Elevated excitatory neurotransmitter levels in the fibromyalgia brain

Richard E Harris

doi:10.1186/ar3136

Abstract

Consistent brain imaging findings demonstrate that neurobiological factors may contribute to the pathology of 'central' pain states such as fibromyalgia (FM). Studies using proton magnetic resonance spectroscopy suggest that glutamate (Glu), a key excitatory neurotransmitter, may be present in higher concentrations within the brains of FM patients. This neurotransmitter imbalance is present in multiple brain regions that have been implicated in processing pain information. However, it is unknown if elevated Glu is acting at the synapse. New investigations are needed to investigate the molecular action of Glu in FM and to investigate these findings during treatment that modulates glutamatergic neurotransmission.

Highlights

Consistent brain imaging findings demonstrate that neurobiological factors may contribute to the pathology of ‘central’ pain states such as fibromyalgia (FM)
Fayed and colleagues performed a cross-sectional 1HMRS investigation of ten patients with FM and ten sexand age-matched healthy controls, looking at four specific brain regions that are thought to be somewhat involved in pain processing: the sensorimotor cortex, the thalamus, the hippocampus, and the posterior gyrus
The authors report elevated levels of Glx, a combined measure of Glu and glutamine, within the posterior cingulate of FM patients. They observed negative correlations between Glx in the patient group and pressure pain thresholds, and positive associations with these metabolites and scores on the Fibromyalgia Impact Questionnaire, suggesting that elevated levels of Glx in the posterior cingulate are associated with increased pain and tenderness in FM

Summary

Introduction

Consistent brain imaging findings demonstrate that neurobiological factors may contribute to the pathology of ‘central’ pain states such as fibromyalgia (FM). The occurrence of central neurobiological factors in chronic pain states is becoming increasingly observed. These authors used a brain imaging tool called proton magnetic resonance spectroscopy (1H-MRS), which can assess the concentration of specific metabolites in the human brain, and looked for altered levels of brain neurotransmitters in individuals with FM.

Results

Conclusion