How did Fibromyalgia become a brain disease? Disentangling conjecture and truth.

[Jonathan Edwards]

I think Clauw's wording is speculative and often clumsy but it is not circular. It is clear what he implies - what Snow Leopard points out would be putative abnormal central sensitization. And that might not be as high as brain. Genetic studies might well show a plausible basis for that.

I agree that Clauw's crowd have hyped the idea in the clinical arena but the critics are just as much wilfully blinding themselves to reasonable biological speculation.

 

[Snow Leopard]

Just out of curiosity since this is not my field—how would you go about controlling for those peripheral factors?

I'm not an expert on this but I'd suggest methods that modulate the excitability of the DRG and/or spinal cord independently via several methods

- Dorsal root ganglion stimulation ('placed near the cell nuclei of the afferent neurons of the dorsal root ganglia')
or tonic spinal cord stimulation ('electrical field over the dorsal columns of the spinal cord')

-local anaesthesia and steroid block of pain in the DRG (not a 100% block but partial)

-pulsed radiofrequency (heat)