Scientific Abstracts
To help Fibromyalgia Network Members talk to their doctors about the information presented in the Fibromyalgia Network Journal, a summary each issue's abstracts is shown below. Please click on the issue date and number to read each of the abstracts in its entirety. Keep in mind, an abstract is only a brief summary of a full research report. The research reports are copyrighted material that are only available in the publication that is referenced in the abstract.
In 2001, a study of 289 family physicians showed that many doctors rely heavily on medical journal abstracts to aid them in finding information that can lead them toward better treatment decisions (Barry H, et al. J Am Board Fam Pract 2001, 14:437-442).
If we have mentioned a subject in the Journal that you would like to discuss with your doctor, you can print out the related abstracts and take them with you on your next doctor's visit. If you are visiting our website for the first time, and have come across these abstracts by chance, you can find patient-friendly articles that explain the importance of these reports in our quarterly publication. To learn more about these topics, join today.
- A retrospective review of the sleep characteristics in patients with chronic fatigue syndrome and fibromyalgia. Narcolepsy and its genetic ties. Health-related quality of life in narcolepsy patients. Treatment of the narcoleptiform sleep disorder with sodium oxybate.
- How fibromyalgia is associated with impaired balance and falls. What predicts falls in older, healthy adults and adults with fibromyalgia? A six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia.
- The abnormal overexpression of mastocytes in skin biopsies of fibromyalgia patients. The biochemical and molecular signals that induce mast cell homing in the central nervous system is an area of active investigation. Altered signaling between mucosa and the nervous system might be involved in development of irritable bowel syndrome. Mast cell involvement in asthma, airway obstruction, and vulvar vestibulitis.
- Sustained nociceptive mechanical stimulation of latent myofascial trigger point induces central sensitization in healthy subjects. Botulinum neurotoxins in the treatment of pain.
- The American College of Rheumatology revised diagnostic criteria for fibromyalgia and measurement of symptom severity in its preliminary state. Tender points versus trigger points. A simple bedside test that may be useful in the recognition of patients with FM.
- Research on the association between FM and decreased ferritin level. Iron as a cofactor in serotonin and dopamine production may have a role in the etiology of FM. The relation between serum ferritin levels and restless legs syndrome.
- Looking at the relationship between spontaneous electrical activity at a latent myofascial trigger point after stimulation of different latent trigger point; how trigger points in one side or area of the body are felt in opposite areas; stimulating a trigger point can increase the spontaneous activity of another trigger point; studies on low-dose ultrasound and acupuncture as a treatment for trigger points.
- Fibromyalgia patients show an abnormal dopamine response to pain. Changes in gray matter density in fibromyalgia: correlation with dopamine metabolism. Treatment with pramipexole improved pain, fatigue, function, and global status, and was safe and well-tolerated but was associated with impulse control disorder behaviors in some patients.
- Confirming what many researchers have believed, most of the tender point sites in fibromyalgia patients are myofascial trigger points. This breakthrough study has many significant implications involving changes in diagnostic criteria for fibromyalgia and treatment options. Researchers have developed ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue. This article discusses muscle pain concepts in the context of myofascial pain syndrome. The concepts of local and referred pain from active myofascial trigger points. Ultrasound as therapy.
- This study determines the type and frequency of neurologic signs and symptoms in fibromyalgia patients.
- Connections between fibromyalgia and skin sensitivities, particularly itching. Patterns of brain activity evoked by histamine-induced itch. Higher concentrations of glutamate in the posterior insula may play a role in the pathophysiology of fibromyalgia and could acts as a biomarker.
- Pain relief depends largely on what patients expect. Research shows that the brain and spinal cord in fibromyalgia patients are not communicating normally not matter what the patient expects. The role of dopamine in the DNIC (diffuse noxious inhibitory control) system of fibromyalgia patients, the genetic interaction, and possible therapies.
- Overview of studies that look at the influences of estrogen, progesterone, testosterone, age, and sleep on the pain inhibitory system and fibromyalgia. How hormonal replacements improve sleep and which hormone combinations may reduce pain.
- Melatonin may assist in the maintenance of normal sleep architecture; the size of the pineal gland and the amount of melatonin produced vary 20-fold between individuals; Patients with fibromyalgia have a lower melatonin secretion. Melatonin as an alternative and safe treatment for FM patients. Melatonin levels lower during migraine.
