oxytocin and Fibromyalgia

To study the direct physiological and emotional impact of an animal-assisted activity (AAA) session (a form of complementary and integrative medicine) in patients with fibromyalgia (FM).. The study population consisted of 221 participants with FM who were attending Mayo Clinic's Fibromyalgia Treatment Program between August 5, 2017, and September 1, 2018. This was a randomized controlled trial. Participants were randomly assigned to either the treatment group (a 20-minute session with a certified therapy dog and handler) or the control group (a 20-minute session with a handler only). To gain a better understanding of the direct physiological and emotional effects of AAA in patients with FM, we used multiple noninvasive physiologic-emotional biomarkers, including salivary cortisol and oxytocin concentrations, tympanic membrane temperatures, and various cardiac parameters, in addition to standardized pain and mood-based questionnaires.. Results show a decrease in heart rate, an increase in heart rate variability, an increase in well-being survey scores, an increase in salivary oxytocin, and subsequent tympanic membrane temperature changes, suggesting that participants in the treatment group were in a more positive emotional-physiologic state as a result of the AAA session compared with the control group.. Our results suggest that a 20-minute therapy dog visit in an outpatient setting can significantly and positively impact the physical and mental health of patients with FM.

Topics: Adolescent; Adult; Aged; Animal Assisted Therapy; Animals; Chronic Pain; Dogs; Electrocardiography, Ambulatory; Female; Fibromyalgia; Humans; Hydrocortisone; Male; Middle Aged; Oxytocin; Pain Measurement; Saliva; Young Adult

Fibromyalgia is a pain disorder associated with frequent comorbid mood, anxiety, and sleep disorders. Despite the frequent use of a complex, poly-drug pharmacotherapy, treatment for fibromyalgia is of limited efficacy. Oxytocin has been reported to reduce the severity of pain, anxiety, and depression, and improve the quality of sleep, suggesting that it may be useful to treat fibromyalgia. To evaluate this hypothesis, 14 women affected by fibromyalgia and comorbid disorders, assuming a complex pharmacotherapy, were enrolled in a double-blind, crossover, randomized trial to receive oxytocin and placebo nasal spray daily for 3 weeks for each treatment. Order of treatment (placebo-oxytocin or oxytocin-placebo) was randomly assigned. Patients were visited once a week. At each visit, the following instruments were administered: an adverse drug reaction record card, Visual Analog Scale of Pain Intensity, Spielberger State Anxiety Inventory, Zung Self-rating Depression Scale, and SF-12. Women self-registered painkiller assumption, pain severity, and quality of sleep in a diary. Unlikely, oxytocin nasal spray (80 IU a day) did not induce positive therapeutic effects but resulted to be safe, devoid of toxicity, and easy to handle.

Topics: Administration, Intranasal; Aerosols; Anxiety; Comorbidity; Cross-Over Studies; Depression; Double-Blind Method; Female; Fibromyalgia; Humans; Middle Aged; Musculoskeletal Pain; Oxytocin; Pain Measurement; Psychiatric Status Rating Scales; Quality of Life; Sleep; Surveys and Questionnaires; Time Factors; Treatment Outcome

Fibromyalgia (FM) is a syndrome characterized by chronic pain with depression as a frequent comorbidity. However, efficient management of the pain and depressive symptoms of FM is lacking. Given that endogenous oxytocin (OXT) contributes to the regulation of pain and depressive disorders, herein, we investigated the role of OXT in an experimental reserpine-induced FM model. In FM model, OXT-monomeric red fluorescent protein 1 (OXT-mRFP1) transgenic rats exhibited increased depressive behavior and sensitivity in a mechanical nociceptive test, suggesting reduced pain tolerance. Additionally, the development of the FM-like phenotype in OXT-mRFP1 FM model rats was accompanied by a significant reduction in OXT mRNA expression in the magnocellular neurons of the paraventricular nucleus. OXT-mRFP1 FM model rats also had significantly fewer tryptophan hydroxylase (TPH)- and tyrosine hydroxylase (TH)-immunoreactive (ir) neurons as well as reduced serotonin and norepinephrine levels in the dorsal raphe and locus coeruleus. To investigate the effects of stimulating the endogenous OXT pathway, rats expressing OXT-human muscarinic acetylcholine receptor (hM3Dq)-mCherry designer receptors exclusively activated by designer drugs (DREADDs) were also assessed in the FM model. Treatment of these rats with clozapine-N-oxide (CNO), an hM3Dq-activating drug, significantly improved characteristic FM model-induced pathophysiological pain, but did not alter depressive-like behavior. The chemogenetically induced effects were reversed by pre-treatment with an OXT receptor antagonist, confirming the specificity of action via the OXT pathway. These results indicate that endogenous OXT may have analgesic effects in FM, and could be a potential target for effective pain management strategies for this disorder.

