Neurological Mechanisms of Fibromyalgia

  • M. Zimmermann
Conference paper

Zusammenfassung

Bei der Pathogenese der Fibromyalgie wirken zahlreiche Faktoren zusammen, wie aus dem Erscheinungsbild der Schmerzen, den Begleitphänomenen und Ergebnissen klinisch-wissenschaftlicher Untersuchungen abgeleitet werden kann.

Die Ausbreitung des Schmerzes über den ganzen Körper zeigt an, daß die Empfindlichkeit des peripheren und/oder zentralen Nervensystems generell erhöht ist. In der Peripherie ist eine Sensibilisierung der Nozizeptoren durch neurogene Entzündungsvorgänge wahrscheinlich. Mediatoren sind Substanz P und andere Tachykinine, die aus den afferenten Nervenfasern freigesetzt werden und unter anderem immunkompetente Zellen stimulieren. Auch Fehlsteuerungen der Skelettmuskulatur und des sympathischen Nervensystems können eine erregungsfördernde Wirkung im peripheren Nervensystem haben. Substanz P ist auch ein erregender Transmitter für die Übertragung von Schmerzinformation im Rückenmark. Der Gehalt an Substanz P ist bei Fibromyalgie-Patienten erhöht. Als weiterer Mechanismus einer zentralen Sensibilisierung ist ein Mangel des schmerzdämpfenden Neurotransmitters Serotonin wahrscheinlich. Bei der Fibromyalgie wirken also mehrere dysfunktionale Systeme zusammen, weshalb die Bezeichnung „disorder of pain modulation“ (38) sinnvoll erscheint.

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Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1991

Authors and Affiliations

  • M. Zimmermann
    • 1
  1. 1.II. Physiologisches InstitutUniversität HeidelbergHeidelbergDeutschland

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