- Reduced knee muscle strength appears to be a common abnormality in FM. A long-lasting exercise therapy in warm water produced relevant gains in muscle strength.
- Functional magnetic resonance imagery (fMRI) in fibromyalgia and the response to milnacipran. Clincal trials on milnacipran. Lack of interaction of milnacipran with the cytochrome p450 isoenzymes frequently involved in the metabolism of antidepressants.
- These are the first results to demonstrate that there is a spatial learning deficit in people with FM. Fibromyalgia appears to be associated with an acceleration of age-related changes in the very substance of the brain. There is a strong correlation between dopamine metabolism and gray matter density.
- Overall fibromyalgia pain is predicted by ratings of local pain and pain-related negative affect, a possible role of peripheral tissues. Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. This study compares the lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome.
- Inflammatory biomarkers increase with severity of upper-extremity overuse disorders. High force reaching task induces widespread inflammation, increased spinal cord neurochemicals and neuropathic pain. Even a low repetition, negligible force upper extremity task for 3 months can induce mild peripheral tissue inflammation. A manual dexterity test for use with patients with fibromyalgia.
- Not all evidence of cortical compression may cause pain at the site. Recognizing unsuspected, comorbid cervical cord compression may provide new insight into its variable presentation, leading to novel treatment considerations. The use of a "dynamic MRI," showing the neck in three different postions, may promote further study of the emerging concept of cervical cord irritation. Natural aging may also caus the discs to compress. Fibromyalgia was 13 times more frequent following neck injury than following lower extremity injury. This study looks at the relationship of adverse events in childhood and chronic widespread pain in adult life.
- Study compares pain sensors, fatigue, sympathetic activity, and immune response of fibromyalgia patients and healthy individuals.
- The findings of this study suggest that the withdrawal of opioids in a chronic pain subgroup leads to an acute increase in pain sensitivity. Low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia. In addition, this study showed that mechanical and heat pain thresholds were improved by the drug. Individuals with sed rates had the greatest reduction of symptoms in response to low-dose naltrexone.
- Researchers are able to image myofascial trigger points (MTPs) in the upper trapezius muscle using ultrasound and vibration. The tests differentiated between the soft tissue characteristic of MTPs and the surrounding muscle. Ultrasound offers a convenient, accessible and low-risk approach for identifying MTPs and for evaluating clinical observations of palpable, painful nodules. Research is also studying the difference between fibromyalgia tender points and MTPs.
- Orofacial pain or temporomandibular disorder (TMD) is common among women with vulvar vestibulitis syndrome (VVS). For men, chronic testicular pain (orchialgia, orchidynia or chronic scrotal pain) is common and well recognized but its pathophysiology is poorly understood. Women with TMD have a high prevalence of fibromyalgia (FM). Discussion on treatment options.
- Evidence indicates that sleep might be regulated at a more local level in the brain: it seems to be a fundamental property of neuronal networks and is dependent on prior activity in each network. Such local-network sleep might be initiated by metabolically driven changes in the production of sleep-regulatory substances. Anti-inflammatory cytokine predominance in FM may explain the common complaint of disturbed sleep because these cytokines are known to disrupt sleep. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain. Science studies the metabolic and cardiovascular consequences of sleep deprivation.
- A six-week traditional exercise program with supplementary whole-body vibration safely reduces pain and fatigue, whereas exercise alone fails to induce improvements. Antagonists / inverse-agonists of 5-HT(2A), such as APD125, volinanserin, eplivanserin, pruvanserin and pimavanserin, are currently being investigated as a treatment of sleep maintenance and quality in people with insomnia. Propranolol in TMD treatment. Data suggests that either positive or negative imbalances in ADRB2 function increase the vulnerability to chronic pain conditions such as TMD.
- These scientific studies look at the difference between men and women when it comes to pressure pain thresholds, referred pain, and the distribution of muscle workload. Healthy women appear to have enhanced central nervous system processing of painful inputs than healthy men.
- Nasal congestion and sinus irritation occurs in about 70 percent of FM patients. Fatigue improves after endoscopic sinus surgery (ESS), with significantly greater improvement in patients with fibromyalgia and in patients that are more severely fatigued at presentation.
