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Fibromiyalji Sendromu ve Nöropatik Ağrı

Year 2018, Volume: 1 Issue: 1, 26 - 31, 01.07.2018

Abstract

Fibromiyalji sendromu yaygın vücut ağrısı ve belirli
anatomik bölgelerde hassas noktaların varlığı ile karakterize, etiyoloji net
olarak bilinmeyen, iş gücü kaybı ve yaşam kalitesinde bozulmaya yol açan kronik
bir kas-iskelet sistemi hastalığıdır.
Fibromiyalji
sendromunda en sık görülen ve karakteristik semptomlar yaygın ağrı, sabah
katılığı, yorgun uyanma ve uyku bozukluğudur. Aile öyküsü olanlarda
fibromiyaljinin daha fazla görülmesi genetik faktörlerin rol aldığını
düşündürmektedir.
Fibromiyaljili hastaların
ağrılı uyaranlara daha duyarlı olduğu gösterilmiştir.
Fibromiyalji sendromunun
etiyopatogenezi üzerine uzun yıllardır birçok çalışma yapılmakta olup
multifaktöryel mekanizmalar olduğu görüşü ağırlık kazanmaktadır. Bu faktörler
genetik nedenler, immunolojik mekanizmalar ve santral ve periferik teoriler
olarak alt başlıklarda toplanmaktadır. Fibromiyaljinin sıklıkla santral
sensitivite sendromları ile beraber olması, glutamat ve P maddesi gibi ağrı
nörotransmitterlerinin artmış olması, noradrenalin, serotonin ve dopamin gibi
antinosiseptif nörotransmitter düzeylerinin azalmış olması, ektopik
deşarjlar/periefrik sensitizasyon/ A
β liflerinin reorganizasyonu ve
hiperaljezi ve allodinin varlığı fibromiyaljinin nöropatik ağrı sendromun bir
parçası olabileceğini düşündürmektedir.

Son yıllarda
yapılan çalışmalar santral mekanizmaların etkinliğini desteklemektedir
Nöropatik ağrı ve fibromiyalji sendromu ilişkisi literatürde yapılan az sayıda çalışmada
gösterilmiştir.
Son yıllardaki çalışmalarda fibromiyalji sendromu
ile küçük lif polinöropatisi sıklığının saptanması ile periferik sisteminde
olaya katkı sağladığı görüşü gündeme gelmiştir
Bu
yazıda fibromiyalji sendromu ve nöropatik ağrı son gelişmeler ışığında tekrar
gözden geçirilecektir. 

