Journal of Chronic Fatigue Syndrome:
Multidisciplinary Innovations in Research, Theory, and Clinical Practice

Volume: 9 Issue: 1/2
ISSN: 1057-3321 Pub Date: 10/4/2001

Concomitant Environmental Chemical Intolerance Modifies the Neurobehavioral Presentation of Women with Fibromyalgia

  • Iris R. Bell MD, PhD, Department of Psychiatry, Department of Psychology, Family and Community Medicine (the Program in Integrative Medicine), Southern Arizona VA Healthcare System
  • Carol M. Baldwin RN, PhD, HNC, Department of Psychology, the Department of Medicine, Southern Arizona VA Healthcare System
  • Erin Stoltz BA, Department of Psychiatry, Southern Arizona VA Helthcare System
  • Bridget T. Walsh DO, Southern Arizona VA Healthcare System and the Department of Medicinej
  • Gary E.R. Schwartz PhD, Department of Psychiatry, the Department of Psychology, Department of Neurology, University of Arizona College of Medicine, Tucson, AZ


The Journal of Chronic Fatigue Syndrome is Copyrighted by The Haworth Press, Inc
Reprinted with Expressed Permission of The Haworth Press, Inc



This study compared personality, dietary, and psychophysiological characteristics of 3 groups of women: fibromyalgia (FM) with illness from low levels of environmental chemicals (chemical intolerance, CI), FM alone without CI, and normal controls. CI may be a marker for enhanced central nervous system response amplification (sensitization) in limbic and mesolimbic pathways, which play a role in hedonic responses to food and drugs and in pain.


Fibromyalgic women with (FM/CI, n = 11) and without CI (FM, n = 10) and normals (NORM, n = 10) participated in the study. Measures included psychological trait questionnaires, a food frequency questionnaire, a taste test for hedonic and sweetness ratings of different sucrose concentrations, pain self-ratings, and resting spectral electroencephalographic alpha over midline sites, averaged over four separate days.


FM with CI had the highest scores on the Harm Avoidance dimension of the Tridimensional Personality Questionnaire, Carbohydrate Addicts Test, Limbic Symptom sensory and behavior subscales, and SCL-90-R somatization and obsessiveness subscales. FM groups both had the highest mean pain ratings for 21 tender point sites. Groups did not differ for macronutrient intake or for sweetness and hedonic ratings for sucrose. The combined FM groups had greater EEG alpha activity towards posterior midline sites than did normals.


The pattern of findings may reflect impaired serotonergic function and/or elevated dopaminergic receptor activation by endogenous and/or exogenous agents. The data could have implications for pharmacological and dietary interventions in different subsets of FM patients

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