Globig, A., Zhao, S., Roginsky, J., Maltez, V., Guiza, J., Avina-Ochoa, N., Heeg, M., Hoffmann, F., Chaudhary, O., Wang, J., Senturk, G., Chen, D., O’Connor, C., Pfaff, S., Germain, R., Schalper, K., Emu, B., & Kaech, S. (2023). The β_1-adrenergic receptor links sympathetic nerves to T cell exhaustion. Nature, 622, 383-392. https://doi.org/10.1038/s41586-023-06568-6.
Ali, U., Apryani, E., Wu, H. Y., Mao, X. F., Liu, H., & Wang, Y. X. (2020). Low frequency electroacupuncture alleviates neuropathic pain by activation of spinal microglial IL-10/β-endorphin pathway. Biomedicine & Pharmacotherapy, 125, 109898. https://doi.org/10.1016/j.biopha.2020.109898
Baba, H., Ji, R. R., Kohno, T., Moore, K. A., Ataka, T., Wakai, A., Okamoto, M., & Woolf, C. J. (2003). Removal of GABAergic inhibition facilitates polysynaptic A fiber-mediated excitatory transmission to the superficial spinal dorsal horn. Molecular and Cellular Neuroscience, 24(3), 818–830. https://doi.org/10.1016/j.mcn.2003.08.001
Behbehani, M. M., & Fields, H. L. (1979). Evidence that an excitatory connection between the periaqueductal gray and nucleus raphe magnus mediates stimulation produced analgesia. Brain Research, 170(1), 85–93. https://doi.org/10.1016/0006-8993(79)90942-9
Borovikova, L. V., Ivanova, S., Zhang, M., Yang, H., Botchkina, G. I., Watkins, L. R., Wang, H., Abumrad, N., Eaton, J. W., & Tracey, K. J. (2000). Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature, 405(6785), 458–462. https://doi.org/10.1038/35013070
Clarke, S., Wanigasekera, V., Rogers, R., Caspani, O., Mouraux, A., Fardo, F., Finnerup, N., Treede, R., & Tracey, I. (2025). Neural correlates underlying high-frequency stimulation-induced secondary hyperalgesia in humans. Pain Reports, 10, e1342. https://doi.org/10.1097/pr9.0000000000001342
DeSantana, J. M., Silva, L. F., Resende, M. A., & Sluka, K. A. (2009). Transcutaneous electrical nerve stimulation at both high and low frequencies activates ventrolateral periaqueductal grey to decrease mechanical hyperalgesia in arthritic rats. Neuroscience, 163(4), 1233–1241. https://doi.org/10.1016/j.neuroscience.2009.06.056
Ezema, C. I., Onyeso, O. K., Nna, E. O., Awosoga, O. A., Odole, A. C., Kalu, M. E., & Okoye, G. C. (2022). Transcutaneous electrical nerve stimulation effects on pain-intensity and endogenous opioids levels among chronic low-back pain patients: A randomised controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 35(6), 1247–1258. https://doi.org/10.3233/bmr-210146
Goebel, A. (2025). Fibromyalgia syndrome—an autoimmune condition? Pain Reports, 10(4), e1270. https://doi.org/10.1097/PR9.0000000000001270
Goebel, A., Krock, E., Gentry, C., Israel, M. R., Jurczak, A., Morado Urbina, C., Sandor, K., Vastani, N., Maurer, M., Cuhadar, U., Sensi, S., Nomura, Y., Menezes, J., Baharpoor, A., Brieskorn, L., Sandström, A., Tour, J., Kadetoff, D., Haglund, L., Kosek, E., Bevan, S., Svensson, C. I., & Andersson, D. A. (2021). Passive transfer of fibromyalgia symptoms from patients to mice. The Journal of Clinical Investigation, 131(13), e144201. https://doi.org/10.1172/JCI144201
Gyorfi, M., Rupp, A., & Abd-Elsayed, A. (2022). Fibromyalgia pathophysiology. Biomedicines, 10(12), 3070. https://doi.org/10.3390/biomedicines10123070
Han, J. S. (2004). Acupuncture and endorphins. Neuroscience Letters, 361(1–3), 258–261. https://doi.org/10.1016/j.neulet.2003.12.019
Hughes, G. S., Lichstein, P. R., Whitlock, D., & Harker, C. (1984). Response of plasma beta-endorphins to transcutaneous electrical nerve stimulation in healthy subjects. Physical Therapy, 64(7), 1062–1066. https://doi.org/10.1093/ptj/64.7.1062
