Hoe zenuwbeschadiging een rol speelt bij fibromyalgie. Recent onderzoek

In een recente studie van patiënten die lijden aan fibromyalgie, had bijna de helft van de patiënten matige tot ernstige schade aan hun huidcellen.

Schade aan de zenuw veroorzaakt zenuwvezels wordt beschouwd als kleine vezel polyneuropathie of SFPN. Polyneuropathie van kleine vezels wordt veroorzaakt door een aantal specifieke medische aandoeningen.

Momenteel is er geen bekende oorzaak van fibromyalgie, dus deze ontdekking van zenuwbeschadiging kan enige vooruitgang boeken bij het vinden van precies wat de oorzaak van de aandoening is.

Fibromyalgie-aandoeningen onderscheiden de patiënt van de patiënt, maar typische symptomen omvatten chronische wijdverspreide pijn, extreme vermoeidheid en overgevoeligheid voor pijn en druk. De aandoening treft onevenredig veel vrouwen in vergelijking met mannen.

Kijken naar zenuwbeschadiging

Er is enige vooruitgang geboekt bij het correct diagnosticeren van de stoornis, maar de pathologie ervan blijft een mysterie. Fibromyalgie heeft enkele van dezelfde symptomen als polyneurobehandeling met kleine vezels omdat polyneurotherapie met kleine vezels wijdverspreide chronische pijn heeft veroorzaakt bij mensen bij wie de diagnose is gesteld.

De studie werd uitgevoerd bij 27 volwassenen met de fibromyalgie-aandoening en een groep van 30 gezonde mensen die zich hadden aangemeld voor de studie. Dezelfde tests gebruikt in de kleine vezel polyneurotherapie diagnostiek werden gebruikt om de studiedeelnemers te evalueren. De tests omvatten een lichamelijk onderzoek en de toediening van een vragenlijst.

Bovendien helpen onderzoeken met toediening van huidbiopten bij de evaluatie van zenuwvezels in de benen van patiënten en de controle van bloeddruk, zweten en hartslag van patiënten.

Neuropathie werd bij zeer hoge aantallen gevonden bij patiënten met fibromyalgie, terwijl de groep gezonde personen normaal leek. Dertien van de 27 patiënten met fibromyalgie werden geregistreerd als individuen met verminderde niveaus van dichtheid van zenuwvezels in de huid.

Die ongeveer dertien mensen hadden ook vreemde resultaten van de autonome functietest. Vanwege deze resultaten werd verondersteld dat deze dertien personen polyneurotherapie met kleine vezels hadden.

Hoewel de conclusies van deze test geen oorzaak suggereren bij de ontwikkeling van alle aandoeningen van fibromyalgie, biedt het wel enig bewijs voor de oorzaken van fibromyalgie bij ten minste sommige patiënten.

Fibromyalgie-stoornis is een zeer complexe, unieke en complexe aandoening. De symptomen en ernst ervan verschillen in elke patiënt die het beïnvloedt. Vanwege deze unieke differentiatie is er geen enkele verklaring voor de ontwikkeling van fibromyalgie.

Dit proces kan maanden of jaren duren voordat er antwoorden worden gevonden over wat de belangrijkste oorzaken van fibromyalgie zijn. Voordat u kunt werken aan de genezing van fibromyalgie, moeten onderzoekers eerst uitvinden wat de oorzaak is van de stoornis bij patiënten.

Deze studie is momenteel de enige in zijn soort. De resultaten zijn onlangs gepubliceerd, zodat andere laboratoria binnenkort hun eigen tests en experimenten zullen gaan maken volgens het model dat deze studie heeft uitgewerkt.

Sommigen zijn misschien al begonnen met enkele aanpassingen. De zoektocht naar een betere diagnose van fibromyalgie is continu.

En het vinden van betere behandelingen voor die mensen die zijn toegebracht door de fibromyalgiestoornis is een van de topprioriteiten als het gaat om deze unieke aandoening.

