Fibromyalgia patients show variations in microbiome composition, study shows

There is a correlation between fibromyalgia chronic pain and alterations in the gut microbiome, according to a new study published in the journal Pain.

The research was based on a cohort of 156 individuals in the Montreal area, 77 of whom suffer from fibromyalgia. Participants in the study were interviewed and gave stool, blood, saliva, and urine samples, which were then compared with those of healthy control subjects, some of whom lived in the same house as the fibromyalgia patients or were their parents, offspring, or siblings.

Approximately 20 different species of bacteria were found in either greater or are lesser quantities in the microbiomes of participants suffering from the disease than in the healthy control group, according to the study abstract. The research team used a range of techniques, including Artificial Intelligence, to confirm that the changes we saw in the microbiomes of fibromyalgia patients were not caused by factors such as diet, medication, physical activity, and age, which are known to affect the microbiome, said Amir Minerbi, PhD, lead author from the Alan Edwards Pain Management Unit at the McGill University Health Centre in Montreal, Quebec.

"We found that fibromyalgia and the symptoms of fibromyalgia, pain, fatigue, and cognitive difficulties, contribute more than any of the other factors to the variations we see in the microbiomes of those with the disease,” said Minerbi. “We also saw that the severity of a patient's symptoms was directly correlated with an increased presence or a more pronounced absence of certain bacteria.”

At this point, it's not clear whether the changes in gut bacteria seen in patients with fibromyalgia are simply markers of the disease or whether they play a role in causing it. Because the disease involves a cluster of symptoms, and not simply pain, the next step in the research will be to investigate whether there are similar changes in the gut microbiome in other conditions involving chronic pain, such as lower back pain, headaches, and neuropathic pain, researchers said.

The researchers are also interested in exploring whether bacteria play a causal role in the development of pain and fibromyalgia, Minerbi said, and whether their presence could, eventually, help in finding a cure, as well as speed up the process of diagnosis.

The researchers say the next step will be to see whether they get similar results in another cohort, perhaps in a different part of the world, and to do studies in animals to discover whether changes in bacteria play a role in the development of the disease.