Neurobiology of fibromyalgia and chronic widespread pain

Inovativna uporaba magnezijeva oksida u liječenju “neuralgije celijačnog pleksusa reumatoidnog podrijetla” G. Moscatija 1923.

“…Another field of employment for Mg is rheumatology, with regards to the chronic management of patients affected by fibromyalgia (FM), a rheumatic non-inflammatory disease characterized by chronic widespread pain, diffuse hyperalgesia, muscle spasms, fatigue, irritable bowel syndrome, sleep disorders, cognitive and mood disturbances. Etiologically, the strongest evidence points to the alteration of pain modulation in the central nervous system; nonetheless, peripheral abnormalities such as local hypoxia may facilitate peripheral nerve sensitization (38,39). Secondly, deregulation in the sympathetic autonomic and hypothalamic-pituitary-adrenal systems was also described in FM (40).…”

Neuroimagen de la fibromialgia: una enfermedad del cerebro

“…En este sentido, la RM es un instrumento versátil de estudio en vivo para ampliar el conocimiento y comprensión del procesamiento central de la nocicepción en la FM (34,36,45,47), y qué circuito neural patofisiológico se involucra en el mantenimiento del dolor (47). Los resultados con RM craneal enfatizan la alteración de un amplio circuito neural implicado en la nocicepción (11,35,73,89) justificando que la FM es un trastorno de sensibilización del SNC (37) y, consecuentemente, un trastorno del cerebro (89). Funcionalmente, se constata un incremento de la activación de la matriz neural del dolor ante diferentes estímulos nonociceptivos (3), un patrón único de activación funcional temporal en la INS durante la aplicación de un estímulo no-nociceptivo (59) y una hipoactividad sensorial primaria no somatosensorial (67).…”

“…Si bien todavía se asume que es un síndrome con gran controversia diagnóstica y de etiología multifactorial y/o idiopática (6,11,19,35), la investigación de las tres últimas décadas (14,36) permiten asumir una disfunción del Sistema Nervioso Central (SNC) (3,11,14,15,20,36), siendo catalogada como un síndrome de Sensibilización Central (SC) (37), junto con una sensibilización o neuropatología periférica aún no bien definida (15,20,33,36).…”

Treatment of fibromyalgia

“…5 The syndrome is characterised by its hallmark features of widespread somatic pain and deep tissue tenderness, which result from sensitisation of neural pain pathways. 6 There are also variable combinations of fatigue, sleep disturbance, cognitive dysfunction and psychological distress. These symptoms occur despite the absence of objective abnormalities on clinical assessment.…”

“…11 Although fibromyalgia has been considered to primarily derive from pathophysiology within the central nervous system, where it is associated with disordered sensory processing, there is growing evidence to suggest that the 'fibromyalgia phenotype' may comprise multiple pathogenetic subsets, including originating, at least in part, within the peripheral nervous system. 6,12,13 Most cases of fibromyalgia evolve out of persistent regional pain. 14 …”