High Brain Insula Glutamate Confirms Fibromyalgia Central Hypersensitivity Idea

The idea sufferers of Fibromyaglia have pain amplifying circuits got confirmation with finding of high glutamate (pain transmitter) in insula of the brain. It’s like the brain is on fire…

Glutamate is the neurotransmitter involved among other things, in the transmission of chronic pain messages. Higher than normal level in the brain in the Insula are seen in Fibromylagia:
ARTHRITIS & RHEUMATISM Vol. 60, No. 10, October 2009, pp 3146–3152
Elevated Insular Glutamate in Fibromyalgia Is Associated With Experimental Pain
Richard E. Harris,1 Pia C. Sundgren,1 A. D. Craig,2 Eric Kirshenbaum,1 Ananda Sen,1
Vitaly Napadow,3 and Daniel J. Clauw1   abstract here

Changes in the glutamate levels seen in the brain on imaging, can be reflected by improvements in FM pain as well:
Arthritis Rheum. 2008 Mar;58(3):903-7. Dynamic levels of glutamate within the insula are associated with improvements in multiple pain domains in fibromyalgia. Harris RE, Sundgren PC, Pang Y, Hsu M, Petrou M, Kim SH, McLean SA, Gracely RH, Clauw DJ. abstract

In a more recent article high glutamate again was found in insula
Arthritis Res Ther. 2010 Jul 7;12(4):R134. [Epub ahead of print]
Localized 1H-NMR spectroscopy in patients with fibromyalgia: a controlled study of changes in cerebral glutamate/glutamine, inositol, choline, and N-acetylaspartate.
Fayed N, Garcia-Campayo J, Magallón R, Andrés-Bergareche H, Luciano JV, Andres E, Beltrán J.

Comment – the insula is considered the area where “affective and evaluative dimensions of pain” are formulated –  “affective – emotional pain – ie. suffering, defeat, and despair  – is the hardest pain to deal with.  Damage that ends up deciding  pain is a major threat that will limit activity and instill fear of injury doesn’t help either. Now there is concrete evidence of abnormal brain processing of pain and central pain augmentation. The question is, what can put out the fire…

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