Individuals with fibromyalgia (FM) and/or chronic fatigue syndrome (CFS) report arthralgias and myalgias. However, only persons
with FM alone exhibit abnormal pain responses to mild levels of stimulation, or allodynia. We identify the abnormalities in
the neuroendocrine axes that are common to FM and CFS as well as the abnormalities in central neuropeptide levels and functional
brain activity that differentiate these disorders. These two sets of factors, respectively, may account for the similiarities
and differences in the pain experiences of persons with FM and CFS.
"In consequence, much interest has recently been expressed in the possible role of the autonomic nervous system in the pathogenesis of chronic pain and fatigue syndromes, like fibromyalgia (FM) and the chronic fatigue syndrome (CFS) . Both are considered as related syndromes, supported by the high percentages of overlap between the two syndromes (35–70%) , but in the meantime substantial differences have been reported  . "
[Show abstract][Hide abstract] ABSTRACT: The goal of this systematic literature review is to determine whether there are differences and similarities in heart rate variability (HRV) between adult patients with Fibromyalgia (FM), Chronic Fatigue Syndrome (CFS), and healthy pain-free control subjects.
To obtain relevant articles, PubMed and Web of Knowledge were searched for case-control studies. Selection of the literature was based on selection criteria ascertaining studies with adult human patient groups comparing HRV. Risk of bias and levels of evidence were determined.
Sixteen case-control studies were included, 10 comparing FM patients to controls and 6 comparing CFS patients to controls. Methodological quality was moderate to good. Both time domain and frequency domain measurements were used. The majority of the researchers observed lower HRV in FM patients compared to healthy control persons, as well as increased sympathetic activity and a blunted autonomic response to stressors. Resistance training improved HRV in FM patients. In CFS patients HRV was only reduced during sleep.
FM patients show more HRV aberrances and indices of increased sympathetic activity. Increased sympathetic activity is only present in CFS patients at night. Since direct comparisons are lacking and some confounders have to be taken into account, further research is warranted. The role of pain and causality can be subject of further research, as well as therapy studies directed to reduced HRV.
Seminars in arthritis and rheumatism 07/2013; 43(2). DOI:10.1016/j.semarthrit.2013.03.004 · 3.93 Impact Factor
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