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Neuroinflammation in Fibromyalgia
Neuroinflammation, a low-grade chronic inflammation within the central nervous system involving activated immune cells (microglia and astrocytes) and elevated inflammatory substances (cytokines), is increasingly recognized as a key factor in fibromyalgia, contributing to central sensitization and symptoms like pain, fatigue, and "brain fog" by altering pain pathways. Research using PET scans shows increased microglial activity in fibromyalgia patients, and elevated inflammatory markers are found in their cerebrospinal fluid and blood, suggesting a bidirectional link between the immune system and nervous system that fuels the condition.
Key Findings & Mechanisms:
Microglial Activation: The brain's resident immune cells, microglia, become overactive in fibromyalgia, releasing pro-inflammatory chemicals (cytokines) that sensitize pain pathways.
Elevated Inflammatory Markers: Patients often have higher levels of Substance P, glutamate, IL-1β, and IL-8 in their cerebrospinal fluid, which activate glial cells and increase pain.
Central Sensitization: Neuroinflammation leads to heightened sensitivity in the nervous system, amplifying pain signals and contributing to widespread pain, fatigue, and cognitive issues (fibro fog).
Brain Regions Affected: PET imaging studies have identified specific brain areas with increased inflammatory activity in fibromyalgia patients, including regions involved in pain processing.
Bidirectional Link: There's complex communication between the nervous and immune systems, meaning immune responses affect nerve function, and nerve signals can trigger immune activation.
Implications for Treatment:
Understanding neuroinflammation opens new avenues for therapy, focusing on blocking inflammatory mediators and dampening glial cell activation to alleviate symptoms.
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In essence, neuroinflammation helps explain why fibromyalgia involves more than just musculoskeletal pain, linking it to persistent central nervous system changes that drive many of its complex symptoms.
Sources:
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC11852494/....
2. https://journals.lww.com/.../evidence_of...
3. https://www.fibromyalgiafund.org/detecting-brain.../....