References

  • Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-172
  • Uguz F, Ciçek E, Salli A, Karahan AY, Albayrak I, Kaya N, Uğurlu H. Axis I and Axis II psychiatric disorders in patients with fibromyalgia. Gen Hosp Psychiatry. 2010;32(1):105-7.
  • Küçükşen S, Genç E, Yılmaz H, Sallı A, Gezer İA, Karahan AY, et al. The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine. Clin Rheumatol. 2013;32:983-90.
  • Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristic of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28
  • Topbaş M, Çakırbay H, Güleç H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol 2005;34(2):140-144
  • Yunus MB, İnanıcı F. Fibromyalgia syndrome: clinical features, diagnosis, and biopathophsiologic mechanisms. In: Rachlin ES, Rachlin IS(Eds). Myoofascial pain and fibromyalgia. Trigger Point Management. Mosby, St. Louis. 2002, pp.3-31
  • Yunus MB, Masi AT, Aldag JC. A controlled study of primary fibromyalgia syndrome: clinical features and association with other functionel syndromes. J Rheumatol 1989;19(suppl):62-71
  • İnanıcı F, Yunus MB, Aldag JC. Prevalence of Temporomandibular Disorder (TMD) in Fibromyalgia Syndrome. Arthritis Rheum 2002;46:(9 Suppl): 106
  • Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 2010 May;62(5):600-10
  • BurkhamJ, Harris ED. Fibromyalgia: A chronic pain syndrome In:Kelly’s Textbook of Rheumatology. Harris ED, Budd RC, Firestein GS, Genovese MC, Servent JS, Ruddy S and Sledge CB(Eds). Elsevier Saunders, Philadelphia, 2005,522-536
  • White LA, Birnbaum HG, Kaltenboeck A, et al.Employees with fibromyalgia medical comorbidty, healthcare costs, and work loss. J Occup Environ Med 2008;50:13-24
  • Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum 2007;36:339-356
  • Price D, Staud R. Neurobiyology of fibromyalgia syndrome. J Rheumatol 2005;32 Suppl 75:22-28
  • Staud R. New İnsights into the Pathogenesis of Fibromyalgia Syndrome: İmportant Role of Peripheral and Central Pain mechanisms. Current Rheumatology Reviews,2007;113-121
  • Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia. Arthritis Rheum 2004;50:944-952
  • Bondy B, Spaeth M, Offenbaecher M, et al. The T102C polymorphism of the 5-HT2A-receptor gene in fibromyalgia. Neurobiol Dis 1999;6:433
  • Offenbaecher M, Bondy B, de Jonge S,et al. Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region. Arthritis Rheum 1999;42:2482-2488
  • Buskila D, Cohen H, Neumann L, Ebstein RP. An associaition between fibromyalgia and the dopamine D4 receptor exon III polymorphism and relationship to novelty seeking personality traits. Mol Psychiatry 2004;9:730-731.
  • Gür A, Karakoç M, Nas K, Çevik R, Denli A.,Saraç J. Citokines and depression in cases with fibromyalgia. J Rheumatol 2002;29:358-61
  • Kelly KW, Bluthe RM, Dantzer R, Zhou JH, et al. Cytokine-induced sickness behaviour. Brain Behav Immun 2003;17:112-118
  • Wang H, Moser M Schiltenwolf M, Buchner M. Circulating cytokine levels compared to pain in patients with fibromyalgia- a prospective longitudinal study over 6 months. J Rheumatol 2008;35:1366-1370
  • Burns JW, Crofford LJ, Chervin RD. Sleep stage dynamics in fibromyaljia patients and controls. Sleep Med 2008;9:689-696
  • Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: A possible role of infection and vaccination. Autoimmun Rev 2008;8(1):41-43
  • Jegede AB, Gilbert C, Tulkin SR. Muscle characteristics of persons with fibromyalgia syndrome. NeuroRehabilitation 2008;27:219-223
  • Merskey H, Bogduk N. International Association fort the Study of Pain. IASP pain terminology. Classification of Chronic pain (2nd edition). IASP Press, Seattle 1994;209-214
  • Trede RD, Jensen TS, Campell JN, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008;70(18):1630-1635
  • Davis MP. What is new in neuropathic pain? Support Care Cancer 2007;15:363-372