Katz, R. S., Leavitt, F., Small, A. K., & Small, B. J. (2021). Intramuscular pressure is almost three times higher in fibromyalgia patients: A possible mechanism for understanding the muscle pain and tenderness. The Journal of Rheumatology, 48(4), 598–602. https://doi.org/10.3899/jrheum.191068
Krock, E., Morado-Urbina, C. E., Menezes, J., Hunt, M. A., Sandström, A., Kadetoff, D., Tour, J., Verma, V., Kultima, K., Haglund, L., Meloto, C. B., Diatchenko, L., Kosek, E., & Svensson, C. I. (2023). Fibromyalgia patients with elevated levels of anti–satellite glia cell immunoglobulin G antibodies present with more severe symptoms. Pain, 164(8), 1828–1840. https://doi.org/10.1097/j.pain.0000000000002881
Latremoliere, A., & Woolf, C. J. (2009). Central sensitization: A generator of pain hypersensitivity by central neural plasticity. Journal of Pain, 10(9), 895–926. https://doi.org/10.1016/j.jpain.2009.06.012
Liptan, G. L. (2023). The widespread myofascial pain of fibromyalgia is sympathetically maintained and immune mediated. Journal of Bodywork and Movement Therapies, 35, 394–399. https://doi.org/10.1016/j.jbmt.2023.04.081
Mehnert, J., Tinnermann, A., Basedau, H., & May, A. (2024). Functional representation of trigeminal nociceptive input in the human periaqueductal gray. Science Advances, 10(6), eadj8213. https://doi.org/10.1126/sciadv.adj8213
Melzack, R., & Wall, P. D. (1965). Pain mechanisms: A new theory. Science, 150(3699), 971–979. https://doi.org/10.1126/science.150.3699.971
Rosas-Ballina, M., Olofsson, P. S., Ochani, M., Valdés-Ferrer, S. I., Levine, Y. A., Reardon, C., Tusche, M. W., Pavlov, V. A., Andersson, U., Chavan, S., Mak, T. W., & Tracey, K. J. (2011). Acetylcholine-synthesizing T cells relay neural signals in a vagus nerve circuit. Science, 334(6052), 98–101. https://doi.org/10.1126/science.1209985
Rüster, M., Franke, S., Späth, M., Pongratz, D. E., Stein, G., & Hein, G. (2005). Detection of elevated Nε-carboxymethyllysine levels in muscular tissue and in serum of patients with fibromyalgia.
Scandinavian Journal of Rheumatology, 34(6), 460–463. https://doi.org/10.1080/03009740510026715
SetPoint Medical. (2025, July 31). SetPoint Medical receives FDA approval for novel neuroimmune modulation therapy for rheumatoid arthritis [Press release]. https://setpointmedical.com/setpoint-medical-receives-fda-approval-for-novel-neuroimmune-modulation-therapy-for-rheumatoid-arthritis/
Tesser, J. D., et al. (2024). RESET-RA study: 242-patient randomized, double-blind, sham-controlled trial of vagus nerve stimulation for rheumatoid arthritis. As cited in SetPoint Medical FDA approval announcement. https://setpointmedical.com/
Tracey, K. J. (2002). The inflammatory reflex. Nature, 420(6917), 853–859. https://doi.org/10.1038/nature01321
Viau, M., & Zouali, M. (2005). B-lymphocytes, innate immunity, and autoimmunity. Clinical Immunology, 114(1), 17–26. https://doi.org/10.1016/j.clim.2004.08.019
Wang, H., Yu, M., Ochani, M., Amella, C. A., Tanovic, M., Susarla, S., Li, J. H., Wang, H., Yang, H., Ulloa, L., Al-Abed, Y., Czura, C. J., & Tracey, K. J. (2003). Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation. Nature, 421(6921), 384–388. https://doi.org/10.1038/nature01339
Wang, Q., Li, Z., Nie, D., Mu, X., Wang, Y., Jiang, Y., Zhang, Y., & Lu, Z. (2024). Low-frequency electroacupuncture exerts antinociceptive effects through activation of POMC neural circuit induced endorphinergic input to the periaqueductal gray from the arcuate nucleus. Molecular Pain, 20, 17448069241254201. https://doi.org/10.1177/17448069241254201
Zouali, M. (2023). Pharmacological and electroceutical targeting of the cholinergic anti-inflammatory pathway in autoimmune diseases. Pharmaceuticals, 16(8), 1089. https://doi.org/10.3390/ph16081089