Abstract:
:Women are four to eight times more likely to be affected by fibromyalgia syndrome (FMS). A lack of cortisol, potentially due to an adrenocortical deficit is postulated in FMS. The cause of such adrenal insufficiency is unknown. It could be assumed that stress exposure during critical periods contributes to vulnerability for FMS. These critical periods might include prenatal periods in which adversities may lead to an impaired development of the adrenal cortex, especially in females. More than 50% of FMS patients report major life events before the onset of the disease. Possibly due to adrenal insufficiency they may not be able to dampen their stress response by secreting sufficient glucocorticoids. Thus, stress mediators, such as catecholamines and pro-inflammatory cytokines, may be disinhibited and affect brain function. This might result in an enhanced responsiveness to external and internal pain- and fatigue-eliciting stimuli. In a study with female FMS patients (N= 93) those patients with a shorter gestational length (<38 weeks) showed a lower cortisol awakening response (CAR) than FMS subjects with a gestational length >38 weeks (F((3,31))= 2.94, P= 0.038). Additionally, more than 70% reported severe psychological stress alone or in combination with other factors at disease onset.
journal_name
Ann N Y Acad Scijournal_title
Annals of the New York Academy of Sciencesauthors
Klingmann PO,Kugler I,Steffke TS,Bellingrath S,Kudielka BM,Hellhammer DHdoi
10.1196/annals.1410.020subject
Has Abstractpub_date
2008-12-01 00:00:00pages
446-55eissn
0077-8923issn
1749-6632pii
NYAS1148020journal_volume
1148pub_type
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