An evolutionary stress-response hypothesis for chronic widespread pain (fibromyalgia syndrome)
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: The study aimed to seek a unifying biological basis for the phenomena encompassed in fibromyalgia syndrome (chronic widespread pain and associated morbidities).
SETTING: While much progress has been made in the last decade in understanding chronic widespread pain, its pathogenesis remains stubbornly obscure and its treatment difficult. Two themes are gaining currency in the field: that chronic widespread pain is the result of central sensitization of nociception, and that chronic pain is somehow related to activation of a global stress response.
DESIGN: In this article we merge these two ideas within the perspective of evolutionary biology to generate a hypothesis about the critical molecular pathway involved in chronic stress response activation, namely substance P and its preferred receptor, neurokinin-1 (NK-1R), which has many empirically testable implications.
CONCLUSION: Drawing on diverse findings in neurobiology, immunology, physiology, and comparative biology, we suggest that the form of central sensitization that leads to the profound phenomenological features of chronic widespread pain is part of a whole-organism stress response, which is evolutionarily conserved, following a general pattern found in the simplest living systems.
related content
- “Neuroinflammation and Central Sensitization in Chronic and Widespread Pain,” Ru-Rong Ji, Andrea Nackley, Yul Huh, Niccolò Terrando, and William Maixner, Anesthesiology, 2018.
- “Brain glial activation in fibromyalgia - A multi-site positron emission tomography investigation,” Daniel S Albrecht, Anton Forsberg, Angelica Sandström, Courtney Bergan, Diana Kadetoff, Ekaterina Protsenko, Jon Lampa, Yvonne C Lee, Caroline Olgart Höglund, Ciprian Catana, Simon Cervenka, Oluwaseun Akeju, Mats Lekander, George Cohen, Christer Halldin, Norman Taylor, Minhae Kim, Jacob M Hooker, Robert R Edwards, Vitaly Napadow, Eva Kosek, and Marco L Loggia, Brain Behav Immun, 2019.
Specifically regarding Lyon 2011:
- “Evolution, Stress and Fibromyalgia,” John Quintner, FMperplex.com.
- “Fibromyalgia and Neuroinflammation: Shall the Twain Ever Meet?,” John Quintner, FMperplex.com.
These four articles on PainScience.com cite Lyon 2011 as a source:
- PS 33 Surprising Causes of Pain — Trying to understand pain when there is no obvious explanation
- PS The 3 Basic Types of Pain — Nociceptive, neuropathic, and “other” (and then some more)
- PS Chronic, Subtle, Systemic Inflammation — One possible sneaky cause of puzzling chronic pain
- PS A Rational Guide to Fibromyalgia — The science of the mysterious disease of pain, exhaustion, and mental fog
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.