  • Scadding J. Neuropathic pain. ACNR 2003;3(2):8-14
  • Woolf CJ, Mannion RJ. Neuropathic pain: a etiology, symptoms, mechanisms and management. Lancet 1999;353:1959-64
  • Ertekin C. Ağrının nöroanatomi ve nörofizyolojisi. Ağrı ve Tedavisinde. Yegül İ ed. Yapım Matbaacılık, 1996:1-18
  • Tan E. Nöropatik ağrı ve tedavisi. Türk Nöroloji Dergisi 2004;(10)5:390-400
  • Blumberg H, Hanig W. Discharge patterns of afferent fibers from a neuroma. Pain 1984;20:335-353
  • Nicholson B. Gabapentin use in neuropathic pain syndromes. Acta Neurol Scand 2000;101:359-371
  • Myers RR. 1994 ASRA Lecture. The pathogenesis of neuropathic pain. Regional Anesthesia 1995;20:173-184
  • Herrero JF, Laid JM, Lopez-Gorcia JA. Wind-up of Spinal Cord Neurons and Pain Sensation. Progress in Neurobiology 2000;61:169-203
  • Woolf CJ, Shortland P, Coggeshall E. Peripheral nevre injury triggers central sprouting of myelinated afferents. Nature 1992;355:75-78
  • Kılıç E, Özgöçmen S. Fibromiyalji ve nöropatik ağrı. Türkiye Klinikleri Özel Sayı 2012;5(1):11-17
  • Crofford LJ. The Relationships of Fibromyalgia to Neuropathic Pain Syndromes. J Rheumatol. 2005;32 Suppl 75:41-45
  • Staud R, Craggs JG, Perlstein WM, Robinson ME, Donald DP. Brain Activity Associated With Slow Temporal Summation of C-fiber Evoked Pain in Fibromyalgia Patients and Healthy Controls. Eur J Pain 2008;12:1078-1089
  • Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000;288:1765-1769
  • Maletic V, Raison CL. Neurobiology of Depression, Fibromyalgia and Neuropathic Pain. Frontiers in Bioscience 2009;14:5291-5338
  • Berker E. Nöropatik ağrı ve fizyopatolojik mekanizmalar. Türk Fiz Tıp Rehab Derg 2005;51(Özel Ek A):A1-A5
  • Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures and treatment. J Rheumatol 2005;32:Suppl 75:6-21
  • Dworkin RH, Fields HL. Fibromyalgia from the perspective of neuropathic pain. J Rheumatol Suppl. 2005 Aug;75:1-5
  • Pamuk ÖN, Yepil Y, Çakır N. Factors That Affect the Number of Tender Points in Fibromyalgia and Chronic Widespread Pain Patients Who Did not Meet the ACR 1990 Criteria for Fibromyalgia: Are Tender Points a Reflection of Neuropathic Pain? Semin Arthritis Rheum. 2006;36:130-134
  • L.Giske, Erik Bautz-Holter, Leiv Sandvik, et al. Relationship Between Pain and Neuropathic Symptoms in Chronic Musculoskeletal Pain. Am. Academy of Pain Med.2009;10(5):910-917
  • Martinez-Lavin M, Lopez S, Medina M, Nava A. Use of the leeds assessment of neuropathic symptoms and signs questionnaire in patients with fibromyalgia. Semin Arthritis Rheum. 2003;32:407-411
  • Gauffin J, Hankama T, Kautiainen H, Hannonen P, Haanpaa M. Neuropathic Pain and use of PainDetect in patients with Fibromyalgia: a cohort study. BMC neurology 2013;13-21
  • Koroschetz J, Rehm SE, Gockel U, et al. Fibromyalgia and neuropathic pain-differences and similarites. A comprasion of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC Neurology 2011;11-15
  • Uceyler N, Zeller D,Kahn AK, et al. Small fibre pathology in patients with fibromyalgia syndrome.Brain 2013;136:1857–67.
  • Oaklander AL,Herzog ZD,Downs HM,Klein MM. Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia. Pain 2013;154:2310–6.
  • Serra J, Collado A, Sola R, et al. Hyperexcitable C nociceptors in fibromyalgia. Ann Neurol 2014;75:196–208.
  • Giannoccaro MP, DonadioV, Incensi A, Avoni P, Liguori R. Small nerve fiber involvement in patients referred for fibromyalgia. Muscle Nerve 2014;49: 757–9.
  • Caro XJ, Winter EF. Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications. Arthritis Rheumatol 2014;66:1945–54.
  • Kosmidis ML, Koutsogeorgopoulou L, Alexopoulos H, et al. Reduction of Intraepidermal Nerve Fiber Density (IENFD) in the skin biopsies of patients with fibromyalgia: a controlled study. J Neurol Sci 2014;347:143–7.
Year 2018, Volume: 1 Issue: 1, 26 - 31, 01.07.2018