Bewijs van zenuwbeschadiging bij ongeveer de helft van de patiënten met fibromyalgie

Samenvatting: Ongeveer de helft van een kleine groep patiënten met fibromyalgie, een veel voorkomend syndroom dat chronische pijn en andere symptomen veroorzaakt, bleek zenuwvezelbeschadiging van de huid en ander bewijs van een ziekte genaamd polyneuropathie van kleine vezels (SFPN) te hebben. ). In tegenstelling tot fibromyalgie heeft SFPN een duidelijke pathologie en is bekend dat het wordt veroorzaakt door specifieke medische aandoeningen, waarvan sommige kunnen worden behandeld en soms worden genezen.

Ongeveer de helft van een kleine groep patiënten met fibromyalgie, een veel voorkomend syndroom dat chronische pijn en andere symptomen veroorzaakt, bleek zenuwvezelbeschadiging van de huid en ander bewijs van een ziekte genaamd polyneuropathie van kleine vezels (SFPN) te hebben. . In tegenstelling tot fibromyalgie, waarvan geen bekende oorzaken en weinig effectieve behandelingen bekend zijn, heeft SFPN een duidelijke pathologie en er is bekend dat het wordt veroorzaakt door specifieke medische aandoeningen, waarvan sommige kunnen worden behandeld en soms worden genezen. De studie door onderzoekers van het Massachusetts General Hospital (MGH) verschijnt in het tijdschrift DOLOR en is online gepubliceerd.

“Dit levert een deel van het eerste objectieve bewijs van een mechanisme achter sommige gevallen van fibromyalgie, en de identificatie van een onderliggende oorzaak is de eerste stap naar het vinden van betere behandelingen”, zegt Anne Louise Oaklander, MD, PhD, directeur van de Unit Nervous Lesions in de MGH Afdeling Neurologie en de corresponderende auteur van het Pain-artikel.

De term fibromyalgie beschrijft een reeks symptomen, waaronder chronische wijdverspreide pijn, verhoogde gevoeligheid voor druk en vermoeidheid, waarvan wordt aangenomen dat deze 1 tot 5 procent van de mensen in westerse landen treft, meestal bij vrouwen. Hoewel de National Institutes of Health en de American College of Rheumatology de diagnose fibromyalgie hebben erkend, blijft de biologische basis onbekend. Fibromyalgie deelt veel symptomen met SFPN, een erkende oorzaak van chronische wijdverspreide pijn waarvoor objectieve testen worden geaccepteerd.

Ontworpen om mogelijke verbanden tussen de twee aandoeningen te onderzoeken. De huidige studie omvatte 27 volwassen patiënten met fibromyalgie-diagnoses en 30 gezonde vrijwilligers. Deelnemers gingen door een reeks testen die werden gebruikt om SFPN te diagnosticeren, waaronder evaluaties van neuropathie op basis van een lichamelijk onderzoek en antwoorden op een vragenlijst, huidbiopten om het aantal zenuwvezels in de onderbenen te evalueren en tests van autonome functies, zoals hartslag , bloeddruk en zweten.

De vragenlijsten, onderzoeksevaluaties en huidbiopten vonden significante niveaus van neuropathie bij patiënten met fibromyalgie, maar niet in de controlegroep. Van de 27 patiënten met fibromyalgie hadden 13 een opmerkelijke afname van de dichtheid van zenuwvezels, abnormale autonome functietests of beide, wat wijst op de aanwezigheid van SFPN. Deelnemers die voldeden aan de criteria voor SFPN ondergingen ook bloedtesten voor bekende oorzaken van de stoornis, en hoewel geen van hen resultaten had die op diabetes leidden, een veel voorkomende oorzaak van SFPN, bleken er twee besmet te zijn met het hepatitis-virus. C, die met succes kan worden behandeld. en meer dan de helft had bewijs voor een soort disfunctie van het immuunsysteem.

“Tot nu toe was er geen goed idee over wat fibromyalgie veroorzaakt, maar nu hebben we bewijs voor sommige, maar niet voor alle patiënten.” Fibromyalgie is te ingewikkeld voor een ‘one size fits all’-verklaring, “zegt Oaklander, een universitair hoofddocent neurologie aan de Harvard Medical School. “De volgende stap van onafhankelijke bevestiging van onze bevindingen van andere laboratoria is al aan de gang, en we moeten ook die patiënten volgen die niet voldeden aan de SFPN-criteria om te zien of we andere oorzaken kunnen vinden. Het helpen van een van deze mensen om een ​​definitieve diagnose te krijgen en een betere behandeling zou een geweldige prestatie zijn. “

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