Rheumatology Department, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy.
Rheumatology Unit, Internal Medicine Department, ASST Settelaghi, Ospedale Di Circolo - Fondazione Macchi, Varese, Italy.
Clin Exp Rheumatol. 2023 Jun;41(6):1205-1213. doi: 10.55563/clinexprheumatol/257e99. Epub 2023 Jun 28.
Fibromyalgia (FM) is a chronic syndrome characterised by widespread pain that affects millions of people worldwide. This article discusses various aspects of FM described in scientific papers published in 2022 and indexed in the PubMed database, including the most recent diagnostic acquisitions (especially in relation to the juvenile form of FM), risk factors, co-morbidities and objective measures. Emphasis is placed on the importance of identifying FM early and improving diagnostic methods (e.g. physical measurements, including walking test performance, hand grip force, and autonomic tests). The article also considers hypotheses concerning the pathophysiology of FM, including the role of inflammation, gut dysbiosis, and neuroinflammation, and possible treatment options, including medications such as antioxidants and kinin antagonists, neurostimulation, and mind-body interventions. Although ketamine, vitamin D, and hormone therapy have shown promise in reducing FM symptoms, further research is needed to optimise their use. Neurostimulation techniques, such as transcutaneous electrical nerve stimulation, transcranial direct-current stimulation and transcranial magnetic stimulation, have been investigated in terms of their efficacy in reducing pain and improving the quality of life. Finally, the role of nutrition is discussed as study findings suggest that weight control, modified high-antioxidant diets, and nutritional supplementation can help to alleviate the symptoms of FM.
纤维肌痛(FM)是一种以广泛疼痛为特征的慢性综合征,影响着全球数以百万计的人。本文讨论了 2022 年在 PubMed 数据库中索引的科学论文中描述的 FM 的各个方面,包括最新的诊断进展(特别是与 FM 的青少年形式有关的)、危险因素、共病和客观措施。本文强调了早期识别 FM 和改进诊断方法(例如身体测量,包括步行测试表现、手握力和自主神经测试)的重要性。本文还考虑了 FM 病理生理学的假设,包括炎症、肠道菌群失调和神经炎症的作用,以及可能的治疗选择,包括抗氧化剂和激肽拮抗剂、神经刺激和身心干预等药物。尽管氯胺酮、维生素 D 和激素疗法已显示出减轻 FM 症状的潜力,但仍需要进一步研究以优化其使用。已经研究了经皮神经电刺激、经颅直流电刺激和经颅磁刺激等神经刺激技术,以评估其减轻疼痛和改善生活质量的疗效。最后,还讨论了营养的作用,因为研究结果表明,体重控制、改良的高抗氧化饮食和营养补充剂有助于减轻 FM 的症状。