5. Which of the following is the acceptable statement about pathogenesis of FMS?
(A) There is evidence to suggest that FMS is a disorder of abnormal processing of sensory
information within the central nervous system.
(B) Several neurochemical mediators of pain, substance P, nerve growth factor, dynorphin A,
glutamate, nitric oxide, serotonin and noradrenaline are viewed as pronociceptive because
they carry or amplify afferent signals, leading to the brain perception of increased pain.
(C) The elevation of cerebrospinal fluid substance P in FMS is due to lowered activity of
cerebrospinal fluid substance P esterase because the rate of cleavage of libeled substance P by
FMS cerebrospinal fluid was lower than normal.
(D) In different subtypes of FMS, it is believed that nerve growth factor may be responsible for
the elevated cerebrospinal fluid substance P through its effects on central sensitization and
neuroplasticity.
(E) A specific Gi-protein–coupled receptor in peripheral blood leukocytes was found to be
dysfunctional in patients with FMS. This resulted in lower baseline, also depressed intracellular
levels of cyclic AMP and proposed as a diagnostic test for FMS.
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