Topics: Animals; Fibromyalgia; Humans; Luminescent Proteins; Neurons; Oxytocin; Pain; Rats; Rats, Transgenic; Receptors, Oxytocin; Reserpine

Topics: Female; Fibromyalgia; Humans; Musculoskeletal Pain; Oxytocin

Topics: Female; Fibromyalgia; Humans; Musculoskeletal Pain; Oxytocin

Topics: Female; Fibromyalgia; Humans; Musculoskeletal Pain; Oxytocin

Topics: Female; Fibromyalgia; Humans; Musculoskeletal Pain; Oxytocin

The aim of the study was to assess the influence of the 5HT3-receptor antagonist tropisetron on circulating catecholamines as biochemical markers of the activity of the sympathoadrenal system in fibromyalgia. Moreover, serum concentrations of serotonin, somatomedin C, oxytocin, calcitonin-gene-related-peptide, calcitonin and cholecystokinin were assayed as putative markers in pain-related disorders like primary fibromyalgia.. In 96 patients, who met the ACR classification criteria for fibromyalgia, and in 20 sex and age matched controls concentrations of dopamine, noradrenaline, adrenaline, serotonin and tropisetron were assayed in serum by HPLC with electrochemical detection. All other transmitters were determined by ELISA.. There was with the exception of tropisetron, calcitonin and dopamine, no correlation between doses of tropisetron 5, 10, 15 mg respectively and significant changes in circulating transmitters or other transmitters as putative biochemicals markers in primary fibromyalgia. Regarding the prediction of pain reduction to tropisetron, patients with elevated dopamine and/or reduced plasma 5-HT concentrations tended to show a higher response rate.. Despite these partly disappointing results another prospective pilot study with selected patients vs. age and sex matched controls, double blind and with comparison of other 5HT3-receptor antagonists e.g. dolasetron and granisetron e.g. after i.v. bolus injection is suggested. Still the data obtained in this preliminary paper provide some evidence regarding the present discussion on subgroups of patients with primary fibromyalgia.

Topics: Analysis of Variance; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Catecholamines; Cholecystokinin; Enzyme-Linked Immunosorbent Assay; Fibromyalgia; Humans; Indoles; Insulin-Like Growth Factor I; Oxytocin; Receptors, Serotonin; Receptors, Serotonin, 5-HT3; Serotonin; Serotonin Antagonists; Tropisetron

Fibromyalgia syndrome (FMS) is a chronic pain disorder, where 90% of the patients struck by the disorder are women. The neuropeptide oxytocin is known to have antinociceptive and analgesic, as well as anxiolytic and antidepressant effects, which makes this neuropeptide of interest in fibromyalgia research. The aim of this study was to assess oxytocin concentrations in female FMS patients with different hormonal status and in depressed and non-depressed patients and relate oxytocin concentrations to adverse symptoms as pain, stress, depression, anxiety and to the positive item happiness.. Thirty-nine patients and 30 controls registered these symptoms daily during 28 days and blood samples for the assessment of oxytocin were drawn twice in all patients and controls. Besides the daily ratings, depression was also estimated with the self-rating instrument Beck Depression Inventory (BDI).. Depressed patients according to the BDI differed significantly with low levels of oxytocin compared to the non-depressed patients and the controls. Low levels of oxytocin were also seen in high scoring pain, stress and depression patients according to the daily ratings; however, these subgroups were small. A negative correlation was found between the scored symptoms depression and anxiety and oxytocin concentration, and a positive correlation between the item happiness and oxytocin. The oxytocin concentration did not differ between the hormonally different subgroups of patients or controls.. The results suggest that the neuropeptide oxytocin may, together with other neuropeptides and neurotransmitters, play a role in the integration of the stress axes, monoaminergic systems and the pain processing peptides in the pathophysiologic mechanisms responsible for the symptoms in the FMS.

Topics: Adult; Anxiety Disorders; Depressive Disorder; Female; Fibromyalgia; Humans; Middle Aged; Oxytocin; Personality Inventory; Reference Values