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Serotonin linked to somatic awareness, a condition long thought to be imaginary

New research suggests serotonin could be involved in a condition where patients experience physical discomforts for which there is no physiological explanation
Published: 19 June 2019

An international team spearheaded by researchers at 平特五不中 has discovered a biological mechanism that could explain heightened somatic awareness, a condition where patients experience physical discomforts for which there is no physiological explanation.

Patients with heightened somatic awareness often experience unexplained symptoms 鈥 headaches, sore joints, nausea, constipation or itchy skin 鈥 that cause emotional distress, and are twice as likely to develop chronic pain. The condition is associated with illnesses such as fibromyalgia, rheumatoid arthritis and temporomandibular disorders, and is thought to be of psychological origin.

鈥淭hink of the fairy tale of the princess and the pea,鈥 says Samar Khoury, a postdoctoral fellow at 平特五不中鈥檚 Alan Edwards Centre for Research on Pain. 鈥淭he princess in the story had extreme sensitivity where she could feel a small pea through a pile of 20 mattresses. This is a good analogy of how someone with heightened somatic awareness might feel; they have discomforts caused by a tiny pea that doctors can鈥檛 seem to find or see, but which is very real.鈥

Thanks to an existing study on genetic association, Samar Khoury and her colleagues might have found the elusive pea capable of explaining somatic awareness.

Their work, recently published in the , used data available through the Orofacial Pain: Prospective Evaluation and Risk Assessment 鈥 the OPPERA study cohort and demonstrates that patients who suffer from somatic symptoms share a common genetic variant. The mutation leads to the malfunctioning of an enzyme critical for the production of serotonin, a neurotransmitter with numerous biological functions.

鈥淚 am very happy and proud that our work provides a molecular basis for heightened somatic symptoms,鈥 says Luda Diatchenko, lead author of the new study and a professor in 平特五不中鈥檚 Faculty of Dentistry. 鈥淲e believe that this work is very important to patients because we can now provide a biological explanation of their symptoms. It was often believed that there were psychological or psychiatric problems, that the problem was in that patient鈥檚 head, but our work shows that these patients have lower levels of serotonin in their blood.鈥

The results of their study have laid the groundwork for the development of animal models that could be used to better characterize the molecular pathways in heightened somatic awareness. Above all, Diatchenko and Khoury hope their work will pave the way for treatment options.

鈥淭he next step for us would be to see if we are able to target serotonin levels in order to alleviate these symptoms,鈥 says Diatchenko, who holds the Canada Excellence Research Chair in Human Pain Genetics.

This work was supported by the Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, the National Institutes of Health and the National Institute of Dental and Craniofacial Research.

鈥,鈥 by Samar Khoury et al. was published in the Annals of Neurology.

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