Neuroendocrine abnormalities in fibromyalgia.

被引:41
作者
Adler G.K. [1 ]
Manfredsdottir V.F. [1 ]
Creskoff K.W. [1 ]
机构
[1] Endocrine-Hypertension Division, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, 02115, MA
基金
美国国家卫生研究院;
关键词
Growth Hormone; Melatonin; Heart Rate Variability; Fibromyalgia; Chronic Fatigue Syndrome;
D O I
10.1007/s11916-002-0050-5
中图分类号
学科分类号
摘要
Fibromyalgia is a disorder of unknown etiology characterized by chronic, widespread musculoskeletal pain and symptoms such as fatigue, poor sleep, gastrointestinal complaints, and psychologic problems that are similar to those experienced by patients with hormone deficiencies. This review summarizes the available data on the neuroendocrine function in fibromyalgia, including data on hormone secretion, circadian phase, and autonomic nervous system function. Studies suggest that there may be lower activity of a number of hypothalamic-pituitary-peripheral gland axes and altered autonomic nervous system function in patients with fibromyalgia. These reductions in activity are mild to moderate and do not result from alterations in circadian rhythms. The reduced hormonal and autonomic responses appear to reflect an impairment in the hypothalamic or central nervous system response to stimuli rather than a primary defect at the level of the pituitary gland or the peripheral glands. A combination of multiple, mild impaired responses may lead to more profound physiologic and clinical consequences as compared with a defect in only one system, and could contribute to the symptoms of fibromyalgia.
引用
收藏
页码:289 / 298
页数:9
相关论文
共 219 条
[1]  
Wolfe F(1995)The prevalence and characteristics of fibromyalgia in the general population Arthritis Rheum 38 19-28
[2]  
Ross K(1990)The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee Arthritis Rheum 33 1600-172
[3]  
Anderson J(1997)Chronic pain and fatigue syndromes: Overlapping clinical and neuroendocrine features and potential pathogenic mechanisms Neuroimmunomodulation 4 134-153
[4]  
Wolfe F(1999)Fibromyalgia syndrome a decade later Arch Intern Med 159 777-785
[5]  
Smythe HA(1998)Current concepts in the pathophysiology of abnormal pain perception in fibromyalgia Am J Med Sci 315 405-412
[6]  
Yunus MB(1994)Corticosteroid therapy, nonendocrine disease, and corticosteroid withdrawal Curr Ther Endocrinol Metab 5 120-124
[7]  
Clauw DJ(1999)Reduced hypothalamicpituitary and sympathoadrenal responses to hypoglycemia in women with fibromyalgia syndrome Am J Med 106 534-543
[8]  
Chrousos GP(1998)Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress disorder and patients with major depression, but not in patients with fibromyalgia Acta Psychiatr Scand 98 328-335
[9]  
Goldenberg DL(1994)Hypothalamicpituitary-adrenal axis perturbations in patients with fibromyalgia Arthritis Rheum 37 1583-1592
[10]  
Weigent DA(1997)Glucocorticoid receptors, fibromyalgia and low back pain Psychoneuroendocrinology 22 603-614