- This article proposes that new concepts may help understand the pathogenesis of fibromyalgia, chronic fatigue syndrome, and Gulf War syndrome. In FM, there is a deranged sympathetic response to orthostatic stress. This abnormality may have implications regarding the pathogenesis of FM.
- Post-traumatic (or post-infective) phenotypic changes would induce a sympathetically maintained neuropathic pain syndrome resulting in widespread pain, allodynia and paresthesias - precisely, the key clinical features of FM. If this hypothesis proves to be true, then sodium channel blockers could become therapeutic options for FM pain.
- Trials are currently being developed to assess the potential additive or synergistic effects of combined central pharmacotherapy and to assess the safety and tolerability of this multidrug therapy.
- These data suggest that sleep continuity disturbance, but not simple sleep restriction, impairs endogenous pain-inhibitory function and increases spontaneous pain, supporting a possible pathophysiologic role of sleep disturbance in chronic pain. Patients with both FM and restless legs syndrome more often experience sleep disturbances and pronounced daytime sleepiness.
- Accumulating evidence points to significant cognitive disruption in individuals with fibromyalgia. This study also supported previous work that showed working memory as it applies to everyday attentional tasks was impaired in this group. It is likely that many factors, including disrupted cognition, play a role in the reduced quality of life reported by individuals with fibromyalgia (FM).
- Studies show that sleep facilitates memory consolidation. This study exposed scents during learning. When the study participant was re-exposed to the scent during slow wave sleep, magnetic resonance imaging revealed significant hippocampal activation in response to odor. This report gives an overview of the large body of sleep research done over the past decade including memory encoding, memory consolidation, brain plasticity, and memory reconsolidation. How does the brain consolidate newly acquired memories for long-term storage? This study looks at the effects of diminished slow wave sleep on cortisol levels and how the role of REM sleep. This study demonstrates an abnormality in hippocampal brain metabolites in premenopausal female fibromyalgia patients with no psychiatric problems. Further study on the loss of brain gray matter in FM patients that may be linked to affective disturbances and chronic widespread pain.
- This study correlates induced muscle pain to a higher frequency of muscle cramps. Results in this study suggest that latent MTrPs could be involved in the generation of muscle cramps. Trigger point dry needling is a relatively new technique used in combination with other physical therapy interventions to treat trigger points.
- A combination of ASIC, P2X5 and/or P2X4, and TRPV1 are the molecular receptors used to detect metabolites by muscle-innervating sensory neurons. This study concludes that the adequate stimuli for muscle metaboreceptors and nociceptors are combinations of protons, ATP, and lactate.
- Sensory amplification may be an underlying pathophysiologic mechanism in FM and chronic fatigue syndrome that is relatively independent of depression and depressive symptoms.
- Night sweats are associated with a variety of other sleep-related symptoms, but researchers are still looking for evidence that links specific sleep disorders and night sweats. Characteristics of patients with upper airway resistance syndrome.
- Serotonin, norepinephrine, and dopamine are three neurotransmitters known to be low in the central nervous system of people with fibromyalgia (FM); doctors anticipate that the U.S. Food and Drug Administration will approve milnacipran to treat FM in the fall of 2008; FM is associated with a global central nervous system increase of sensory information, and these study findings may also help to explain why people with FM display a number of comorbid physical symptoms other than pain; milnacipran is a dual serotonin norepinephrine reuptake inhibitor (SNRI) that boosts the secretion of serotonin and norepinephrine transmitters from the nerves into the body; the drug exerts twice the effect on norepinephrine (NE) than serotonin; this study supports the hypothesis that compounds with greater NRI activity should be more effective for the treatment of pain than compounds having only SRI activity.
- These data provide the first objective confirmation that tolerance develops to the sedative effect of a prototypical first-generation H1 antihistamine, diphenhydramine after three days.
- This study suggests that the gray matter change observed in chronic pain patients are the consequence of frequent nociceptive input and should thus be reversible when pain is adequately treated; researchers are using functional magnetic resonance imaging (fMRI) to measure brain response to pain in FM patients; FM patients required a lower pain stimulus to record brain activity similar to healthy controls; the pain of FM seems to be accompanied by generalized central sensitization.