Abstract

References

  • Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-172
  • Uguz F, Ciçek E, Salli A, Karahan AY, Albayrak I, Kaya N, Uğurlu H. Axis I and Axis II psychiatric disorders in patients with fibromyalgia. Gen Hosp Psychiatry. 2010;32(1):105-7.
  • Küçükşen S, Genç E, Yılmaz H, Sallı A, Gezer İA, Karahan AY, et al. The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine. Clin Rheumatol. 2013;32:983-90.
  • Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristic of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28
  • Topbaş M, Çakırbay H, Güleç H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol 2005;34(2):140-144
  • Yunus MB, İnanıcı F. Fibromyalgia syndrome: clinical features, diagnosis, and biopathophsiologic mechanisms. In: Rachlin ES, Rachlin IS(Eds). Myoofascial pain and fibromyalgia. Trigger Point Management. Mosby, St. Louis. 2002, pp.3-31
  • Yunus MB, Masi AT, Aldag JC. A controlled study of primary fibromyalgia syndrome: clinical features and association with other functionel syndromes. J Rheumatol 1989;19(suppl):62-71
  • İnanıcı F, Yunus MB, Aldag JC. Prevalence of Temporomandibular Disorder (TMD) in Fibromyalgia Syndrome. Arthritis Rheum 2002;46:(9 Suppl): 106
  • Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 2010 May;62(5):600-10
  • BurkhamJ, Harris ED. Fibromyalgia: A chronic pain syndrome In:Kelly’s Textbook of Rheumatology. Harris ED, Budd RC, Firestein GS, Genovese MC, Servent JS, Ruddy S and Sledge CB(Eds). Elsevier Saunders, Philadelphia, 2005,522-536
  • White LA, Birnbaum HG, Kaltenboeck A, et al.Employees with fibromyalgia medical comorbidty, healthcare costs, and work loss. J Occup Environ Med 2008;50:13-24
  • Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum 2007;36:339-356
  • Price D, Staud R. Neurobiyology of fibromyalgia syndrome. J Rheumatol 2005;32 Suppl 75:22-28
  • Staud R. New İnsights into the Pathogenesis of Fibromyalgia Syndrome: İmportant Role of Peripheral and Central Pain mechanisms. Current Rheumatology Reviews,2007;113-121
  • Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia. Arthritis Rheum 2004;50:944-952
  • Bondy B, Spaeth M, Offenbaecher M, et al. The T102C polymorphism of the 5-HT2A-receptor gene in fibromyalgia. Neurobiol Dis 1999;6:433
  • Offenbaecher M, Bondy B, de Jonge S,et al. Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region. Arthritis Rheum 1999;42:2482-2488
  • Buskila D, Cohen H, Neumann L, Ebstein RP. An associaition between fibromyalgia and the dopamine D4 receptor exon III polymorphism and relationship to novelty seeking personality traits. Mol Psychiatry 2004;9:730-731.
  • Gür A, Karakoç M, Nas K, Çevik R, Denli A.,Saraç J. Citokines and depression in cases with fibromyalgia. J Rheumatol 2002;29:358-61
  • Kelly KW, Bluthe RM, Dantzer R, Zhou JH, et al. Cytokine-induced sickness behaviour. Brain Behav Immun 2003;17:112-118
  • Wang H, Moser M Schiltenwolf M, Buchner M. Circulating cytokine levels compared to pain in patients with fibromyalgia- a prospective longitudinal study over 6 months. J Rheumatol 2008;35:1366-1370
  • Burns JW, Crofford LJ, Chervin RD. Sleep stage dynamics in fibromyaljia patients and controls. Sleep Med 2008;9:689-696
  • Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: A possible role of infection and vaccination. Autoimmun Rev 2008;8(1):41-43
  • Jegede AB, Gilbert C, Tulkin SR. Muscle characteristics of persons with fibromyalgia syndrome. NeuroRehabilitation 2008;27:219-223
  • Merskey H, Bogduk N. International Association fort the Study of Pain. IASP pain terminology. Classification of Chronic pain (2nd edition). IASP Press, Seattle 1994;209-214
  • Trede RD, Jensen TS, Campell JN, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008;70(18):1630-1635
  • Davis MP. What is new in neuropathic pain? Support Care Cancer 2007;15:363-372
  • Scadding J. Neuropathic pain. ACNR 2003;3(2):8-14
  • Woolf CJ, Mannion RJ. Neuropathic pain: a etiology, symptoms, mechanisms and management. Lancet 1999;353:1959-64
