Neuroendocrine dysfunction in fibromyalgia and migraine

Abstract

Fibromyalgia (FM) and migraine are common chronic disorders that predominantly affect women. The prevalence of headache in patients with FM is high (35%-88%), with migraine being the most frequent type. A particular subgroup of patients with FM (approximately half) presents with a combined clinical form of these two painful disorders, which may exhibit a different manner of progression regarding symptomatology and impact on daily activities. This article reviews several common aspects of the pathophysiology regarding pain control mechanisms and neuroendocrine dysfunction occurring in FM and migraine, particularly in the chronic form of the latter. We also discuss the participation of hypothalamic and brainstem centers of pain control, the putative role played by neurotransmitters or neuromodulators on central sensitization, and changes in their levels in the cerebrospinal fluid. Understanding their mechanisms will help to establish new treatment strategies for treating these disabling brain disorders.

Frequency of Migraine Headaches in Patients With Fibromyalgia

“…In one small study comparing patients with fibromyalgia with those with arthritis and healthy controls, self‐report of migraine was significantly higher in patients with fibromyalgia (72%) than in patients with arthritis (43%) or healthy controls (13%) . The explanation for the high degree of comorbidity between migraine and fibromyalgia is unclear; altered pain control mechanisms and neuroendocrine dysfunction associated with both disorders may be responsible …”

“…9 The explanation for the high degree of comorbidity between migraine and fibromyalgia is unclear; altered pain control mechanisms and neuroendocrine dysfunction associated with both disorders may be responsible. 10,11 Research also suggests that the presence of both headache and fibromyalgia have a substantial impact on disease burden. 6,12 Given this, and the purported high degree of comorbidity between fibromyalgia and migraine, assessment of migraine in patients with fibromyalgia is paramount.…”

Migraine and Obesity: Possible Link to Inflammation

“…The extracranial terminal branches of the external carotid artery were suspected to be the reason of pain in the aura [11,12]. Newer data imply that migraine headache is caused by an inappropriate activation of trigeminovascular system, that is, pain sensitive innervation of dural, arachnoid, and pial vessels as well as large intracranial vessels by nociceptive fibers originating in trigeminal ganglion (TG) and travelling mainly through ophthalmic and to a much lesser extent through maxillary and mandibular divisions of trigeminal nerve [10,13,14]. Appropriately, "neurovascular disorder" definition has been used to address dysfunction of the cerebral nerves and blood vessels through cortical activation which is followed by brainstem activation with neurogenic inflammation and vasodilation [15][16][17].…”

Headache Research and Medical Practice in Brazil: An Historical Overview

“…In Rio de Janeiro, São Paulo, Paraná, Santa Catarina, and Rio Grande do Sul, there are several centers dealing with headache disorders and an excellent scientific production has been made by a number of headache specialists, mentioning Abouch Krymchantowski, Carla da Cunha Jevoux, Maurice Vincent, Pedro Ferreira Moreira Filho, Jano Alves de Souza, Maria Eduarda Nobre in Rio de Janeiro; Celia P. Roesler, Deusvenir de Souza Carvalho, Eliova Zukerman, Mario Fernando Prieto Peres,…”