Fibromyalgia and Bipolar Disorder: Emerging Epidemiological Associations and Shared Pathophysiology

Current Molecular Medicine
B BortolatoAndre F Carvalho

Abstract

Fibromyalgia (FM) is a prevalent disorder defined by the presence of chronic widespread pain in association with fatigue, sleep disturbances and cognitive dysfunction. Recent studies indicate that bipolar spectrum disorders frequently co-occur in individuals with FM. Furthermore, shared pathophysiological mechanisms anticipate remarkable phenomenological similarities between FM and BD. A comprehensive search of the English literature was carried out in the Pubmed/MEDLINE database through May 10th, 2015 to identify unique references pertaining to the epidemiology and shared pathophysiology between FM and bipolar disorder (BD). Overlapping neural circuits may underpin parallel clinical manifestations of both disorders. Fibromyalgia and BD are both characterized by functional abnormalities in the hypothalamic-pituitary-adrenal axis, higher levels of inflammatory mediators, oxidative and nitrosative stress as well as mitochondrial dysfunction. An over-activation of the kynurenine pathway in both illnesses drives tryptophan away from the production of serotonin and melatonin, leading to affective symptoms, circadian rhythm disturbances and abnormalities in pain processing. In addition, both disorders are associated with impaired neu...Continue Reading

Citations

Jun 19, 2018·Journal of Dental Research·A Ritchie, J M Kramer
Oct 19, 2017·Current Opinion in Rheumatology·Adi LichtensteinHoward Amital
Aug 17, 2018·Endocrine, Metabolic & Immune Disorders Drug Targets·Michele IovinoVincenzo Triggiani
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Jan 1, 2021·Seminars in Arthritis and Rheumatism·Bethea A KleykampRobert H Dworkin
Apr 22, 2021·Psychological Medicine·Kevin S O'Connell, Brandon J Coombes

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