Neuroendocrine Aspects of Fibromyalgia

Abstract

Fibromyalgia [FM] is a stress-associated syndrome. Since a critical component of the stress-adaptation mechanism is activation of the hypothalmic-pituitary-adrenal [HPA] axis, the current understanding of HPA axis function in patients with FM is reviewed. Results: Studies of HPA axis hormones in patients with FM are reviewed. Patients with FM have low 24 hour urine free cortisol and loss of circadian fluctuation. Stimulation of the HPA axis in patients with FM reveals significant differences compared with normal subjects characterized by exaggerated ACTH secretion and a relatively blunted cortisol response. Conclusions: Patients with FM have perturbed HPA axis function that may play a role in the pathophysiology of the syndrome.

KEYWORDS:

• Fibromyalgia
• hypothalmic-pituitary-adrenal axis
• corticotrophic hormone
• cortisol
• argining-vasopressin