The role of the vagus nerve in fibromyalgia syndrome

Daniel F Martins; Frederic J F Viseux; Daiana C Salm; Anny Caroline Avelino Ribeiro; Helen Kassiana Lopes da Silva; Lynsey A Seim; Edsel B Bittencourt; Gianluca Bianco; Ari Ojeda Ocampo Moré; William R Reed; Leidiane Mazzardo-Martins

doi:10.1016/j.neubiorev.2021.10.021

The role of the vagus nerve in fibromyalgia syndrome

Neurosci Biobehav Rev. 2021 Dec:131:1136-1149. doi: 10.1016/j.neubiorev.2021.10.021. Epub 2021 Oct 25.

Affiliations

¹ Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, SC, Brazil. Electronic address: daniel.martins4@unisul.br.
² Laboratoire d'Automatique, de Mécanique et d'Informatique industrielle et Humaine (LAMIH), UMR CNRS 8201, Université Polytechnique des Hauts-de-France, Valenciennes, France; Centre d'Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France.
³ Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, SC, Brazil.
⁴ Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil.
⁵ Hospital Internal Medicine, 4500 San Pablo Road, Mayo Clinic, Jacksonville, FL, USA.
⁶ Coastal Health Institute, Central Parkway Suite 201, Jacksonville, FL, USA.
⁷ Research Laboratory of Posturology and Neuromodulation RELPON, Department of Human Neuroscience, Sapienza University, Rome, Italy; Istituto di Formazione in Agopuntura e Neuromodulazione IFAN, Rome, Italy.
⁸ Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
⁹ Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA; Rehabilitation Science Program, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁰ Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

PMID: 34710514
DOI: 10.1016/j.neubiorev.2021.10.021

Abstract

Fibromyalgia (FM) syndrome is a common illness characterized by chronic widespread pain, sleep problems, fatigue, and cognitive difficulties. Dysfunctional neurotransmitter systems that influence the body's endogenous stress response systems are thought to underlie many of the major FM-related symptoms. A model of FM pathogenesis suggests biological and psychosocial variables interact to influence the genetic predisposition, but the precise mechanisms remain unclear. The Polyvagal Theory provides a theoretical framework from which to investigate potential biological mechanisms. The vagus nerve (VN) has anti-inflammatory properties via its afferent and efferent fibers. A low vagal tone (as assessed by low heart rate variability), has been observed in painful and inflammatory diseases, including FM, while the ventral branch of the VN is linked to emotional expression and social engagement. These anti-inflammatory and psychological (limbic system) properties of the VN may possess therapeutic potential in treating FM. This review paper summarizes the scientific literature regarding the potential role of the VN in transducing and/or therapeutically managing FM signs and symptoms.

Keywords: Autonomic nervous system; Chronic pain; Polyvagal theory; Stress.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Chronic Pain*
Fatigue
Fibromyalgia*
Humans
Vagus Nerve / physiology
Vagus Nerve Stimulation*