Neurobiological dysregulation in chronic pain. (WC2012-035)

Background

Starting date: 08/10/2013

Chronic widespread pain (CWP), defined as “pain lasting longer than three months in the axial area, in the left and right side of the body, and above and below the waist”(1), is common in the general population with prevalence numbers up to 15% (2) and results in reduced quality of life (3). Whereas acute localized pain is often attributable primarily to damage in the peripheral structures, CWP can exist without any nociceptive input (4). Existing interventions are only moderately effective (5) and although epidemiological studies have improved our knowledge of the etiology of CWP, the underlying biological mechanisms of CWP are still largely unclear.

Dysregulation of hypothalamic-pituitary-adrenal axis, the autonomic nervous system  and the immune system may play a crucial role in initiating and perpetuating central sensitization and, in response to trigger events, chronic pain (6). This PhD project examines whether dysregulation of these biological systems are associated with the onset, perpetuation and intensity of chronic widespread pain.

 

References

(1) Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33(2):160-172.

(2)   McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 2007; 21(3):403-425.

(3)  Forseth KO, Forre O, Gran JT. A 5.5 year prospective study of self-reported musculoskeletal pain and of fibromyalgia in a female population: significance and natural history. Clin Rheumatol 1999; 18(2):114-121.

(4)  Phillips K, Clauw DJ. Central pain mechanisms in the rheumatic diseases: Future directions. Arthritis Rheum 2013; 65(2):291-302.

(5) Garcia-Campayo J, Magdalena J, Magallon R, Fernandez-Garcia E, Salas M, Andres E. A meta-analysis of the efficacy of fibromyalgia treatment according to level of care. Arthritis Res Ther 2008; 10(4):R81.

(6) Maletic V, Raison CL. Neurobiology of depression, fibromyalgia and neuropathic pain. Front Biosci 2009; 14:5291-5338