- The intestinal permeability is increased for many FM patients. Intestinal infections and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may both contribute to leaky gut; the study suggests that proinflammatory cytokines TNF-alpha and IL-8 are involved in FM, but they do not apparently provoke the pain of FM directly; multidisciplinary pain therapy modified the cytokine profile in patients with FM during the observation period; according to the results of this study, serum magnesium and zinc levels may play an important role in the pathophysiology of FM.
- The widespread pain and diagnostic criteria of FM alters the ratio of female to male patients in the U.S. and Canada; raloxifen was superior to placebo in the treatment of menopausal patients with fibromyalgia; long-term treatment using raloxifene in a population of postmenopausal women showed a reduction in breast density, thus creating a hypothesis that perhaps explains the concurrent reduction of mammary carcinoma in these patients.
- A decrease in the length of periods of uninterrupted sleep in chronic fatigue patients resulted with more sleepiness in the morning than on the night before and may explain the overwhelming fatigue, report of unrefreshing sleep, and pain in this subgroup of patients; dynamic transitional analysis of sleep stages is useful to understand human sleep regulation mechanisms with pathophysiological implications; shorter durations of stage 2 sleep distinguish FM and healthy control subjects and may predict pain levels experienced in FMS.
- In a retrospective chart review study of 17 FM patients, preliminary data suggest that food intolerance can significantly affect FM pain as well as other co-morbid symptoms; the double-blind, placebo-controlled food challenge remains the most specific test for confirming food allergies.
- Patients with FM display sensitivity to a number of sensory stimuli; this study suggests that FM is associated with a global central nervous system amplification of sensory information; the findings may also help to explain why FM patients display a number of physical symptoms other than pain; higher concentrations of glutamate in the insula correlate with patients’ pain score.
- A significant subset of FM patients tested have chronic inflammatory demyelinating polyneuropathy (CIDP) that responds favorably to intravenous immunoglobulin G (IVIg) therapy; several studies show that the immune system in FM patients is not working properly and one of its first-line defense systems is reduced; in addition, cytokine levels in the blood and skin are significantly higher in FM patients and appear to play a role in FM symptoms.
- High-tech innovations have been developed to better understand the complex microbial habitat of the human gastrointestinal tract; FM patients have a higher prevalence of irritable bowel syndrome (IBS) than healthy subjects; patients with FM produce more gas than IBS patients; the amount of gas produced by FM patients directly corresponds with the amount of pain; small intestinal bacterial overgrowth is associated with IBS and FM (both of which involve reduced pain thresholds), and this overgrowth responds transiently to antimicrobial therapy; the probiotic B infantis alleviates symptoms in IBS and normalizes the ratio of an anti-inflammatory to a proinflammatory cytokines, suggesting an immune-modulating role for this organism in this disorder.
- Patients in all Lyrica (pregabalin) groups showed statistically significant improvement in mean pain score compared with placebo; the chances that Lyrica alone will significantly reduce FM symptoms are between 10 and 20 percent; weight gain tends to plateau after three or four months and is variable; Lyria is believed to work by reducing glutamate, an excitatory pain transmitter, and enhancing the quality of sleep.
- Patients with FM are much more likely to have other medical conditions that lead to higher levels of healthcare use and cost; study findings indicate that genetic factors are involved in the etiology of FM and in pain sensitivity; in addition, mood disorders and FM may share some of these inherited factors.
- REM, or rapid eye movement, sleep decreases from childhood to young adults and usually plateaus off sometime during middle age; the fast alpha activity, resembling an awake-like state, was found to increase with age; comparing sleep differences between genders of study participants around 60 years of age, men spent twice the amount of time in slow-wave sleep; reduced sleep quality with low levels of slow-wave sleep, as occurs in aging and in many obese individuals, may contribute to increased risk of type 2 diabetes; although melatonin is commonly known as a sleep aid, it has a variety of other beneficial effects that may account for its potential therapeutic value to treat FM.
- In small preliminary studies, tai chi appears to have physiological and psychosocial benefits. It also appears to be safe and effective in promoting balance control, flexibility, and cardiovascular fitness in older patients with chronic conditions. The effects of tai chi for rheumatoid arthritis patients are inconclusive; one small study of tai chi in FM patients showed a reduction in symptoms.
