Fibromyalgia--from syndrome to disease. Overview of pathogenetic mechanisms.
According to the classification criteria proposed by the American College of Rheumatology, fibromyalgia is a long-standing multifocal pain condition combined with generalised allodynia/hyperalgesia. It is the generalised allodynia/hyperalgesia that distinguishes fibromyalgia from other conditions with chronic musculoskeletal pain. Central sensitisation of nociceptive neurons in the dorsal horn due to activation of N-methyl-D-aspartic acid receptors and disinhibition of pain due to deficient function of the descending inhibitory system are probable pathogenic factors for allodynia/hyperalgesia. Furthermore, chronic pain is a chronic emotional and physical stressor. Chronic stress and chronic sleep disturbance are not specific for fibromyalgia but could be the causes of symptoms like fatigue, cognitive difficulties and other stress-related symptoms. They may also cause neuroendocrinological and immunological aberrations.
Henriksson
Karl G
KG
Department of Neuroscience and Locomotion Section of Medical Rehabilitation, Faculty of Health Sciences, Linköping University, Sweden. karl-g@telia.com
D005356:Fibromyalgia / Q000503:physiopathology*; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology; D009619:Nociceptors / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology; D013577:Syndrome