scholarly journals Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome

2006 ◽  
Vol 26 (4) ◽  
pp. 465-473 ◽  
Author(s):  
Mira Meeus ◽  
Jo Nijs
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Central Sensitization ◽  
Chronic Fatigue ◽  
Chronic Widespread Pain ◽  
Widespread Pain ◽  
Fatigue Syndrome

Treatment of fibromyalgia (chronic widespread pain) and chronic fatigue syndrome

2020 ◽  
pp. 1330-1341
Author(s):  
Jonathan Price
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Chronic Widespread Pain ◽  
Widespread Pain ◽  
Fatigue Syndrome ◽  
System P ◽  
The Central Nervous System ◽  
Key Aspects

Fibromyalgia (FM), one of the chronic widespread pain syndromes, and chronic fatigue syndrome (CFS) are important and common conditions. They are considered together here because they are commonly comorbid and because of their similarities—they are long-term conditions with a relatively poor prognosis; central nervous system mechanisms and deconditioning play an important role in aetiology; graded exercise and psychological treatments have an important role in management; and comorbid mental disorders are common and have an adverse impact on important outcomes, including disability and chronicity. The prevalence of FM is rising, while that of CFS is declining. There is increased acceptance of the pivotal role of central nervous system factors in FM, while in CFS, the positions of different aetiological ‘movements’ appear bitterly entrenched. The main focus of this chapter is on FM and, in particular, key aspects of aetiology and treatment, especially those relating to the central nervous system.

Genetic Factors in Neuromuscular Pain

CNS Spectrums ◽  
2005 ◽  
Vol 10 (4) ◽  
pp. 281-284 ◽  
Author(s):  
Dan Buskila ◽  
Lily Neumann ◽  
Joseph Press
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chronic Fatigue Syndrome ◽  
Environmental Factors ◽  
Genetic Factors ◽  
Recent Literature ◽  
Chronic Fatigue ◽  
Chronic Widespread Pain ◽  
Widespread Pain ◽  
Fatigue Syndrome ◽  
Irritable Bowel

AbstractRecent evidence suggests that fibromyalgia, a chronic widespread pain condition and related syndromes (chronic fatigue syndrome, irritable bowel syndrome, etc.) may share heritable pathophysiologic features. We review the recent literature on genetic and familial factors found to participate in the pathogenesis of these syndromes, specifically fibromyalgia, including evidence suggesting that serotonin- and dopamine-related genes may play a role in the pathogenesis of these illnesses. The importance of environmental factors triggering these conditions in predisposed individuals is also discussed.

scholarly journals Pain in Patients with Chronic Fatigue Syndrome: Time for Specific Pain Treatment?

2012 ◽  
Vol 5;15 (5;9) ◽  
pp. E677-E686
Author(s):  
Jo Nijs
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioral Therapy ◽  
Central Sensitization ◽  
Pain Treatment ◽  
Pain Catastrophizing ◽  
Behavioral Therapy ◽  
Chronic Fatigue ◽  
Cognitive Behavioral ◽  
Fatigue Syndrome ◽  
Endogenous Analgesia

Background: Besides chronic fatigue, patients with chronic fatigue syndrome (CFS) have debilitating widespread pain. Yet pain from CFS is often ignored by clinicians and researchers. Objectives: To examine whether pain is a unique feature of CFS, or does it share the same underlying mechanisms as other CFS symptoms? Second, it is examined whether effective treatments for pain from CFS are currently available. Study Design: Narrative review covering the scientific literature up through December 2011. Setting: Several universities. Results: From the available literature, it is concluded that musculoskeletal factors are unlikely to account for pain from CFS. Pain seems to be one out of many symptoms related to central sensitization from CFS. This idea is supported by the findings of generalized hyperalgesia (including widespread increased responsiveness to painful stimuli) and dysfunctional endogenous analgesia in response to noxious thermal stimuli. Pain catastrophizing and depression partly account for pain from CFS. Pain increases during exercise is probably due to the lack of endogenous analgesia and activation of several genes in response to exercise in CFS. There is currently no evidence in support for the efficacy of complementary medicine in the treatment of pain from CFS. Intensive education about the biology of pain from CFS (within the framework of central sensitization) has positive short-term effects for patients with CFS, and fatigue-targeting cognitive behavioral therapy appears to be effective for pain from CFS as well. Limitations: The role of the deficient hypothalamus-pituitary-adrenal axis in relation to pain from CFS, as well as the interactions with immune (dys)functioning require further study. Conclusion: Recent research has increased our understanding of pain from CFS, including its treatment. It is advocated to optimize current CFS treatment protocols by targeting the underlying mechanism for those patients having severe pain. Key words: Chronic pain, chronic fatigue syndrome, fibromyalgia, central sensitization, catastrophizing, exercise, cognitive behavioral therapy.

