Fibromyalgia, Somatoform, and Glutamate

January 10, 2012

by Jacynthe Sonne
for FM/CFS/ME RESOURCES

There are several studies being released on Fibromyalgia and the Central Nervous System (CNS.) One of the most recent studies is from Spain, examining brain dysfunction of Glutamate in Fibromyalgia and Somatoform Disorder. Fibromyalgia is a wide-spread chronic pain disorder with multiple symptoms. Somatoform Disorder (STD/SD) is defined as, "a history of many physical complaints beginning before age 30 years, over a period of several years, and and treatment being sought or significant impaired functioning." The criteria for diagnosing Somatoform Disorder are as follows;

• 4 pain symptoms - a history of pain at 4 different sites, or functions
• 2 gastrointestinal symptoms - a history of GI symptoms other than pain
• 1 sexual symptom - a history of one sexual or or reproductive symptom, other than pain
• 1 pseudoneurological symptom other than pain - a history of at least 1 symptom or deficit suggesting a neurological condition, not limited to pain.

It is important to understand the term Somatoform, it is used when a physician cannot explain a patients symptoms. Or, when the symptoms cause the patient to become socially isolated, and unable to work. Most importantly Somatoform means that, "the symptoms are not intentionally produced, or feigned" (faked.) It is also important to note, that nearly everyone with Fibromyalgia would fall into the Somatoform catagory. Pain in the neck, lower back, hips, and legs would beet the first criteria. Irritable Bowel Syndrome, bouts of constipation or diarrhea would meet the second criteria. Symptoms of painful menses or pain during sex would meet the sexual criteria. Catastrophic thinking would meet the psdeuoneurological criteria. The Somatoform issue is why many health practitioners, and researchers feel that Cognitive Behavioral Therapy (CBT) is a valid form or treatment for Fibromyalgia. This also explains why Fibromyalgia is still considered a stress illness.

To recap the new study, Glutamate is a neurotransmitter within the brain. There are two types of neurotransmitters than send messages to the neurons; excitatory, which stimulate and inhabitory, which calm. What this means, is that in Fibromyalgia patients, they have found abnormally high amounts of glutamate in the Insular Cortex. The insula is linked to emotions and homeostasis. This could mean future studies involving testing medications that could suppress Glutamate production in Fibromyalgia patients, and potentially reduce the pain.

The research of Fibromyalgia was seriously lacking in the 1980's and 1990's. There are now studies being conducted (or in process) on Fibromyalgia on a global basis, from Spain, to Korea, the US, New Zealand, Arabic countries, and the UK. While Fibromyalgia is still not classified as a disease, many of the studies are focusing on the CNS, and the changes that happen within the brain of Fibromyalgia patients.