in Fibromyalgia Research
1975: Harvey Moldofsky et. al. document EEG abnormality with
deficient stage 4 sleep in patients with FM.
(Moldofsky H, Scarisbrick P, England R, Smythe H. Musculosketal
symptoms and non-REM sleep disturbance in patients with "fibrositis
1988: Elevated spinal fluid substance P levels in FM patients,
53% of FM patients in this study had Raynaud’s (blood vessel
spasms in fingers or toes). (Vaerøy
H, Helle R, Førre O, Kåss E, Terenius L. Elevated CSF
levels of substance P and high incidence of Raynaud phenomenon in
patients with fibromyalgia: new features for diagnosis. Pain. 1988
1989: Swedish researchers find evidence of muscle tissue
hypoxia, disturbed microcirculation and mitochondrial damage in
FM patients. (Bengtsson A, Henriksson
KG. The muscle in fibromyalgia--a review of Swedish studies. J Rheumatol
Suppl. 1989 Nov;19:144-9.).
1992: Metabolic derangement in neurotransmitter synthesis
noted in the spinal fluid of FM patients. (Russell
IJ, Vaeroy H, Javors M, Nyberg F. Cerebrospinal fluid biogenic amine
metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis.
Arthritis Rheum. 1992 May;35(5):550-6.)
1995: Mountz et. al. find abnormal blood flow in the brains
of FM patients. (Mountz JM, Bradley
LA, Modell JG, Alexander RW, Triana-Alexander M, Aaron LA, Stewart
KE, Alarcón GS, Mountz JD. Fibromyalgia in women. Abnormalities
of regional cerebral blood flow in the thalamus and the caudate
nucleus are associated with low pain threshold levels. Arthritis
Rheum. 1995 Jul;38(7):926-38.)
1997: Robert Bennett, M.D. at OHSU finds low somatomedin
C levels in fibromyalgia patients. (Bennett
AL, Mayes DM, Fagioli LR, Guerriero R, Komaroff AL. Somatomedin
C (insulin-like growth factor I) levels in patients with chronic
fatigue syndrome. J Psychiatr Res. 1997 Jan-Feb;31(1):91-6.).
1998: Evidence that impaired activation of the hypothalamic-pituitary-adrenal
(HPA) axis is an essential neuroendocrine feature of this condition.
(Demitrack MA, Crofford LJ. Evidence
for and pathophysiologic implications of hypothalamic-pituitary-adrenal
axis dysregulation in fibromyalgia and chronic fatigue syndrome.Ann
N Y Acad Sci. 1998 May 1;840:684-97.)
1998: Dr. Bennett finds impaired growth hormone release in
30% of FM patients confirming dysregulation of the hypothalamic-pituitary
axis. (Bennett RM. Disordered growth
hormone secretion in fibromyalgia: a review of recent findings and
a hypothesized etiology. Z Rheumatol. 1998;57 Suppl 2:72-6. Bennett
RM. Adult growth hormone deficiency in patients with fibromyalgia.
Curr Rheumatol Rep. 2002 Aug;4(4):306-12.
1999: Vanderbilt’s Jane Park, Ph.D uses P-31 MRS to
show 60% lower phosphocreatine and ATP levels in FM muscle &
44% decrease in total oxidative capacity. (Park
JH, Phothimat P, Oates CT, Hernanz-Schulman M, Olsen NJ. Use of
P-31 magnetic resonance spectroscopy to detect metabolic abnormalities
in muscles of patients with fibromyalgia. Arthritis Rheum. 1998
1999: Georgetown’s Rheumatology Professor Daniel Clauw,
MD and colleagues find an association between interstitial cystitis
& FM. They note that both conditions have increased peripheral
nociception & they postulate that both conditions may share
a similar pathogenic mechanism. (Clauw
DJ, Schmidt M, Radulovic D, Singer A, Katz P, Bresette J. The relationship
between fibromyalgia and interstitial cystitis. J Psychiatr Res.
2000: Elevated resting norepinephrine levels and exaggerated
norepinephrine release after IL-6 administration in FM patients
when compared to controls. (Torpy
DJ, Papanicolaou DA, Lotsikas AJ, Wilder RL, Chrousos GP, Pillemer
SR. Responses of the sympathetic nervous system and the hypothalamic-pituitary-adrenal
axis to interleukin-6: a pilot study in fibromyalgia. Arthritis
Rheum. 2000 Apr;43(4):872-80.)
