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, Volume 26, Issue 3, pp 259–267 | Cite as

Ätiologie und Pathophysiologie des Fibromyalgiesyndroms

  • C. Sommer
  • W. Häuser
  • M. Burgmer
  • R. Engelhardt
  • K. Gerhold
  • F. Petzke
  • T. Schmidt-Wilcke
  • M. Späth
  • T. Tölle
  • N. Üçeyler
  • H. Wang
  • A. Winkelmann
  • K. Thieme
Schwerpunkt

Zusammenfassung

Hintergrund

Die planmäßige Aktualisierung der S3-Leitlinie zum Fibromyalgiesyndrom (FMS; AWMF-Registernummer 041/004) wurde ab März 2011 vorgenommen.

Material und Methoden

Die Leitlinie wurde unter Koordination der Deutschen Interdisziplinären Vereinigung für Schmerztherapie (DIVS) von 9 wissenschaftlichen Fachgesellschaften und 2 Patientenselbsthilfeorganisationen entwickelt. Acht Arbeitsgruppen mit insgesamt 50 Mitgliedern wurden ausgewogen in Bezug auf Geschlecht, medizinischen Versorgungsbereich, potenzielle Interessenkonflikte und hierarchische Position im medizinischen bzw. wissenschaftlichen System besetzt.

Die Literaturrecherche erfolgte über die Datenbanken Medline, PsycInfo, Scopus und Cochrane Library (bis Dezember 2010). Die Graduierung der Evidenzstärke erfolgte nach dem Schema des Oxford Center for Evidence Based Medicine.

Ergebnisse

Die aktuelle Studienlage erlaubt keine eindeutigen Aussagen zur Ätiologie und Pathophysiologie des FMS. Die Entwicklung eines FMS ist mit entzündlich-rheumatischen Erkrankungen (EL2b), Genpolymorphismen des 5-Hydroxytryptamin(HT)2-Rezeptors (EL3a), Lebensstilfaktoren (Rauchen, Übergewicht, mangelnde körperliche Aktivität; EL2b), körperlicher Misshandlung und sexuellem Missbrauch in Kindheit und Erwachsenenalter (EL3a) assoziiert.

Schlussfolgerung

Das FMS ist wahrscheinlich die Endstrecke verschiedener ätiopathogenetischer Faktoren und pathophysiologischer Mechanismen.

Schlüsselwörter

Fibromyalgiesyndrom Leitlinie Systematische Übersicht Ätiologie Pathophysiologie 

Etiology and pathophysiology of fibromyalgia syndrome

Abstract

Background

The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies (“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”, AWMF; registration number 041/004) was planned starting in March 2011.

Materials and methods

The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy (“Deutsche Interdisziplinären Vereinigung für Schmerztherapie”, DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields.

Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Centre for Evidence-Based Medicine.

Results

Current data do not identify distinct etiologic or pathophysiological factors mediating development of FMS. The development of FMS is associated with inflammatory rheumatic diseases (EL2b), with gene polymorphisms of the 5-hydroxytryptamine (HT)2 receptor (EL3a), lifestyle factors (smoking, obesity, lack of physical activity; EL2b), physical and sexual abuse in childhood and adulthood (EL3a).

Conclusion

FMS is most likely the result of various pathogenetic factors and pathophysiological mechanisms.

The English full-text version of this article is available at SpringerLink (under “Supplemental”).

Keywords

Fibromyalgia syndrome Guideline Review, systematic Etiology Physiopathology 

Notes

Interessenkonflikt

Siehe Tab. 5 im Beitrag „Methodenreport“ von W. Häuser, K. Bernardy, H. Wang, I. Kopp in dieser Ausgabe

Supplementary material

482_2012_1174_MO1_ESM.pdf (358 kb)
English version of "Ätiologie und Pathophysiologie des Fibromyalgiesyndroms" (PDF 0,4 MB)
482_2012_1174_MO2_ESM.pdf (415 kb)
Evidenzbericht: Forest Plots der standardisierten Mittelwertdifferenzen von experimenteller Gruppe versus Kontrollgruppe bei ausgewählten Zielvariablen am Therapieende und bei Nachuntersuchungen (PDF 0,4 MB)
482_2012_1174_MO3_ESM.pdf (430 kb)
Evidence report: Forest Plots of standardised mean differences between experimental groups versus controls on selected outcomes at final treatment and at follow up (PDF 0,4 MB)
482_2012_1174_MO4_ESM.pdf (299 kb)
Evidenzbericht: Tabellen - Charakteristiken der Studien, die in qualitative und/oder quantitative Analyse einbezogen wurden (PDF 0,3 MB)
482_2012_1174_MO5_ESM.pdf (676 kb)
Evidence report: Tables - Characteristics of studies included into qualitative and/or quantitative analysis (PDF 0,7 MB)

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • C. Sommer
    • 1
  • W. Häuser
    • 2
  • M. Burgmer
    • 3
  • R. Engelhardt
    • 4
  • K. Gerhold
    • 5
  • F. Petzke
    • 6
  • T. Schmidt-Wilcke
    • 7
  • M. Späth
    • 8
  • T. Tölle
    • 9
  • N. Üçeyler
    • 1
  • H. Wang
    • 10
  • A. Winkelmann
    • 11
  • K. Thieme
    • 12
  1. 1.Neurologische KlinikUniversitätsklinikum WürzburgWürzburgDeutschland
  2. 2.Innere Medizin 1Klinikum Saarbrücken gGmbHSaarbrückenDeutschland
  3. 3.Klinik für Psychosomatische Medizin und PsychotherapieUniversitätsklinikum MünsterMünsterDeutschland
  4. 4.Zentralinstitut für die kassenärztliche Versorgung in DeutschlandBerlinDeutschland
  5. 5.Klinik für Pädiatrie mit Schwerpunkt Pneumologie/Immunologie und Berlin School of Public HealthCharité – Universitätsmedizin BerlinBerlinDeutschland
  6. 6.Schmerz-Tagesklinik und -AmbulanzUniversitätsmedizin Göttingen, Georg-August-Universität GöttingenGöttingenDeutschland
  7. 7.Department of Anesthesiology, Chronic Pain and Fatigue Research CenterUniversity of MichiganAnn Arbor (Michigan)USA
  8. 8.Rheumatologische PraxisMünchen-GräfelfingDeutschland
  9. 9.Klinik für NeurologieTechnische Universität MünchenMünchenDeutschland
  10. 10.Department für Orthopädie und UnfallchirurgieUniversitätsklinik HeidelbergHeidelbergDeutschland
  11. 11.Klinik und Poliklinik für Physikalische Medizin und RehabilitationKlinikum der Universität MünchenMünchenDeutschland
  12. 12.Institut für Medizinische PsychologiePhilipps-Universität MarburgMarburgDeutschland

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