Neuroendocrinology of Fibromyalgia Syndrome - Looking at the Role of the Peripheral Nervous System in FMS
|FMS may be a stress related disorder. The neurological substrates for stress as they are understood currently include CNS components as well as PNS components including the sympathetic division of the autonomic nervous system. The hypothalamic-pituitary-adrenal (HPA) axis is an important neuroendocrinological integrative system that has much to do with stress and also FMS symptoms. Corticotropin Releasing Hormone (CRH) regulates the HPA axis. Substance-P inhibits CRH activity.|
Given the fact that SP levels are high in FMS patients, the interaction between the HPA axis and SP is likely significant in the pathophysiology of FMS. If SP is inhibiting the production of CRH, then the activity of the HPA axis diminsihes. Moreover, the stress response diminishes. An added complication is that the HPA axis also plays an important role in female reproductive mechanisms. Unfortunately, a female FMS patient may have reproductive complications.