Reduced insular γ‐aminobutyric acid in fibromyalgia
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OBJECTIVE: Recent scientific findings have reinvigorated interest in examining the role of γ-aminobutyric acid (GABA), the major inhibitory central nervous system neurotransmitter, in chronic pain conditions. Decreased inhibitory neurotransmission is a proposed mechanism in the pathophysiology of chronic pain syndromes such as fibromyalgia (FM). The purpose of this study was to test the hypothesis that decreased levels of insular and anterior cingulate GABA would be present in FM patients, and that the concentration of this neurotransmitter would be correlated with pressure-pain thresholds. METHODS: Sixteen FM patients and 17 age- and sex-matched healthy controls underwent pressure-pain testing and a 3T proton magnetic resonance spectroscopy session in which the right anterior insula, right posterior insula, anterior cingulate, and occipital cortex were examined in subjects at rest. RESULTS: GABA levels in the right anterior insula were significantly lower in FM patients compared with healthy controls (mean ± SD 1.17 ± 0.24 arbitrary institutional units versus 1.42 ± 0.32 arbitrary institutional units; P = 0.016). There was a trend toward increased GABA levels in the anterior cingulate of FM patients compared with healthy controls (P = 0.06). No significant differences between groups were detected in the posterior insula or occipital cortex (P > 0.05 for all comparisons). Within the right posterior insula, higher levels of GABA were positively correlated with pressure-pain thresholds in the FM patients (Spearman's rho = 0.63; P = 0.02). CONCLUSION: Diminished inhibitory neurotransmission resulting from lower concentrations of GABA within the right anterior insula may play a role in the pathophysiology of FM and other central pain syndromes.
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The model fits data about the presence of GABA-glutamate unbalance and the finding of glutamic acid decarboxylase decrease in FM patients.
“Second, it fits data about the presence of GABA-glutamate unbalance [136–138], and the finding of glutamic acid decarboxylase decrease in FM patients [139].”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [137]
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- Authors
- Foerster, B. R., Petrou, M., Edden, R. A. E., Sundgren, P. C., Schmidt‐Wilcke, T., Lowe, S. E., Harte, S. E., Clauw, D. J., & Harris, R. E.
- Affiliations
- Johns Hopkins University (US)
- Kennedy Krieger Institute (US)
- Lund University (SE)
- University of Michigan (US)
- ORCID
- Venue
- Arthritis & Rheumatism
- Publisher
- Wiley
- Published
- 2012-01-27
- Volume
- 64
- Issue
- 2
- Pages
- 579-583
- ISSN
- 0004-3591 (ISSN-L)
- 1529-0131
- PMC
- PMC3374930
- OpenAlex
- W1978379118
- Cited by
- 212
- References
- 16
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 9 · 2023: 22 · 2022: 14 · 2021: 24 · 2020: 9 · 2019: 11 · 2018: 13 · 2017: 19 · 2016: 18 · 2015: 17 · 2014: 13 · 2013: 13 · 2012: 9
- FWCI
- 7.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Arthritis & Rheumatism (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institute of Biomedical Imaging and Bioengineering (P41EB015909)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Keywords
- fibromyalgia, GABA, insula, anterior cingulate cortex, pressure pain threshold, inhibitory neurotransmission, central pain, chronic pain, 1H NMR
- MeSH terms
- Adult, Cerebral Cortex, Female, Fibromyalgia, gamma-Aminobutyric Acid, Gyrus Cinguli, Humans, Middle Aged, Magnetic Resonance Spectroscopy, Occipital Lobe
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