Neurogenic neuroinflammation in fibromyalgia and complex regional pain syndrome

@article{Littlejohn2015NeurogenicNI,
  title={Neurogenic neuroinflammation in fibromyalgia and complex regional pain syndrome},
  author={Geoffrey Owen Littlejohn},
  journal={Nature Reviews Rheumatology},
  year={2015},
  volume={11},
  pages={639-648}
}
  • G. Littlejohn
  • Published 1 November 2015
  • Medicine, Psychology
  • Nature Reviews Rheumatology
Although fibromyalgia and complex regional pain syndrome (CRPS) have distinct clinical phenotypes, they do share many other features. Pain, allodynia and dysaesthesia occur in each condition and seem to exist on a similar spectrum. Fibromyalgia and CRPS can both be triggered by specific traumatic events, although fibromyalgia is most commonly associated with psychological trauma and CRPS is most often associated with physical trauma, which is frequently deemed routine or minor by the patient… 

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References

SHOWING 1-10 OF 163 REFERENCES

Fibromyalgia and related conditions.

  • D. Clauw
  • Medicine
    Mayo Clinic proceedings
  • 2015

The science of fibromyalgia.

TLDR
Evidence suggests that both the ascending and descending pain pathways operate abnormally, resulting in central amplification of pain signals, analogous to the "volume control setting" being turned up too high.

A Chronic fatigue syndrome model demonstrates mechanical allodynia and muscular hyperalgesia via spinal microglial activation

TLDR
Results indicated that activated microglia were involved in the development of abnormal pain in CS animals, suggesting that the pain observed in CFS and FMS patients may be partly caused by a mechanism in which microglial activation is involved.

Central amplification and fibromyalgia: Disorder of pain processing

TLDR
Two areas where strong evidence exists for abnormalities in sensory signaling: the reduction of descending control, including suppression of descending inhibitory pathways and/or enhancement of descending facilitatory pathways, and changes in key neurotransmitters associated with central sensitization are discussed.

Complex regional pain syndrome in adults.

TLDR
Results from recent randomized controlled trials suggest that it is possible that some patients whose condition was considered refractory in the past can now be effectively treated, but confirmatory trials are required.

Status of immune mediators in complex regional pain syndrome type I

TLDR
A review of recent study results shows a clear underlying inflammatory response at the local site of CRPS-I, where systemic responses seem to be inconsistent.
...