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01.06.2008 | Schwerpunkt

Ätiopathogenese und Pathophysiologie des Fibromyalgiesyndroms und chronischer Schmerzen in mehreren Körperregionen

verfasst von: Prof. Dr. C. Sommer, W. Häuser, K. Gerhold, P. Joraschky, F. Petzke, T. Tölle, N. Üçeyler, A. Winkelmann, K. Thieme

Erschienen in: Der Schmerz | Ausgabe 3/2008

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Zusammenfassung

Ziel

Die Erstellung eines ersten systematischen Reviews zur Ätiopathogenese und Pathophysiologie des Fibromyalgiesyndroms (FMS) und chronischer Schmerzen in mehreren Körperregionen (engl. „chronic widespread pain“, CWP).

Methodik

Eine interdisziplinäre Leitlinie wurde in Kooperation von 10 medizinischen bzw. psychologischen Fachgesellschaften und 2 Patientenselbsthilfeorganisationen erstellt. Eine Literatursuche über alle Übersichtsarbeiten zur Ätiopathogenese und Pathophysiologie des FMS und CWP wurde unter Benutzung der Cochrane Collaboration Reviews (1993–12/2006), Medline (1980–2006), PsychInfo (1966–12/2006) und Scopus (1980–12/2006) durchgeführt. Für die Vergabe von Evidenzklassen wurde das System des Oxford Centre for Evidence-Based Medicine verwendet. Ein Konsens über die Evidenzklassen erfolgte in einem mehrstufigen nominalen Gruppenprozess.

Ergebnisse

Das FMS tritt gehäuft in Familien auf. Physische und psychische Stressoren am Arbeitsplatz sind Risikofaktoren für die Entwicklung von CWP und FMS. Affektive Störungen sind Risikofaktoren für die Entwicklung und Aufrechterhaltung eines FMS. Operante Lernmechanismen und Sensitivierung sind Risikofaktoren für die Chronifizierung eines FMS (Evidenzgrad 2b). Verschiedene Faktoren sind mit der Pathophysiologie des FMS assoziiert, ohne dass die Ursache-Wirkungs-Relation geklärt ist. Dazu gehören Störungen der zentralen Schmerzverarbeitung, eine Hyporeaktivität der Hypothalamus-Hypophysen-Nebennierenachse, eine Störung des Wachstumhormonsystems, erhöhte systemische proinflammatorische und verminderte antiinflammatorische Zytokinprofile, Veränderungen des dopaminergen und serotonergen Systems.

Schlussfolgerung

Das FMS ist eine Endstrecke verschiedener ätiopathogenetischer Faktoren und pathophysiologischer Mechanismen.

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Titel: Ätiopathogenese und Pathophysiologie des Fibromyalgiesyndroms und chronischer Schmerzen in mehreren Körperregionen
verfasst von: Prof. Dr. C. Sommer
W. Häuser
K. Gerhold
P. Joraschky
F. Petzke
T. Tölle
N. Üçeyler
A. Winkelmann
K. Thieme
Publikationsdatum: 01.06.2008
Verlag: Springer-Verlag
Erschienen in: Der Schmerz / Ausgabe 3/2008
Print ISSN: 0932-433X
Elektronische ISSN: 1432-2129
DOI: https://doi.org/10.1007/s00482-008-0672-6

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