2000: Dr. Charles Stratton at Vanderbilt identifies possible
role for Chlamydia pneumoniae in FM and CFS. He has published many
articles related to Chlamydia pneumoniae. You
may download his review article here.
Dr. Garth Nicolson & colleagues find evidence of Mycoplasma
infection in majority of FM & CFS patients. Nasralla
M, Haier J, Nicolson GL. Multiple mycoplasmal infections detected
in blood of patients with chronic fatigue syndrome and/or fibromyalgia
syndrome. Eur J Clin Microbiol Infect Dis. 1999 Dec;18(12):859-65).
HHV-6A suspected as
a viral source of fatigue in MS and CFS.
(Ablashi DV, Eastman HB, Owen CB, Roman MM, Friedman J, Zabriskie
JB, Peterson DL, Pearson GR, Whitman JE. Frequent HHV-6 reactivation
in multiple sclerosis (MS) and chronic fatigue syndrome (CFS) patients.
J Clin Virol. 2000 May;16(3):179-91).
University of Michigan,
Denise Park Ph.D. documents cognitive impairment in FM, especially
memory and vocabulary. (Glass JM,
Park DC.Cognitive dysfunction in fibromyalgia. Curr Rheumatol Rep.
Stratton documents a link between multiple sclerosis and Chlamydia
pneumoniae infection. Antibiotic treatment reverses some cases of
is one of his review articles.
& colleagues document elevated infection-related DNA in the
bllod of patients with CFS. Mixed infections with Mycoplasma, Chlamydia
pneumoniae & HHV-6 in CFS patients were common. (Nicolson
GL, Gan R, Haier J. Multiple co-infections (Mycoplasma, Chlamydia,
human herpes virus-6) in blood of chronic fatigue syndrome patients:
association with signs and symptoms. APMIS. 2003 May;111(5):557-66).
2004: “Relentless sympathetic hyperactivity”
may explain the nature of FM pain. (Martinez-Lavin
M. Fibromyalgia as a sympathetically maintained pain syndrome. Curr
Pain Headache Rep. 2004 Oct;8(5):385-9.)
2005: Elevated glycation product, N(epsilon)-carboxymethyllysine,
in the muscles of FM patients is associated with increased levels
of NF kappa B in muscles. [NFkB generally increases in response
to inflammatory signals and infection]. (Rüster
M, Franke S, Späth M, Pongratz DE, Stein G, Hein GE. Detection
of elevated N epsilon-carboxymethyllysine levels in muscular tissue
and in serum of patients with fibromyalgia. Scand J Rheumatol. 2005
2005: Amy Yasko, Ph.D, N.D. published an intriguing new perspective
on CFS, Autism and FM in her book “Genetic Bypass: Using Nutrition
To Bypass Genetic Mutations”[it is worth reading]. Dr. Yasko
describes genetic mutations that alter one’s ability to methylate
properly, leading to compromised immune and cognitive function which
can be compensated for with methylated vitamins. Genetic testing
is avilable for those interested. In 2007, Richard A. Van Konynenburg,
Ph.D presents a hypothesis related to Dr. Yasko’s work and
proposes a simplified nutritional program to support methylation
2006: Excellent summary of insights into the neurochemical
and genetic features associated with FM. Narcotics and anti-inflammatories
are less effective than are “neuroactive compounds that down
regulate sensory processing.” (Dadabhoy
D, Clauw DJ. Therapy Insight: fibromyalgia--a different type of
pain needing a different type of treatment. Nat Clin Pract Rheumatol.
2006: Spinal fluid CRF levels (a molecule that produces/maintains
stress reactions) are elevated in FM patients and are associated
with chronic pain but not fatigue. (McLean
SA, Williams DA, Stein PK, Harris RE, Lyden AK, Whalen G, Park KM,
Liberzon I, Sen A, Gracely RH, Baraniuk JN, Clauw DJ. Cerebrospinal
fluid corticotropin-releasing factor concentration is associated
with pain but not fatigue symptoms in patients with fibromyalgia.
Neuropsychopharmacology. 2006 Dec;31(12):2776-82).
2006: “Recent genetic findings suggest that specific
gene mutations may predispose individuals to develop fibromyalgia.”
(Harris RE, Clauw DJ. How do we know
that the pain in fibromyalgia is "real"? Curr Pain Headache
Rep. 2006 Dec;10(6):403-7).
