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Neuroendokrine Veränderungen und Maladaptationen bei Fibromyalgie

Befunde zur Ätiopathogenese

Neuroendocrine changes and maladaptations in fibromyalgia

Pathogenetic findings

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Zusammenfassung

Der vorliegende Beitrag stellt psychosoziale, psychopathologische, psycho- und elektrophysiologische sowie endokrine Erkenntnisse in der Ätiopathogenese des Fibromyalgiesyndroms vor. Es finden sich 3 Untergruppen, denen psychosoziale Lernprozesse zugrunde liegen. Sie unterscheiden sich in der Schmerzintensität und schmerzbedingten Beeinträchtigung, der affektiven Verstimmung, der Aktivität und den Partnerreaktionen auf die Erkrankung. Diese beeinflussen im Sinne der operanten Konditionierung das Schmerzverhalten und die ZNS-Aktivität. Es wird der Zusammenhang von dysregulierter Schmerzmodulation im ZNS und endokrinologischer Dysregulation der HPA-Achse diskutiert, die für die autonome Hyporeaktion der Muskulatur und der Blutdrucks relevant zu sein scheint. Abschließend wird das ‚Dynamische Prozessmodell des FMS‘ vorgestellt.

Abstract

This contribution presents the psychosocial, psychopathological, psycho- and elektrophysiological as well as endocrine results in the aetiopathogenesis of fibromyalgia syndrome (FMS). Three subgroups could be differentiated based on psychosocial learning processes. They differ in pain intensity and interference, affective distress, activity and spouse responses. They influence pain behavior and CNS activity in the sense of operant conditioning. The relationship between dysregulated pain modulation in the CNS and endocrine dysregulation of the HPA-axis, which seems to be relevant for the autonome hyporeaction of muscle and blood pressure, are discussed. The “dynamic processing model for FMS” is presented.

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  1. Department of Anesthesiology, University of Washington, Seattle, 1959NE Pacific Street, Washington 98195-6540, USA

    K. Thieme

  2. Klinik für Psychosomatik und Psychotherapeutische Medizin—Zentralinstitut für Seelische Gesundheit an der Universität Heidelberg, J 5, 68159 , Mannheim

    K. Thieme

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Thieme, K. Neuroendokrine Veränderungen und Maladaptationen bei Fibromyalgie. Orthopäde 33, 576–582 (2004). https://doi.org/10.1007/s00132-003-0617-9

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