Fibromyalgia and Bipolar Disorder: Emerging Epidemiological Associations and Shared Pathophysiology

摘要: Fibromyalgia (FM) is a prevalent disorder defined by the presence of chronic widespread pain in association with fatigue, sleep disturbances and cognitive dysfunction. Recent studies indicate that bipolar spectrum disorders frequently co-occur in individuals FM. Furthermore, shared pathophysiological mechanisms anticipate remarkable phenomenological similarities between FM BD. A comprehensive search English literature was carried out Pubmed/MEDLINE database through May 10th, 2015 to identify unique references pertaining to epidemiology pathophysiology bipolar disorder (BD). Overlapping neural circuits may underpin parallel clinical manifestations both disorders. Fibromyalgia BD are characterized functional abnormalities hypothalamic-pituitary-adrenal axis, higher levels inflammatory mediators, oxidative nitrosative stress as well mitochondrial dysfunction. An over-activation kynurenine pathway illnesses drives tryptophan away from the production serotonin melatonin, leading affective symptoms, circadian rhythm and abnormalities processing. In addition, associated impaired neuroplasticity (e.g., altered brain-derived neurotrophic factor signaling). The recognition symptomatic pathophysiological overlaping bipolar spectrum has relevant etiological, therapeutic implications deserve future research consideration.