journal, it is an Accepted Article (Accepted, unedited articles are
published online for future issues)
European Journal of Clinical Investigation July 2011
In the mind or in the brain? Scientific evidence for central
sensitization in chronic fatigue syndrome
Jo Nijs PhD , Mira Meeus PhD, Jessica Van Oosterwijck MSc, Kelly
Ickmans MSc, Greta Moorkens PhD, Guy Hans PhD, Luc S De Clerck and PhD
Abstract
Central sensitization entails several top-down and bottom-up
mechanisms, all contributing to the hyper-responsiveness of the
central nervous system to a variety of inputs. In the late nineties,
it was first hypothesized that chronic fatigue syndrome (CFS) is
characterized by hypersensitivity of the central nervous system (i.e.
central sensitization). Since then, several studies have examined
central sensitization in patients with CFS. The present paper provides
an overview of such studies.
Various studies showed generalized hyperalgesia in CFS for a variety
of sensory stimuli, including electrical stimulation, mechanical
pressure, heat and histamine. Various tissues are affected by
generalized hyperalgesia: the skin, muscle tissue, and the lungs.
Generalized hyperalgesia in CFS is augmented, rather than decreased,
following various types of stressors like exercise and noxious heat
pain. Endogenous inhibition is not activated in response to exercise
and activation of diffuse noxious inhibitory controls following
noxious heat application to the skin is delayed.
The observation of central sensitization in CFS is in line with our
current understanding of CFS. The presence of central sensitization in
CFS corroborates with the presence of several psychological influences
on the illness, the presence of infectious agents and immune
dysfunctions, and the dysfunctional hypothalamus pituitary
adrenal-axis as seen in these severely debilitated patients.
DOI: 10.1111/j.1365-2362.2011.02575.x
European Journal of Clinical Investigation =A9 2011 Stichting European
Society for Clinical Investi gation Journal Foundation
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2362.2011.02575.x/abstrac=
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