Fibromyalgia and Overlapping Disorders: The Unifying Concept of Central Sensitivity Syndromes

• Published in: Seminars in arthritis and rheumatism Vol. 36; no. 6; pp. 339 - 356
• Main Author: Yunus, Muhammad B., MD
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-06-2007; Elsevier
• Subjects: Biological and medical sciences; central sensitivity syndromes; central sensitization; Diseases of the osteoarticular system; Fatigue Syndrome, Chronic - complications; Fatigue Syndrome, Chronic - physiopathology; fibromyalgia; Fibromyalgia - complications; Fibromyalgia - physiopathology; fibromyalgia associations; functional syndromes; Gastroenterology. Liver. Pancreas. Abdomen; Headache Disorders - complications; Headache Disorders - physiopathology; Humans; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - physiopathology; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Other diseases. Semiology; overlapping syndromes; Rheumatology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; AMPA; DNIC; N-methyl- d-aspartate; COMT; SLE; MPS; NK1; wide dynamic range; IC; substance P; fibromyalgia syndrome; WDR; restless legs syndrome; catechol- O-methyltransferase; nociceptive flexion reflex; rheumatoid arthritis; CEP; central nervous system; posttraumatic stress disorder; RA; HPA; PubMed identification; regional soft-tissue pain syndrome; D; central sensitization; CNS; functional dyspepsia; CFS; fibromyalgia; diffuse noxious inhibitory control; nerve growth factor; NMDA; RLS; primary dysmenorrheal; myofascial pain syndrome; complex regional pain syndrome; IBS; interstitial cystitis; SP; hypothalamic-pituitary-adrenal; GWS; FUS; human leukocyte antigens; FMS; CS; PTSD; QST; α-amino-3-hydroxy-5-methyl-4-isoxazoleproprionate; Gulf war syndrome; REM; MCS; TP; dopamine; neurokinin-1; PLMS; tender point(s); NFR; corticotrophin-releasing hormone; EEG; multiple chemical sensitivity; NGF; fibromyalgia associations; CRPS; electroencephalogram; γ-amino-butyric acid; mGlu; cerebral-evoked potential; overlapping syndromes; CRH; GABA; female urethral syndrome; HLA; metabotropic glutamate; FD; functional magnetic resonance imaging; positron-emission tomography; central sensitivity syndromes; TTH; periodic limb movement in sleep; rapid eye movement; systemic lupus erythematosus; Trk-B; RSTPS; quantitative sensory testing; temporomandibular disorders; CSS; TDS; irritable bowel syndrome; TMD; tyrosine kinase B; tension-type headache; f-MRI; PD; chronic fatigue syndrome; PMID; PET; functional syndromes; time-dependent sensitization; Diseases of the osteoarticular system; Fibromyalgia; Chronic fatigue syndrome; Striated muscle disease; Chronic; Sensitivity; Pain; Treatment; Irritable bowel syndrome; Digestive diseases; Intestinal disease
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2006.12.009

Objectives To discuss fibromyalgia syndrome (FMS) and overlapping conditions, eg, irritable bowel syndrome, headaches, and chronic fatigue syndrome, within the concept of central sensitivity syndromes (CSS). Methods A critical overview of the literature and incorporation of the author’s own views. Results The concept of CSS seems viable. It is based on mutual associations among the CSS conditions as well as the evidence for central sensitization (CS) among several CSS members. However, such evidence is weak or not available in other members at this time, requiring further studies. The biology of CSS is based on neuroendocrine aberrations, including CS, that interact with psychosocial factors to cause a number of symptoms. Conclusions CSS is an important new concept that embraces the biopsychosocial model of disease. Further critical studies are warranted to fully test this concept. However, it seems to have important significance for new directions for research and patient care involving physician and patient education. Each patient, irrespective of diagnosis, should be treated as an individual considering both the biological and psychosocial contributions to his or her symptoms and suffering.