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Life Sciences
Gautam Ullal

Fibromyalgia February-05-13 2:56 PM Symptoms 1. Tenderness in at least 11 of 18 spots called "trigger points", accompanied by allodynia 2. Easily fatigues 3. Non-restorative sleep 4. No evidence of any physical/bodily related pathology 5. Most common in women F:M ratio = 9:1 6. Stressful childhood 7. Chronic disorder - Tenderness is reported in areas where muscles or ligaments attach to bones like the neck, shoulders, knees, thighs, lower back Neurobiological causes MRI scan - Shows reduced volume of grey matter in the PFC, amygdala and ACC - People on medication for fibromyalgia(NSAI) show an increase in grey matter compared to normal - The severity of pain in correlation to how long the patient had it for had no relationship - The medication had no effect on the pain, but their ability to cope with the pain was better than people not on medication PET scan - This PET scan was done in a patient in perimenopause. It showed hypoactivity in her insula compared to normal - We don't know if this was the cause Central sensitization - The pain matrix along with HPA axis both become sensitized due to an increase in glutamate and Substance-P - This increase in GLUT can be modulated by Gabapentin (GABA agonist) which will in turn decrease the [GLUT] - SNRIs are also effective in treatment (increase the amount of serotonin and norepinephrine at the synaptic cleft) Gate control theory of Pain - L-fiber
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