New Research Links Fibromyalgia to Altered Heat Regulation, Sensory Nerve Fibers

Fibromyalgia, a condition characterized by chronic widespread pain and a potential array of other symptoms, is presumptive for veterans with Persian Gulf War service (between Aug. 2, 1990 and the present)  for the purposes of VA service-connected disability claims.

-A.H.

***

SOURCE:   Integrated Tissue Dynamics LLC (Intidyn)

http://www.intidyn.com/Newsroom/Fibromyalgia%20Pathology%20for%20lay%20people%202013-06-24.pdf

Scientists at Integrated Tissue Dynamics LLC (Intidyn) and Albany Medical College (AMC) have made a major discovery that should provide a more certain diagnosis of fibromyalgia, significant insight into the source and symptoms of the disease, and new strategies for its prevention and treatment. The discovery has been published in the June issue of the journal Pain Medicine (the journal of the American Academy of Pain Medicine) where it was featured on the cover and accompanied by a laudatory editorial by Robert Gerwin, MD, of the Johns Hopkins University School of Medicine.  

What the team uncovered was an enormous increase in sensory nerve fibers at specific sites within the blood vessels of the skin in the palms of the hands. These critical sites are tiny muscular valves, called arteriole-venule (AV) shunts, which form a direct connection between arterioles and venules. The discovered pathology involving the nerve endings to the shunts provides a logical explanation not only for extreme tenderness in the hands, but also for the widespread deep pain and fatigue symptomatic of fibromyalgia. 

Read the full article here.

And, according to the full journal publication by Dr. Phillip Albrecht et al:

The excessive sensory innervation to the glabrous skin AVS is a likely source of severe pain and tenderness in the hands of FM patients. Importantly, glabrous AVS regulate blood flow to the skin in humans for thermoregulation and to other tissues such as skeletal muscle during periods of increased metabolic demand. 

Therefore, blood flow dysregulation as a result of excessive innervation to AVS would likely contribute to the widespread deep pain and fatigue of FM. SNRI compounds may provide partial therapeutic benefit by enhancing the impact of sympathetically mediated inhibitory modulation of the excess sensory innervation.

Read the full journal article:  http://onlinelibrary.wiley.com/doi/10.1111/pme.12139/abstract

Albrecht, P. J., Hou, Q., Argoff, C. E., Storey, J. R., Wymer, J. P. and Rice, F. L. (2013), Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole–Venule Shunts (AVS) in the Palmar Glabrous Skin of Fibromyalgia Patients: Implications for Widespread Deep Tissue Pain and Fatigue. Pain Medicine, 14: 895–915. doi: 10.1111/pme.12139

1. The authors each declare no conflicts of interest associated with this research.
2. Correction made after online publication May 20, 2013: the author affiliations have been updated.