whether the mind and the body are separate entities. The primary
argument that the mind and the body are not separate is most popular
in social, cultural and behavioral medicine. Whether psychological
influences play a role in the etiology of disease is often fiercely
debated in all diseases. Other believe that there will always be
individual psychosocial responses to any disease, but that they are no
more prevalent in ME and CFS, IBS, MCS, or GWS than any other disease
- minus the influence of tremendous social and medical stigma. The
CDC states that combating stigma in illness is a public health
priority.
Eur J Clin Invest. 2011 Jul 2. doi: 10.1111/j.1365-2362.2011.02575.x.
[Epub ahead of print]
In the mind or in the brain? Scientific evidence for central
sensitisation in chronic fatigue syndrome.
Nijs J, Meeus M, Van Oosterwijck J, Ickmans K, Moorkens G, Hans G, De Clerc=
k LS.
Department of Human Physiology, Faculty of Physical Education &
Physiotherapy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
Division of Musculoskeletal Physiotherapy, Department of Health Care
Sciences, Artesis University College Antwerp, Antwerp, Belgium
Department of Physical Medicine and Physiotherapy, University Hospital
Brussels (UZB), Brussels, Belgium Reference Centre for Chronic Fatigue
Syndrome, Department of Internal Medicine, University Hospital
Antwerp, Antwerp, Belgium Multidisciplinary Pain Center (PCT),
University Hospital Antwerp (UZA), Antwerp, Belgium Department of
Immunology, Allergy and Rheumatology, University of Antwerp (UA),
Antwerp, Belgium.
Abstract
Eur J Clin Invest 2011 ABSTRACT:
Background=E2=80=82 Central sensitisation entails several top-down and
bottom-up mechanisms, all contributing to the hyperresponsiveness of
the central nervous system to a variety of inputs.
In the late nineties, it was first hypothesised that chronic fatigue
syndrome (CFS) is characterised by hypersensitivity of the central
nervous system (i.e. central sensitisation). Since then, several
studies have examined central sensitisation in patients with CFS. This
study provides an overview of such studies.
Materials and Methods
Narrative review.
Results=E2=80=82 Various studies showed generalised hyperalgesia in CFS for=
a
variety of sensory stimuli, including electrical stimulation,
mechanical pressure, heat and histamine. Various tissues are affected
by generalised hyperalgesia: the skin, muscle tissue and the lungs.
Generalised 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. Conclusions=E2=80=82 The observati=
on
of central sensitisation in CFS is in line with our current
understanding of CFS.
The presence of central sensitisation 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.
=C2=A9 2011 The Authors. European Journal of Clinical Investigation =C2=A9 =
2011
Stichting European Society for Clinical Investigation Journal
Foundation.
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