  • Ertekin C. Ağrının nöroanatomi ve nörofizyolojisi. Ağrı ve Tedavisinde. Yegül İ ed. Yapım Matbaacılık, 1996:1-18
  • Tan E. Nöropatik ağrı ve tedavisi. Türk Nöroloji Dergisi 2004;(10)5:390-400
  • Blumberg H, Hanig W. Discharge patterns of afferent fibers from a neuroma. Pain 1984;20:335-353
  • Nicholson B. Gabapentin use in neuropathic pain syndromes. Acta Neurol Scand 2000;101:359-371
  • Myers RR. 1994 ASRA Lecture. The pathogenesis of neuropathic pain. Regional Anesthesia 1995;20:173-184
  • Herrero JF, Laid JM, Lopez-Gorcia JA. Wind-up of Spinal Cord Neurons and Pain Sensation. Progress in Neurobiology 2000;61:169-203
  • Woolf CJ, Shortland P, Coggeshall E. Peripheral nevre injury triggers central sprouting of myelinated afferents. Nature 1992;355:75-78
  • Kılıç E, Özgöçmen S. Fibromiyalji ve nöropatik ağrı. Türkiye Klinikleri Özel Sayı 2012;5(1):11-17
  • Crofford LJ. The Relationships of Fibromyalgia to Neuropathic Pain Syndromes. J Rheumatol. 2005;32 Suppl 75:41-45
  • Staud R, Craggs JG, Perlstein WM, Robinson ME, Donald DP. Brain Activity Associated With Slow Temporal Summation of C-fiber Evoked Pain in Fibromyalgia Patients and Healthy Controls. Eur J Pain 2008;12:1078-1089
  • Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000;288:1765-1769
  • Maletic V, Raison CL. Neurobiology of Depression, Fibromyalgia and Neuropathic Pain. Frontiers in Bioscience 2009;14:5291-5338
  • Berker E. Nöropatik ağrı ve fizyopatolojik mekanizmalar. Türk Fiz Tıp Rehab Derg 2005;51(Özel Ek A):A1-A5
  • Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures and treatment. J Rheumatol 2005;32:Suppl 75:6-21
  • Dworkin RH, Fields HL. Fibromyalgia from the perspective of neuropathic pain. J Rheumatol Suppl. 2005 Aug;75:1-5
  • Pamuk ÖN, Yepil Y, Çakır N. Factors That Affect the Number of Tender Points in Fibromyalgia and Chronic Widespread Pain Patients Who Did not Meet the ACR 1990 Criteria for Fibromyalgia: Are Tender Points a Reflection of Neuropathic Pain? Semin Arthritis Rheum. 2006;36:130-134
  • L.Giske, Erik Bautz-Holter, Leiv Sandvik, et al. Relationship Between Pain and Neuropathic Symptoms in Chronic Musculoskeletal Pain. Am. Academy of Pain Med.2009;10(5):910-917
  • Martinez-Lavin M, Lopez S, Medina M, Nava A. Use of the leeds assessment of neuropathic symptoms and signs questionnaire in patients with fibromyalgia. Semin Arthritis Rheum. 2003;32:407-411
  • Gauffin J, Hankama T, Kautiainen H, Hannonen P, Haanpaa M. Neuropathic Pain and use of PainDetect in patients with Fibromyalgia: a cohort study. BMC neurology 2013;13-21
  • Koroschetz J, Rehm SE, Gockel U, et al. Fibromyalgia and neuropathic pain-differences and similarites. A comprasion of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC Neurology 2011;11-15
  • Uceyler N, Zeller D,Kahn AK, et al. Small fibre pathology in patients with fibromyalgia syndrome.Brain 2013;136:1857–67.
  • Oaklander AL,Herzog ZD,Downs HM,Klein MM. Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia. Pain 2013;154:2310–6.
  • Serra J, Collado A, Sola R, et al. Hyperexcitable C nociceptors in fibromyalgia. Ann Neurol 2014;75:196–208.
  • Giannoccaro MP, DonadioV, Incensi A, Avoni P, Liguori R. Small nerve fiber involvement in patients referred for fibromyalgia. Muscle Nerve 2014;49: 757–9.
  • Caro XJ, Winter EF. Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications. Arthritis Rheumatol 2014;66:1945–54.
  • Kosmidis ML, Koutsogeorgopoulou L, Alexopoulos H, et al. Reduction of Intraepidermal Nerve Fiber Density (IENFD) in the skin biopsies of patients with fibromyalgia: a controlled study. J Neurol Sci 2014;347:143–7.
There are 55 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Review
Authors

Meryem Kösehasanoğulları

Nihal Yılmaz

Publication Date July 1, 2018
Acceptance Date June 22, 2018
Published in Issue Year 2018 Volume: 1 Issue: 1

Cite

EndNote Kösehasanoğulları M, Yılmaz N (July 1, 2018) Fibromiyalji Sendromu ve Nöropatik Ağrı. Ege Tıp Bilimleri Dergisi 1 1 26–31.

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