The mysterious pain disorder fibromyalgia may have some surprising genetic roots. An analysis of 2.5 million people suggests fibromyalgia is neurological in nature, scientists report July 28 in Nature Medicine. The genetics study is the latest — and largest — to try and get a grasp on a long-debated condition.
The work establishes a biological basis for fibromyalgia, which was historically thought to be psychological. Evidence of the condition’s biological origins has been accumulating for years, says Michael Wainberg, a geneticist at the University of Toronto. They may also have anxiety, depression and sleep disruptions, says Jonathan Aebischer, a chronic pain researcher and clinician at Oregon Health & Science University in Portland who was not part of the new study.
And though fibromyalgia has real, physical symptoms, they can appear to be invisible, says Kristal Kent, a patient advocate at the nonprofit organization Veteran Voices for Fibromyalgia, based in Cleveland. Fibromyalgia affects some 4 million adults in the United States, but the true number of people affected might be even higher, says Hanna Ollila, a genetic epidemiologist at the University of Helsinki. Besides the symptom variability, there are no blood tests to screen for fibromyalgia and it can be misdiagnosed as other diseases.
What’s more, “there are still to this day physicians who don’t really believe it’s a real condition,” says Gerard Limerick, a pain medicine doctor at Johns Hopkins School of Medicine who was not involved with the work. Among those who accept the condition as real, there’s debate about fibromyalgia’s origins. Some evidence has suggested the condition is an autoimmune one.
But scientists don’t have a good understanding of what drives the disorder. They know genetics factor in because fibromyalgia can run in families. Yet no one had pinned down what parts of people’s genetic instruction books might be involved.
Ollila, Wainberg and their colleagues uncovered 26 regions of the genome that might enhance people’s risk. The team analyzed the genomes of 2.5 million people, nearly 55,000 of whom had been diagnosed with fibromyalgia. The researchers were looking for genetic variants that occurred in people with the disorder more or less often than in the general population.
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