scholarly journals Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study

2017 ◽  
Vol 4 (20;4) ◽  
pp. E489-E497
Author(s):  
Kelly Ickman
Keyword(s):  
Multiple Sclerosis ◽  
Chronic Fatigue Syndrome ◽  
Central Sensitization ◽  
Temporal Summation ◽  
Cuff Pressure ◽  
Experimental Pain ◽  
Chronic Fatigue ◽  
Pain Modulation ◽  
Fatigue Syndrome ◽  
Pressure Threshold

Background: Commonalities in the core symptoms of fatigue and cognitive dysfunction experienced by chronic fatigue syndrome (CFS, also known as ME) and multiple sclerosis (MS) patients have been described. Many CFS and MS patients also experience chronic pain, which has been attributed to central sensitization in both groups of patients. However, the characteristics of pain in CFS and MS patients have not been compared. Objectives: To compare experimental pain measurements in patients with CFS or MS and healthy controls. Study design: Observational study. Setting: This study took place in Belgium at Vrije Universiteit Brussel and the University of Antwerp. Methods: Pressure pain thresholds, temporal summation, conditioned pain modulation, and occlusion cuff pressure thresholds rated as painful (1st cuff pressure threshold) and as 3/10 on a verbal numerical scale (2nd cuff pressure threshold) were measured in patients with CFS (n = 48), MS (n = 19) and healthy pain-free controls (n = 30). Adjusted between-group differences were estimated using linear regression models. Results: Finger pain pressure thresholds of patients with CFS, compared with patients with MS, were 25% lower (difference ratio 0.75 [95% CI 0.59, 0.95], P = 0.02) and shoulder pain pressure thresholds were 26% lower (difference ratio 0.74 [0.52, 1.04], P = 0.08). Compared with patients with MS, patients with CFS had 29% lower first cuff pressure threshold (difference ratio 0.71 [0.53, 0.94], P = 0.02) and 41% lower 2nd cuff pressure threshold (0.59 [0.41, 0.86], P = 0.006). Finger temporal summation was higher in patients with CFS than in patients with MS (mean difference 1.15 [0.33, 1.97], P = 0.006), but there were no differences in shoulder temporal summation or conditioned pain modulation at either site. Differences between patients with CFS and MS tended to be greater than between either patient group and healthy controls. Pain pressure thresholds and cuff pressure thresholds tended to be positively correlated, and temporal summation negatively correlated, with higher physical function and lower fatigue in both groups of patients. Subjective pain in patients with CFS but not in patients with MS was strongly negatively correlated with pain pressure thresholds and cuff pressure thresholds, and positively correlated with temporal summation. Limitations: The main limitations of our study are the relatively small sample sizes, its crosssectional design, and its exploratory nature. Conclusions: We found differences in the characteristics of pain symptoms reported by patients with CFS and patients with MS, which suggest different underlying mechanisms. Specifically, overactive endogenous pain facilitation was characteristic of pain in patients with CFS but not in patients with MS, suggesting a greater role for central sensitization in CFS. Keywords: Chronic fatigue syndrome, CFS/ME, multiple sclerosis, experimental pain, central sensitization

Long- and short-term blood pressure andRR-interval variability and psychosomatic distress in chronic fatigue syndrome: authors’ reply 1

1999 ◽  
Vol 97 (3) ◽  
pp. 319 ◽  
Author(s):  
D.A. DUPREZ ◽  
M.L. DE BUYZERE ◽  
B. DRIEGHE ◽  
F. VANHAVERBEKE ◽  
Y. TAES ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Short Term ◽  
Fatigue Syndrome

Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome

2017 ◽  
Vol 33 (3) ◽  
pp. 158-165
Author(s):  
Natalia Calvo ◽  
Naia Sáez-Francàs ◽  
Sergi Valero ◽  
Jesús Castro-Marrero ◽  
José Alegre Martín ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Chronic Fatigue Syndrome ◽  
Personality Assessment ◽  
Chronic Fatigue ◽  
Specific Pattern ◽  
Harm Avoidance ◽  
Assessment Instrument ◽  
Compulsive Disorder ◽  
Fatigue Syndrome ◽  
Self Transcendence

Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.

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