Emotion regulation and the salience network: a hypothetical integrative model of fibromyalgia.
Publication Title
Nat Rev Rheumatol
Document Type
Article
Publication Date
1-1-2023
Keywords
washington; swedish
Abstract
Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances and other symptoms, and has a substantial socioeconomic impact. Current biomedical and psychosocial treatments are unsatisfactory for many patients, and treatment progress has been hindered by the lack of a clear understanding of the pathogenesis of fibromyalgia. We present here a model of fibromyalgia that integrates current psychosocial and neurophysiological observations. We propose that an imbalance in emotion regulation, reflected by an overactive 'threat' system and underactive 'soothing' system, might keep the 'salience network' (also known as the midcingulo-insular network) in continuous alert mode, and this hyperactivation, in conjunction with other mechanisms, contributes to fibromyalgia. This proposed integrative model, which we term the Fibromyalgia
Clinical Institute
Neurosciences (Brain & Spine)
Clinical Institute
Mental Health
Specialty/Research Institute
Rheumatology
Specialty/Research Institute
Neurosciences
DOI
10.1038/s41584-022-00873-6
