Source: Rich Carson, ProHealth Founder & CFS Patient
Fibromyalgia Edition: CFS & FM Treatment & Research News
Pieces of the Fibromyalgia puzzle are slowly falling into place, and researchers are moving toward a unified theory that explains the etiology and pathogenesis of the disease.
While the conviction among the majority of Fibromyalgia researchers is that Fibromyalgia represents a significant sensitization of the brain and spinal cord, some leading researchers have recently formed a theory that takes the “Sensitization Theory” a step further, to what can be called the “Hippocampus Hypothesis” or “Dopamine Hypothesis.” This fascinating theory states that FM is primarily a brain dysfunction resulting from stress-induced physiological changes to a part of the brain called the hippocampus and to the important neurotransmitter that it regulates – dopamine.
Specifically, the hippocampus is extremely sensitive to stress, and in fact is the brain organ that enables us to respond to environmental stressors in a way that helps us avoid danger. The best example of the beneficial stress response is when our ancestors crossed paths with a saber tooth tiger – an immediate “fight or flight” response was mandatory to ensure survival. Studies have shown that chronic stress, however, can contribute to a disruption of normal hippocampus function. The hippocampus plays a major role in pain perception and memory formation, and it is involved in controlling the production of that crucial brain neurotransmitter, dopamine. Dopamine abnormalities have been linked to “restless leg syndrome,” increased pain, and feelings of self doubt, anxiety, and problems with memory formation.
If the “Dopamine Hypothesis” is correct, then it is reasonable to assume that drugs that restore normal dopamine levels and activity in the brain should have a therapeutic effect when administered to Fibromyalgia patients.
And this is where the “Dopamine Hypothesis” picks up steam. Andrew Holman, MD, recently conducted a controlled, double blind study of the drug pramipexole with several Fibromyalgia patients. Pramipexole, sold under the brand name Mirapex™, is approved for treatment for Parkinson’s disease – a primary dopamine disorder. Patients experienced significant improvement in their symptoms. Another drug that affects dopamine and has been approved by the FDA as a treatment for restless legs syndrome – ropinirole – also met with remarkable success in another recent Fibromyalgia study conducted by Dr. Holman.
All told, the Dopamine Hypothesis looks promising for several reasons. It ties in nicely to the pathogenesis of the disease – that the onset of Fibromyalgia frequently occurs during times of prolonged or intense emotional or physical stress, when the hippocampus may become overworked and become dysfunctional as a result. And it ties into the fact that dopamine, which is largely regulated by the hippocampus, may cause many of the symptoms of Fibromyalgia when its levels are unregulated.
I would like to acknowledge Patrick B. Wood, MD, and Dr. Holman for their brilliant work with brain imaging, neurotransmitter physiology, and creative pharmaceutical approaches to normalizing/regulating dopamine in Fibromyalgia. Their work has proven beneficial to many Fibromyalgia patients and may hold promise for treatment of millions more. I applaud their bold, creative, and compassionate work.