- Glia cells play an integral part of the immune system acting as surveillance; they activate when foreign bodies such as viruses, bacteria, etc. are perceived in the central nervous system; cytokines released by glia are elevated in FM patients; an imbalance of anti- and pro-inflammatory and cytokines may be associated with enhanced pain states; products created by the active glia are not only implicated with pain processes, but also with fatigue and disturbed sleep; glia may be responsible for producing analgesic tolerance and withdrawal side effects; new medications are being studied that "quiet" the glia.
- A study shows that Schwann cells, a type of glia, were enlarged or ballooned in skin cells of FM patients; Schwann cells surround all fibers in the peripheral nervous system; In an activated state, they cells pour out pain-producing cytokines such as IL-1, IL-6 and TNF; when experiencing pain, the body releases opioid-like substances; in a brain-imaging study, FM patients had fewer opioid receptors available.
- Abnormal breathing patterns can cause myofascial trigger points in the chest wall muscles leading to an out-of-breath feeling.
- One out of three FM patients report their tongue or whole mouth burns; most cases of burning mouth syndrome are caused by a yeast or fungal infection; Some cases are due to a malfunction of small nerve fibers and abnormal pain processing.
- Milnacipran, the first drug to treat FM, not just pain, is closing in on FDA approval; this SNRI increases both serotonin and norepinephrine; Cymbalta also is pending FDA approval to treat FM pain.
- Opioids are successful in treating chronic pain in about one-fourth of patients; low-dose naltrexone enhances opioids and pain relief while minimizing side effects and tolerance.
- Effects of testosterone, estrogen, progesterone, lutenizing hormone, and melatonin on sleep; the role of sex hormone on glial cell function.
- Ultraviolet (UV) rays can have relaxing and pain relieving powers as they stimulate the skin to release potent pain-relieving opioid-like substances such as endorphins; the number of delta and kappa opioid receptors in the skin of FM patients is substantially greater than healthy controls; participants in a UV tanning bed study reported improvement in pain, mood, and quality of life; researchers encourage developing drugs that work on delta and kappa opioid receptors.
- FM patients show an accelerated loss of gray matter in the hippocampus and other important pain processing areas of the brain; normal aging and fragmented sleep in rats (e.g. apnea, insomnia) have been determined to interfere with the hippocampus’ ability to make new neurons; researchers suggest a link between FM pain and a lack of dopamine in the brain; reports show that dopamine depletion diminishes REM (dreaming) sleep; scientists suggest that dopaminergic treatments should be explored.
- Researchers are beginning to understand how the brain in FM patients processes pain; depression does not cause pain; researchers are viewing FM as a CNS disease aggravated by peripheral pain generators; high and low levels of chemicals and substances produced in the body correlate to pain; medications and non-drug therapies can balance out the pain and restore function.
- Researchers are identifying sleep as a resource to thwart off pain, anxiety, and depression; not getting enough quality sleep and getting too much sleep result in the same negative effects of fatigue, sadness, and depression; minimizing the negative impact of poor sleep.
- New device could replace conventional CPAP for people with various forms of sleep-related breathing problems such as UARS, snoring and less sever forms of sleep apnea; the treatment with nasal insufflation (TNI) has fewer side effects and is easier than the CPAP to use; researchers are working to obtain approval of the new device by spring 2008.
- Myofascial trigger points in the pelvic floor muscles (PFM) can contribute to many different kinds of pain in the pelvic region; patients often are incorrectly diagnosed with irritable bowel or interstitial cystitis; physical signs of trigger points in the PFM; non-surgical treatment of PFM trigger points.
July 2007, #78
- Myofascial trigger points (MTrPs) in chest muscles can mimic heart attack pain; ways to distinguish MTrP pain from cardiac pain; treatments targeting irritable bowel and other painful digestive disorders will fail if the pain is due to MTrPs in the abdominal wall; MTrP pain can mimic the pain of appendicitis; a simple physical test is a reliable predictor of abdominal wall pain; studies show that trigger point injection therapy can be highly effective.
- Research supports the high prevalence of often undiagnosed sleep-disordered breathing in women with FMS; further research is needed to identify the mechanism accounting for sleep apnea in women with FMS; timely screening and effective treatment of sleep apnea could potentially have a role in FMS management.
- Vitamin D deficiency is considered pandemic; a few minutes of sunshine each day is not enough for most people to maintain healthy vitamin D levels; studies found that 40% to 70% of FMS patients were deficient in this vitamin; a lack of vitamin D in highly pain-sensitive individuals could aggravate symptoms; vitamin D affects calcium absorption, muscle strength, gait and balance, mood and memory, the immune system, and protects brain cells; supplementation is an effective way to maintain healthy levels.
