Abstract：
Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are both complex conditions that are challenging to treat. This may be related to an incomplete understanding of their pathophysiology, itself obfuscated by their heterogeneity. The symptomatic overlap between them and their common comorbidity suggests a shared vulnerability, which might be explained by central sensitisation.
19 CFS cases, 19 FM cases and 20 age and sex matched healthy controls (HC) were recruited primarily from secondary care clinics in London. Those with other pain disorders, psychiatric diagnoses and those taking centrally acting or opiate medications were excluded. Participants were asked to abstain from alcohol and over the counter analgaesia 48 h prior to assessment by static and dynamic quantitative sensory tests, including measures of temporal summation (TS) and conditioned pain modulation (CPM).
CS, as defined by the presence of both enhanced TS and inefficient CPM, was present in 16 (84%) CFS cases, 18 (95%) FM cases, and none of the HC (p < 0.001). Pressure pain thresholds were lower in CFS (Median222kPaIQR 146-311; p = 0.04) and FM cases (Median 189 kPa; IQR 129-272; p = 0.003) compared to HC (Median 311 kPa; IQR 245-377). FM cases differed from HC in cold-induced (FM = 22.6 °C (15.3-27.7) vs HC = 14.2 °C (9.0-20.5); p = 0.01) and heat-induced (FM = 38.0 °C (35.2-44.0) vs HC = 45.3 °C (40.1-46.8); p = 0.03) pain thresholds, where CFS cases did not.
Central sensitisation may be a common endophenotype in chronic fatigue syndrome and fibromyalgia. Further research should address whether central sensitisation is a cause or effect of these disorders.
19 CFS cases, 19 FM cases and 20 age and sex matched healthy controls (HC) were recruited primarily from secondary care clinics in London. Those with other pain disorders, psychiatric diagnoses and those taking centrally acting or opiate medications were excluded. Participants were asked to abstain from alcohol and over the counter analgaesia 48 h prior to assessment by static and dynamic quantitative sensory tests, including measures of temporal summation (TS) and conditioned pain modulation (CPM).
CS, as defined by the presence of both enhanced TS and inefficient CPM, was present in 16 (84%) CFS cases, 18 (95%) FM cases, and none of the HC (p < 0.001). Pressure pain thresholds were lower in CFS (Median222kPaIQR 146-311; p = 0.04) and FM cases (Median 189 kPa; IQR 129-272; p = 0.003) compared to HC (Median 311 kPa; IQR 245-377). FM cases differed from HC in cold-induced (FM = 22.6 °C (15.3-27.7) vs HC = 14.2 °C (9.0-20.5); p = 0.01) and heat-induced (FM = 38.0 °C (35.2-44.0) vs HC = 45.3 °C (40.1-46.8); p = 0.03) pain thresholds, where CFS cases did not.
Central sensitisation may be a common endophenotype in chronic fatigue syndrome and fibromyalgia. Further research should address whether central sensitisation is a cause or effect of these disorders.
摘要：
慢性疲劳综合征（CFS）和纤维肌痛（FM）都是复杂的疾病，难以治疗。这可能与对其病理生理学的不完全理解有关，本身被它们的异质性所模糊。它们与常见合并症之间的症状重叠表明存在共同的脆弱性，这可以用中央敏感性来解释。
19例CFS，主要从伦敦的二级保健诊所招募了19例FM病例和20例年龄和性别匹配的健康对照（HC）。那些有其他疼痛障碍的人，精神病诊断和服用中枢作用或阿片类药物的患者被排除.在通过静态和动态定量感官测试进行评估之前48小时，要求参与者戒酒和柜台止痛剂。包括时间总和(TS)和条件性疼痛调节(CPM)的测量。
CS，如增强的TS和低效的CPM的存在所定义的那样，出现在16例（84%）CFS病例中，18例（95%）FM病例，无HC(p<0.001)。与HC（中位数311kPa；IQR245-377）相比，CFS（Median222kPaIQR146-311；p=0.04）和FM（中位数189kPa；IQR129-272；p=0.003）的压力疼痛阈值较低。在冷诱发（FM=22.6°C（15.3-27.7）vsHC=14.2°C（9.0-20.5）；p=0.01）和热诱发（FM=38.0°C（35.2-44.0）vsHC=45.3°C（40.1-46.8）；p=0.03）的疼痛阈值中，FM病例与HC不同，CFS病例没有。
中枢致敏可能是慢性疲劳综合征和纤维肌痛的常见内表型。进一步的研究应该解决中枢致敏是否是这些疾病的原因或影响。
19例CFS，主要从伦敦的二级保健诊所招募了19例FM病例和20例年龄和性别匹配的健康对照（HC）。那些有其他疼痛障碍的人，精神病诊断和服用中枢作用或阿片类药物的患者被排除.在通过静态和动态定量感官测试进行评估之前48小时，要求参与者戒酒和柜台止痛剂。包括时间总和(TS)和条件性疼痛调节(CPM)的测量。
CS，如增强的TS和低效的CPM的存在所定义的那样，出现在16例（84%）CFS病例中，18例（95%）FM病例，无HC(p<0.001)。与HC（中位数311kPa；IQR245-377）相比，CFS（Median222kPaIQR146-311；p=0.04）和FM（中位数189kPa；IQR129-272；p=0.003）的压力疼痛阈值较低。在冷诱发（FM=22.6°C（15.3-27.7）vsHC=14.2°C（9.0-20.5）；p=0.01）和热诱发（FM=38.0°C（35.2-44.0）vsHC=45.3°C（40.1-46.8）；p=0.03）的疼痛阈值中，FM病例与HC不同，CFS病例没有。
中枢致敏可能是慢性疲劳综合征和纤维肌痛的常见内表型。进一步的研究应该解决中枢致敏是否是这些疾病的原因或影响。
