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Autonomic Stress-Reactivity in Fibromyalgia

In a study funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and led by Akiko Okifuji, PhD, investigators employed a novel method to assess the association between pain sensitivity in fibromyalgia and the autonomic nervous system's reaction to stress.

Although the cause of fibromyalgia is not well understood, the accumulation of research seems to indicate that the syndrome is associated with problems in the way the body responds to stress. In particular, past studies suggest that the nervous systems of people with fibromyalgia react less vigorously than others to physical, emotional, and environmental stressors. (Environmental stressors include noise, light, or temperature changes).

In Dr. Okifuji's study, researchers are investigating the relationship between fibromyalgia pain and the autonomic nervous system, which is the part of the nervous system that directs body functions that are not consciously controlled, such as the heartbeat and intestinal movements. The study involves two groups of women, one with fibromyalgia and one without. Each group is given a widely used test, called the postural challenge stressor, which involves having the women rise quickly from a lying position. Blood pressure measurements taken after the women rise allow the researchers to assess and compare the ability of the women's autonomic nervous systems to adjust to physiologic stress.

The study has involved 90 women (21 with fibromyalgia and 69 without) to date. Preliminary results show that the women with fibromyalgia did not react abnormally to the postural stressor. In general, the researchers think there appears to be a modest relationship between the women's sensitivity to the tender points associated with fibromyalgia and their blood pressure reaction to the postural stressor. A complete analysis of the data is underway.