- Brain imaging offers evidence of premature aging in people with FMS; the loss of gray matter may be from long-term exposure to substances that are toxic to the brain; a lack of dopamine production may explain widespread pain and other FMS symptoms; evidence links low dopamine levels to accelerated gray matter loss; DHA protects brain cells from exposure to toxic substances and promotes serotonin and dopamine production; theanine, magnesium, vitamin D, and DHA can protect brain cells.
October 2006, #75
- Memory impairment linked to distractions; Standardized tests may overlook memory problems in FMS unless an element of distraction is used
- Rashes and skin sensitivity symptoms common in FMS; Cytokines detected in the skin; Pro-inflammatory proteins found just beneath the skin and abnormal capillary blood flow to area
- Restless legs syndrome (RLS) associated with low dopamine in the brain and FMS patients also have low dopamine levels; Reduced iron ferritin and sleep disordered breathing can trigger RLS
- Intravenous lidocaine studies in FMS and neuropathic pain; Side effects and safety issues
- Guidelines for treating sleep disordered breathing; Oral appliances effective for mild to moderate apnea, snoring and upper airway resistance syndrome
July 2006, #74
- Hypertension and chronic pain; Gender differences in pain regulation
- Role of respiratory events on heart rate in sleep apnea and upper airway resistance syndrome; insomnia associated with sympathetic nervous system arousal
- Targeting mast cells in CFS; Management of interstitial cystitis
- Behavioral therapy for insomnia in FMS; Airflow limitations and high frequency of sleep disordered breathing in FMS
- Testosterone patch therapy for androgen deficiency and impaired sexual function
- Hydrotherapy and physiotherapy improve sleep; Abnormal processing of pain-related signals in FMS; Increased substance P causes sleep disturbance
April 2006, #73
- Capillary permeability; Reduced enzyme and capillary levels; Circulation abnormalities; Increased lactate in FMS; Anti-inflammatory effects of exercise
- Abnormal collagen breakdown in FMS
- Cymbalta (duloxetine), milnacipran, and NMDA blocker trials in FMS
- Development of pain not related to muscle activity during low-grade stress; Abnormal endogenous pain inhibitory system in FMS; Sleep deprivation linked to increased pain
- Ultrasound shows decreased muscle blood flow in FMS
- Impaired balance and ear symptoms
- Untreated UARS leads to worsening of symptoms
January 2006, #72
- Relationship between sleep and appetite
- Oral symptoms of FMS; management of dental erosion
- Managment of gastroesophageal reflux disease (GERD); effect of GERD on sleep quality
- Mechanisms of acupuncture for pain: Chinese medical approach to FMS; acupuncture for circulation abnormalities; importance of needle placement & stimulation; physician vs. nonphysician practitioners
- Nighttime airflow dynamics in FMS patients; effects of CPAP in apnea treatment; trazodone, quetiapine, melatonin, pregabalin, tiagabine, & gaboxadol for sleep; Xyrem for reduced pain and improved function; long term effects of apnea
- Pramipexole for RLS
October 2005, #71
- Bio-identical hormone therapy, DHEA and Melatonin supplementation studies; Hand and joint pain in FMS patients; Correlations between exercise and pain in FMS
- Microcirculation abnormalities in FMS; Effects of exercise and pyridostigmine on growth hormone levels; Impact of sleep on alertness, mood, and inflammatory cytokines
- Negative effects of excessive zinc supplementation; Malic acid and magnesium supplementation in FMS; Treatment of whiplash injuries; Role of cytokines in pain occurrence
- Low Level Laser therapy (LLLT) for pain and improved wound healing
- Ultracet, pindolol, and acupuncture trials; BA receptor function in FMS
- COMT gene influences pain sensitivity; Abnormal pain processing in TMD patients; Physiological manifestations of sleep disordered breathing (UARS and sleep apnea)
- Mapping chronic pain with brain imaging; Differentiation of depression and FMS; Association of brain activity and cytokines in FMS
- Use of Clonazepam and CPAP in patients with dual sleep disorders
July 2005, #70
- Cognitive function in FMS; Relationship between sleep and memory; Conditions responsible for impaired alertness; Neural mechanisms of chronic pain; Cognition and sleep disorders
- Relationship between FMS and CFS; Effect of dextromethorphan and exercise on pain; Genetic basis for pain sensitivity and morphine requirements
- Overview of IBS treatments; Rifaximin for GI conditions
- Medications for pain including complimentary treatments that enhance effectiveness.
