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In the mind or in the brain? : scientific evidence for central sensitisation in chronic fatigue syndrome

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Abstract
Background  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  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  The observation 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.
Keywords
chronic pain, fibromyalgia, Central nervous system, hyperalgesia, hyperexcitability, CHRONIC NEUROPATHIC PAIN, COGNITIVE-BEHAVIORAL THERAPY, MAGNETIC STIMULATION RTMS, TENSION-TYPE HEADACHE, LOW-BACK-PAIN, SPATIAL SUMMATION, AUTONOMIC DYSFUNCTION, MUSCULOSKELETAL PAIN, TEMPORAL SUMMATION, WIDESPREAD PAIN

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Chicago
Nijs, Jo, Mira Meeus, Jessica Van Oosterwijck, Kelly Ickmans, Greta Moorkens, Guy Hans, and Luc De Clerck. 2012. “In the Mind or in the Brain? : Scientific Evidence for Central Sensitisation in Chronic Fatigue Syndrome.” European Journal of Clinical Investigation 42 (2): 203–212.
APA
Nijs, Jo, Meeus, M., Van Oosterwijck, J., Ickmans, K., Moorkens, G., Hans, G., & De Clerck, L. (2012). In the mind or in the brain? : scientific evidence for central sensitisation in chronic fatigue syndrome. EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 42(2), 203–212.
Vancouver
1.
Nijs J, Meeus M, Van Oosterwijck J, Ickmans K, Moorkens G, Hans G, et al. In the mind or in the brain? : scientific evidence for central sensitisation in chronic fatigue syndrome. EUROPEAN JOURNAL OF CLINICAL INVESTIGATION. 2012;42(2):203–12.
MLA
Nijs, Jo, Mira Meeus, Jessica Van Oosterwijck, et al. “In the Mind or in the Brain? : Scientific Evidence for Central Sensitisation in Chronic Fatigue Syndrome.” EUROPEAN JOURNAL OF CLINICAL INVESTIGATION 42.2 (2012): 203–212. Print.
@article{2014638,
  abstract     = {Background  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  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  The observation 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.},
  author       = {Nijs, Jo and Meeus, Mira and Van Oosterwijck, Jessica and Ickmans, Kelly and Moorkens, Greta and Hans, Guy and De Clerck, Luc},
  issn         = {0014-2972},
  journal      = {EUROPEAN JOURNAL OF CLINICAL INVESTIGATION},
  keywords     = {chronic pain,fibromyalgia,Central nervous system,hyperalgesia,hyperexcitability,CHRONIC NEUROPATHIC PAIN,COGNITIVE-BEHAVIORAL THERAPY,MAGNETIC STIMULATION RTMS,TENSION-TYPE HEADACHE,LOW-BACK-PAIN,SPATIAL SUMMATION,AUTONOMIC DYSFUNCTION,MUSCULOSKELETAL PAIN,TEMPORAL SUMMATION,WIDESPREAD PAIN},
  language     = {eng},
  number       = {2},
  pages        = {203--212},
  title        = {In the mind or in the brain? : scientific evidence for central sensitisation in chronic fatigue syndrome},
  url          = {http://dx.doi.org/10.1111/j.1365-2362.2011.02575.x},
  volume       = {42},
  year         = {2012},
}

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