Hypothalamic-pituitary axis response to a 0.25-MG dexamethasone test in women with fibromyalgia
Open accessAbstract
Fibromyalgia has been reported as having some clinical overlap with both depression and emotionally-unstable disorders, although both types of disorders present different cortisol suppression response to dexamethasone. In this study we investigated the hypothalamic-pituitary-adrenal system (HPA) in the fibromyalgic syndrome (FMS) using a dexamethasone suppression test (DST) of 0.25 mg designed to specifically detect cortisol hypersuppression. We studied 59 women (20 patients and 39 healthy controls) to whom the DST was administered together with a battery of psychometric tests. In our results, patients with FMS had significant lower levels of basal cortisol pre- and post-DST compared with control subjects. However, cortisol suppression rate in patients after DST was not significantly different than in controls. As other syndromes like post-traumatic stress disorder or emotionally unstable personality disorders, also related with high incidence of severe trauma, FMS patients presented significant low basal cortisol. However, they did not have cortisol hypersuppression as is commonly found in the mentioned disorders. The relation of FMS with lifetime traumas and with emotional instability should be further investigated in order to improve psychological treatment approaches for these patients.LAY SUMMARYPatients with fibromyalgic syndrome have basal hypocortisoism but no cortisol hypersuppression after dexamethasone infusion compared to control subjects, as other trauma-related syndromes.
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The model is in tune with a bulk of data suggesting a role of HPA and HPG axes in FM pathogenesis.
“Third, it is in tune with a bulk of data suggesting a role of HPA and HPG axes in FM pathogenesis [10–17]”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [14]
The Introduction (page unavailable) describes evidence of HPA-axis dysfunction in fibromyalgia, and the Discussion reports lower basal cortisol in the women studied. The paper does not address the HPG axis, so it supports only the HPA portion of the attributed claim. (LLM, conf=0.88)
Experimental — accuracy not yet measuredFibromyalgia patients show hypothalamus-pituitary-adrenocortical axis dysfunction.
“FM patients show hypothalamus–pituitary–adrenocortical axis (HPA) dysfunction [14,15].”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [14]
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مصطفى, س. ح. ا. (2024) · مجلة البحث العلمى فى التربية · doi:10.21608/jsre.2024.329112.1740
- Authors
- González-Vives, S., Díaz-Marsá, M., De la Vega, I., Palomares, N., Vázquez, S., López-Villatoro, J. M., Palomo, T., & Carrasco, J. L.
- Affiliations
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (ES)
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain;
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain;
- Universidad Complutense de Madrid (ES)
- Venue
- Stress
- Publisher
- Informa UK Limited
- Published
- 2019-10-18
- Volume
- 23
- Issue
- 3
- Pages
- 284-289
- ISSN
- 1025-3890 (ISSN-L)
- 1607-8888
- OpenAlex
- W2980241305
- Cited by
- 8
- References
- 47
- Citations by year
- 2024: 3 · 2023: 2 · 2021: 2 · 2020: 1
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stress (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Instituto de Salud Carlos III (PI14/, 2013-2016, PI14/01449)
- European Regional Development Fund (2013-2016)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- fibromyalgia, hypothalamic-pituitary-adrenal axis, dexamethasone suppression test, cortisol, adrenal insufficiency, trauma, neuroticism, depression, post-traumatic stress disorder, borderline personality disorder, women
- MeSH terms
- Dexamethasone, Female, Fibromyalgia, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Stress, Psychological
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