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Ätiologie und Pathophysiologie des Fibromyalgiesyndroms

Etiology and pathophysiology of fibromyalgia syndrome

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Zusammenfassung

Hintergrund

Die planmäßige Aktualisierung der S3-Leitlinie zum Fibromyalgiesyndrom (FMS; AWMF-Registernummer 041/004) wurde ab März 2011 vorgenommen.

Material und Methoden

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.

Ergebnisse

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.

Schlussfolgerung

Das FMS ist wahrscheinlich die Endstrecke verschiedener ätiopathogenetischer Faktoren und pathophysiologischer Mechanismen.

Abstract

Background

The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies (“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”, AWMF; registration number 041/004) was planned starting in March 2011.

Materials and methods

The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy (“Deutsche Interdisziplinären Vereinigung für Schmerztherapie”, DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields.

Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Centre for Evidence-Based Medicine.

Results

Current data do not identify distinct etiologic or pathophysiological factors mediating development of FMS. The development of FMS is associated with inflammatory rheumatic diseases (EL2b), with gene polymorphisms of the 5-hydroxytryptamine (HT)2 receptor (EL3a), lifestyle factors (smoking, obesity, lack of physical activity; EL2b), physical and sexual abuse in childhood and adulthood (EL3a).

Conclusion

FMS is most likely the result of various pathogenetic factors and pathophysiological mechanisms.

The English full-text version of this article is available at SpringerLink (under “Supplemental”).

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Interessenkonflikt

Siehe Tab. 5 im Beitrag „Methodenreport“ von W. Häuser, K. Bernardy, H. Wang, I. Kopp in dieser Ausgabe

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Correspondence to C. Sommer.

Additional information

Die englische Volltextversion dieses Beitrags und der Evidenzbericht sind in SpringerLink zugänglich (unter „Supplemental“).

Zusatzmaterial online

English version of "Ätiologie und Pathophysiologie des Fibromyalgiesyndroms" (PDF 0,4 MB)

482_2012_1174_MO2_ESM.pdf

Evidenzbericht: Forest Plots der standardisierten Mittelwertdifferenzen von experimenteller Gruppe versus Kontrollgruppe bei ausgewählten Zielvariablen am Therapieende und bei Nachuntersuchungen (PDF 0,4 MB)

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Evidence report: Forest Plots of standardised mean differences between experimental groups versus controls on selected outcomes at final treatment and at follow up (PDF 0,4 MB)

482_2012_1174_MO4_ESM.pdf

Evidenzbericht: Tabellen - Charakteristiken der Studien, die in qualitative und/oder quantitative Analyse einbezogen wurden (PDF 0,3 MB)

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Evidence report: Tables - Characteristics of studies included into qualitative and/or quantitative analysis (PDF 0,7 MB)

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Sommer, C., Häuser, W., Burgmer, M. et al. Ätiologie und Pathophysiologie des Fibromyalgiesyndroms. Schmerz 26, 259–267 (2012). https://doi.org/10.1007/s00482-012-1174-0

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