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Articles

Nagasaki (Japan) Fibromyalgia Symposium

In October, last year an internationally recognised set of speakers gathered in Japan for a symposium on fibromyalgia. The event brought together researchers from many different areas of science and medicine to discuss new findings about fibromyalgia. Below is a summary of some of the articles that were presented. It’s important to keep in mind that some of the conclusions are preliminary and will require further study or trials to confirm or improve their understanding.

It is now widely accepted that problems with the central nervous system are important in fibromyalgia. The central nervous system includes the brain and spinal cord. The rest of the nervous system is known as the peripheral nervous system. Less is known about the role of the peripheral nervous system in fibromyalgia but the symposium highlighted some new research findings in this area. One particularly interesting topic was about how overdrive of the fight-or-flight response (which is created by a part of the peripheral nervous system known as the sympathetic nervous system) may be involved in fibromyalgia. New findings about the role of the peripheral nervous system in fibromyalgia help improve our understanding and may help in developing new treatments at some point in the future.

 

Another finding that was spoken about at the symposium was the role of certain life stressors in fibromyalgia. Possible examples of stressors include illnesses and injuries as well as bullying or abuse. Stress effects many parts of the body including the nervous system and immune system. For this reason, stress is known to play a role in many medical conditions. The talk highlighted that in susceptible people, stressful events may trigger changes within the body that contribute to the development of fibromyalgia and worsening of fibromyalgia symptoms.

A recent phase 2 drug trial in Japan was also spoken about during the event. The drug was called mirtazapine and the results of the trial were positive. It not only helped with pain but also helped improve quality of life in the people taking part. Although mirtazapine is known as an antidepressant drug, it was found to help with pain even in people who did not also have depression.  It is not yet known how some antidepressant drugs help relieve pain in people with fibromyalgia but we know that mirtazapine acts on a variety of different neurotransmitters, including those involved in the sensing and processing of pain. Trials like this are early indicators and would need to be reproduced in further trials.

A particularly interesting talk focused on brain scan findings of the pain network in people with fibromyalgia. The pain network is thought to include many different parts of the brain. It was discussed how different fibromyalgia treatments have been shown to target different parts of this network and improve their function. The treatments discussed included fibromyalgia drugs as well as graded exercise therapy and CBT. Understanding how different treatments effect different parts of the pain network in people with fibromyalgia is important for understanding how these treatments might work. If you look at these findings together it not only suggests that some of the brain abnormalities in people with fibromyalgia can be reversed with treatment, but also that people may find a combination of different therapies useful.

A more detailed summary of the event can be found here: http://journals.lww.com/painrpts/Fulltext/2017/02000/Summary_of_the_Fibromyalgia_Research_Symposium.2.aspx

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