Ätiologie und Pathophysiologie des Fibromyalgiesyndroms

Der Schmerz - Tập 26 - Trang 259-267 - 2012
C. Sommer1, W. Häuser2, M. Burgmer3, R. Engelhardt4, K. Gerhold5, F. Petzke6, T. Schmidt-Wilcke7, M. Späth8, T. Tölle9, N. Üçeyler1, H. Wang10, A. Winkelmann11, K. Thieme12
1Neurologische Klinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
2Innere Medizin 1, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland
3Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Münster, Münster, Deutschland
4Zentralinstitut für die kassenärztliche Versorgung in Deutschland, Berlin, Deutschland
5Klinik für Pädiatrie mit Schwerpunkt Pneumologie/Immunologie und Berlin School of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
6Schmerz-Tagesklinik und -Ambulanz, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland
7Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor (Michigan), USA
8Rheumatologische Praxis, München-Gräfelfing, Deutschland
9Klinik für Neurologie, Technische Universität München, München, Deutschland
10Department für Orthopädie und Unfallchirurgie, Universitätsklinik Heidelberg, Heidelberg, Deutschland
11Klinik und Poliklinik für Physikalische Medizin und Rehabilitation, Klinikum der Universität München, München, Deutschland
12Institut für Medizinische Psychologie, Philipps-Universität Marburg, Marburg, Deutschland

Tóm tắt

Die planmäßige Aktualisierung der S3-Leitlinie zum Fibromyalgiesyndrom (FMS; AWMF-Registernummer 041/004) wurde ab März 2011 vorgenommen. 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. 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. Das FMS ist wahrscheinlich die Endstrecke verschiedener ätiopathogenetischer Faktoren und pathophysiologischer Mechanismen.

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