Voir aussi: Fibromyalgie: quatre profils distincts de la pathologie sous-jacente; implications pour le traitement (décembre 2016).
La fibromyalgie, » caractérisée par des douleurs musculo – squelettiques chroniques pour lesquels aucune autre cause peut être identifiée
, » rassemble des pathologies hétérogènes impliquant différents mécanismes, affirment des chercheurs américains Kathleen A. Sluka et Daniel J. Clauw dans une synthèse de l’ article sur la neurobiologie de la fibromyalgie publiée dans la revue Neuroscience (Juin 2016).
rôle cérébral est corroboré par des différences fonctionnelles observables par les déséquilibres de neuroimagingand dans les niveaux de neurotransmetteurs qui affectent la douleur et transmission sensorielle.
Les différents changements du cerveau observées ont le potentiel de permettre l’identification des sous-types de la maladie basés sur des mécanismes différents.
rôle cérébral dans la fibromyalgie est compatible avec le fait que les médicaments généralement efficaces contre la douleur causée par des lésions des tissus ou une inflammation, tels que les médicaments anti-inflammatoires non stéroïdiens (AINS) ou des injections locales ne sont pas efficaces contre la douleur de la fibromyalgie. Il serait également expliquer les bienfaits de l’exercice, connus pour modifier la transmission de certains neurotransmetteurs.
rôle cérébral prédominant ne l’empêche pas de signaux de la douleur du tissu et du système nerveux périphérique endommagé peut contribuer à la perception de la douleur est amplifiée par les mécanismes de sensibilisation du cerveau.
Chez certaines personnes atteintes de fibromyalgie, la conscience cérébrale pourrait également être alimentée par les signaux de la douleur de maladies liées au système périphériques tels que les maladies auto-immunes ou l’arthrite, par exemple. Ce qui est suggéré par le fait que lorsque la condition périphérique douloureuse est améliorée, les changements du cerveau semblent améliorer aussi les chercheurs.
Des études récentes (2011-2013) ont commencé à explorer, ils se rapportent, des altérations du système nerveux périphérique qui contribuent potentiellement à la douleur de la fibromyalgie. (Dans certains cas, la fibromyalgie est plutôt une neuropathie parfois être traitée, l’hypothèse d’une neuropathie des petites fibres est exacte.)
Enfin, certaines études ont également commencé à explorer le rôle potentiel de l’inflammation systémique.
Les auteurs proposent que toutes les personnes atteintes de fibromyalgie se trouve le long d’un continuum avec une extrémité représente la douleur nociceptive (en raison de dommages aux tissus tels que les muscles) et l’autre extrémité, la douleur d’origine centrale. Entre les deux, sont la douleur neuropathique d’origine (en raison de lésions nerveuses).
Dans un article qui veulent un livre blanc sur la fibromyalgie, publié en Septembre 2016 , dans le Journal clinique de la douleur , l’ un des auteurs de cette analyse, Daniel J. Clauw, et une douzaine de collègues et de la fibromyalgie sont (globalement) et d’ autres troubles douloureux le long de cette continuum:
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