- Symptoms and causes of serotonin syndrome
- Lunesta (eszopiclone) and other treatments for insomnia
- Causes, mechanisms, and management of migraine and tension-type headaches; Relationship of FMS and migraine
April 2005, #69
- Efficacy and safety of opioids and nonopioid analgesics for chronic pain
- Assessing sleep disorders in CFS
- Growth Hormone findings in FMS; Abnormal HPA-axis function; Asymmetrical distribution of mast cells in the thalamus of female mice
- Fewer capillaries in periphery in FMS and other microcirculation abnormalities; Unusual cytokine findings in endometriosis
- Scientific grounds for declaring fibromyalgia a disease, rather than a syndrome
- Efficacy of Lyrica (pregabalin) for treatment of FMS
- Vulvodynia – differential diagnosis, causes, and treatments
- Implications of temperature sensitivity in FMS; Upper Airway Resistance findings in FMS; and prevalence of FMS in society
January 2005, #68
- Research on judging pain in others
- Treatment trial establishes opioid efficacy for FMS
- Neurotropin for FMS; Pain processing & exercise; FMS cervical spine radiographs; Evidence of sensory processing disturbance in FMS.
- Prevalence of Upper Airway Resistance Syndrome (UARS) in women; Potential for using Mirtazapine in apnea treatment; Research on idiopathic edema & OSA; Increased incidence of apnea in FMS
- New studies link insomnia and sleep disordered breathing
- Review of UARS research
- Role of cytokines in FMS, insomnia, and sleep disordered breathing
- Allergic Rhinitis (AR) implicated in sleep disorders, current research and treatments
- Interventions for newly identified FMS airflow abnormality
October 2004, #67
- Brain mechanisms in the placebo response
- Role of benzodiazepine receptors in FMS; elevated cerebrospinal glutamate; Cerebral blood flow; Windup in FMS
- Research findings on massage therapy, application of heat, education, exercise, and other nondrug therapies for FMS/CFS
- Risk associated with cholesterol-lowering meds in FMS
- Occupational therapy
- Sleep disordered breathing in FMS – New findings
July 2004, #66
- Fatigue generators and targeted treatments
- Pre-emptive pain therapies for surgery
- Peripheral tissue findings
- Structural brain abnormality in FMS, possible link with low dopa
- Hormone updates
- Intestinal bacteria; Hyperbaric oxygen therapy; FMS after cervical spinal injuries; Bone mineral density findings
January 2004, #64
- Research findings improve patient credibility
- Back pain research
- Drug interactions
October 2003, #63
- Science behind Aromatherapy, Massage, and Acupuncture
- Opioid tolerance
- FMS in an Amish population & editorials
- Pain and the law
- Topical medications for FMS
- Creative uses of old meds
July 2003, #62
- The role of stress in FMS
- Effects of weather and season on pain
- Sodium oxybate (Xyrem)
- FMS and cancer risk
- Post-exertion fatigue
- Gender affects pain therapy
- CFS cardiovascular findings
April 2003, #61
- CFS population studies
- Anti-viral pathway (AVP)
- Oxidative stress
- Nitric Oxide in blood and CNS
- Immune dysfunction
- CFS & FMS two ends of a spectrum?
- Affect of gender and age on symptoms
- Staphylococcal vaccine therapy for FMS
- Exercise impact on CNS; Cytokines and brain blood flow
- Accurate pain measures; Fentanyl attenuates windup
January 2003, #60
- Musculoskeletal pain generators
- Pain and cytokines: the neuro-immune link to FMS
- Pregabalin; cyclobenzaprine; tizanidine; vitamin supplements; methylphenidate; CBT
- Rehab approach
October 2002, #59
- Identifying Non-FMS symptoms
- New medications
- Substance P Blockers
- Snore Guards (mandibular advancement devices and other oral appliances)
- Hormonal abnormalities
- Role of diet
- FMS over time; Sleep disorder; beta-endorphins