2006: Stanford Infectious Disease specialist, Dr. Jose Montoya
and colleagues treated CFS patients with antiviral medication for
5 months and documented a significant improvement in symptoms. Larger
trials are underway. (Kogelnik AM,
Loomis K, Hoegh-Petersen M, Rosso F, Hischier C, Montoya JG. Use
of valganciclovir in patients with elevated antibody titers against
Human Herpesvirus-6 (HHV-6) and Epstein-Barr Virus (EBV) who were
experiencing central nervous system dysfunction including long-standing
fatigue. J Clin Virol. 2006 Dec;37 Suppl 1:S33-8).
2007: “...using mu-opioid receptor (MOR) positron emission
tomography. We demonstrate that FM patients display reduced MOR
binding potential (BP) within several regions known to play a role
in pain modulation, including the nucleus accumbens, the amygdala,
and the dorsal cingulate.” [Mu-opioid receptors = the morphine
receptor. Low mu-receptor levels mean our natural morphine-like
substances are not going to control pain and morphine (synthetic
opioids) will not work very well to control pain in FM]. (Harris
RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased
central mu-opioid receptor availability in fibromyalgia. J Neurosci.
2007 Sep 12;27(37):10000-6).
2007: Elevated TNF-alpha, IL-8, & IL-10 observed in FM
patients and these inflammatory markers were higher in those who
were more symptomatic. (Bazzichi
L, Rossi A, Massimetti G, Giannaccini G, Giuliano T, De Feo F, Ciapparelli
A, Dell'Osso L, Bombardieri S. Cytokine patterns in fibromyalgia
and their correlation with clinical manifestations. Clin Exp Rheumatol.
Low Vitamin D level is more common in FM than in controls. Low Vitamin
D was associated with increased anxiety & depression. (Armstrong
DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB. Vitamin D
deficiency is associated with anxiety and depression in fibromyalgia.
Clin Rheumatol. 2007 Apr;26(4):551-4).
Abnormal unmyelinated nerve fibers are observed in the skin biopsies
taken from FM patients. This may explain some of the increased pain
signaling in FM. (Kim SH, Kim DH,
Oh DH, Clauw DJ. Characteristic electron microscopic findings in
the skin of patients with fibromyalgia-preliminary study. Clin Rheumatol.
Infection Related Research
Chronic rhinitis is noted in nearly 70% of patients with FM and
CFS. (Baraniuk JN, Clauw D, Yuta
A, Ali M, Gaumond E, Upadhyayula N, Fujita K, Shimizu T. Nasal secretion
analysis in allergic rhinitis, cystic fibrosis, and nonallergic
fibromyalgia/chronic fatigue syndrome subjects. Am J Rhinol. 1998
Dr. Ponikau at Mayo Clinic documents that fungal sinusitis produces
chronic rhinosinusitis and allergy. Treatment with anti-fungal nasal
spray leads to remission of allergy and chronic sinusitis.
(Ponikau JU, Sherris DA, Kern EB, Homburger HA, Frigas E, Gaffey
TA, Roberts GD. The diagnosis and incidence of allergic fungal sinusitis.Mayo
Clin Proc. 1999 Sep;74(9):877-84.; Ponikau JU, Sherris DA, Kephart
GM, Adolphson C, Kita H. The role of ubiquitous airborne fungi in
chronic rhinosinusitis. Clin Rev Allergy Immunol. 2006 Jun;30(3):187-94).
Chlamydia pneumoniae and Mycoplasma pneumoniae implicated as sources
of chronic bronchitis and asthma. Antibiotic treatment improves
pulmonary function. Daian CM, Wolff
AH, Bielory L. The role of atypical organisms in asthma. Allergy
Asthma Proc. 2000 Mar-Apr;21(2):107-11; Beuther DA, Martin RJ. Antibiotics
in asthma. Curr Allergy Asthma Rep. 2004 Mar;4(2):132-8.).
Although this study is not specifically a study of CFS or FM, Toffel
& Christensen report EBV infection of B-cells can lead to low
production of IgG, and this may be associated with chronic sinusitis.
They report monthly shots of gammaglobulin can be very helpful for
those with low gammaglobulin levels and chronic sinusitis. (Toffel
PH, Christensen J. Epstein-Barr virus-mild acquired immune deficiency
syndrome (EBV-MAIDS) in postsurgical sinusitis. Am J Rhinol. 2002