts of the sympathetic nervous system that are fundamental for maintenance of homeostasis. We undertook this study to correlate ␣-AR and ␤-AR gene polymorphisms with the presence of FM and with different domains of the FM syndrome as measured by the Fibromyalgia Impact Questionnaire (FIQ).Methods. We studied 78 Mexican FM patients and 48 age-matched controls as well as 78 Spanish FM patients and 71 controls. All subjects studied were women. Single-nucleotide polymorphisms (SNPs) of ␣ 1A -AR (rs574584, rs1383914, rs1048101, and rs573542), ␤ 2 -AR (rs1042713 and rs1042714), and ␤ 3 -AR (rs4994) were analyzed by 5 exonuclease TaqMan polymerase chain reaction. Polymorphic haplotypes were constructed after linkage disequilibrium analysis.Results. The ␤ 2 -AR AC haplotype was a risk factor for the presence of FM. This haplotype had an increased frequency in Mexican patients compared with Mexican controls (42.1% versus 30.5%; P ‫؍‬ 0.04). Similarly, 50.4% of Spanish patients had this haplotype compared with 40.0% of Spanish controls (P ‫؍‬ 0.05). In Spanish patients, the ␣ 1A -AR SNP rs1383914 was associated with the presence of FM (P ‫؍‬ 0.01), and the ␣ 1A -AR SNP rs1048101 was linked with FIQ disability (P ‫؍‬ 0.02). Mexican patients with the rs574584 GG genotype presented the highest FIQ score compared with Mexican patients with other genotypes (P ‫؍‬ 0.01), and in Mexicans SNP rs574584 was associated with FIQ morning stiffness (P ‫؍‬ 0.04) and with FIQ tiredness upon awakening (P ‫؍‬ 0.02).Conclusion. AR gene polymorphisms are related to the risk of developing FM and are also linked to different domains of the FM syndrome.

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Section: Discussionmentioning

confidence: 73%

“…Furthermore, mounting evidence suggests that FM is a sympathetically maintained neuropathic pain syndrome (3). Dysautonomia may also explain FM symptoms not related to pain.…”

Section: Conclusion Ar Gene Polymorphisms Are Related To the Risk Ofmentioning

confidence: 99%

Association of adrenergic receptor gene polymorphisms with different fibromyalgia syndrome domains

Vargas‐Alarcón

Fragoso

Cruz-Robles

et al. 2009

Arthritis & Rheumatism

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“…1,2 In these patients, stress and pain may increase sympathetic nervous system (SNS) activity, and it has been reported that SNS function is changed in patients with FM. 6,7,12 On the other hand, arterial wall-stiffening process is significantly affected by SNS activity. 12 Increased sympathetic activity may change cardiovascular responses and cause endothelial damage.…”

Section: Discussionmentioning

confidence: 99%

“…5 Additionally, sympathetic activity may increase in these patients due to pain and stress. 6,7 Previous studies have shown that sympathetic overactivity and autonomic dysfunction may contribute to the risk of endothelial dysfunction and cardiovascular disease in patients with FM.…”

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confidence: 99%

Increased Carotid Intima-Media Thickness in Female Patients With Fibromyalgia: A Preliminary Study

Bölük

2015

Arch Rheumatol

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Objectives: This study aims to measure the carotid artery intima-media thickness (IMT) of patients with fibromyalgia (FM) by using ultrasound imaging and to investigate whether carotid IMT measurements were associated with the severity of FM. Patients and methods: Nineteen female patients (mean age 42.9±8.1 years; range 24 to 57 years) and 17 healthy female subjects (mean age 41.5±6.3 years; range 33 to 57 years) were included in this study. The Fibromyalgia Impact Questionnaire was used to determine the severity of FM. After clinical evaluation of the subjects, ultrasound imaging examinations of the carotid IMT were performed. Results: Right and left carotid IMT values were thicker in the patient group in comparison to the control group (p1=0.05, p2=0.03, respectively). Carotid IMT values were correlated with age and body mass index. Carotid IMT values did not have any correlation with blood glucose levels, creatinine levels, serum lipid profile and Fibromyalgia Impact Questionnaire scores in FM patients. Conclusion: Carotid IMT of FM patients seems to be affected. Our finding may have stemmed from endothelial dysfunction possibly due to increased sympathetic activity.

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“…Many researchers have recently uncovered a link between the sympathetic nervous system and the stress reaction, especially in fibromyalgia patients. A "sympathetic hyperactivity" in the sympathetic portion of the autonomic nervous system as well as perturbation in the HPA axis (Griep, Boersma & Lentjes, 1998;Crofford et al, 1994;van Houdenhove, Egle & Luyten, 2005;van Houdenhove & Luyton, 2006) has been put forward as an explanation for both difficulties in pain relief and pain oversensitivity in fibromyalgia patients (Martinez-Lavin, 2007). This hyperactivity has its origins in disturbances of certain neurotransmitters (catecholamines).…”

Section: Introductionmentioning

confidence: 99%

Theater for, by and with fibromyalgia patients – Evaluation of emotional expression using video interpretation

Horwitz

Kowalski

Anderberg

2010

The Arts in Psychotherapy

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The healing function of theater is reflected in all human cultures. Today, therapists and scientists work with psychodrama and drama therapy, often describing theater as the art form closest to life itself. In a unique cooperation between professional actors and a dance movement therapist/pain researcher, patients with fibromyalgia have first been trained in body-and voice expression and thereafter acted out a drama onstage together with professional actors. A video interpretation technique was used to help patients interpret their own emotional expressions towards other actors and evaluate their perceived pain and selfrated health. The results of this feasibility study show that the variation of emotional expression from video interpretation is dependent upon whether or not the patient acts with an actor. The intensity of emotional expression increases significantly when acting together with a professional actor. The results also show an increase in self-rated health and a decrease in pain after three months of using this theater-based technique. A correlation between strong emotional expression and decreased pain was also observed. However, when patients did not actively participate in a theater play, their self-estimated pain was not significantly decreased. In this study, the cross-fertilization of culture/expressive arts and health care is presented as a new resource for pain treatment. In particular there may be a link between intense emotional expressions when acting with professional actors and decreased perceptions of pain. The paper also discusses the potential therapeutic value of working with professional actors in the treatment of other pain patients. Hopefully, this theater related method can contribute to developing collaboration between actors and creative art therapists and stimulate controlled studies of evidence-based science.

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Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia

Cited by 200 publications

References 32 publications

Association of adrenergic receptor gene polymorphisms with different fibromyalgia syndrome domains

Association of adrenergic receptor gene polymorphisms with different fibromyalgia syndrome domains

Increased Carotid Intima-Media Thickness in Female Patients With Fibromyalgia: A Preliminary Study

Theater for, by and with fibromyalgia patients – Evaluation of emotional expression using video interpretation

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