Small-fiber neuropathy and fibromyalgia

Reduced intraepidermal nerve fiber density after a sustained increase in insular glutamate: a proof-of-concept study examining the pathogenesis of small fiber pathology in fibromyalgia
Here is what the study states: “Neuroimaging reveals increased glutamate within the insula of patients with fibromyalgia (FM), suggesting a link between FM symptoms and increased central excitatory neurotransmission. Many patients with FM also present with decreased intraepidermal nerve fiber density (IENFD), consistent with small fiber pathology. It remains unknown, however, whether either of these mechanistic findings represent a cause or a consequence of the other. This study tests the hypothesis that an excitatory imbalance within the insula leads to small fiber pathology.” (Abstract)

The study is looking at whether the glutamate within our insula in fact leads to their findings of small-fiber neuropathy in people with fibromyalgia. They delivered an increase of glutamate into rats for 6 weeks into the insula. Then tissue biopsies were tested and assessed after the experiment.

Conclusion: “Bilateral insular PDC administration produced a persistent increase in multimodal pain behaviors and a decrease in peripheral nerve fibers in rat. These preclinical findings offer preliminary support that insular hyperactivity may be a casual factor in the development of small fiber pathology in FM.” (Abstract)


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