Hypothetical model ignores many important pathophysiologic mechanisms in fibromyalgia.

Hypothetical model ignores many important pathophysiologic mechanisms in fibromyalgia.
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假设模型忽略了纤维肌痛的许多重要病理生理机制。

DOI:
10.1038/s41584-023-00951-3
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发表时间:
2023
期刊:
Nature reviews. Rheumatology
影响因子:
--
通讯作者:
Harte,Stev
Harte,Stev
中科院分区:
--
文献类型:
--
作者:
Clauw,DanielJ;Choy,ErnestHS;Napadow,Vitaly;Soni,Anushka;Boehnke,KevinF;Naliboff,Bruce;Hassett,AftonL;Arewasikporn,Anne;Schrepf,Andrew;Kaplan,ChelseaM;Williams,David;Basu,Neil;Bergmans,RachelS;Harris,RichardE;Harte,Stev

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(Pinto,AM等人)情绪调节与突显网络:纤维肌痛的假想整合模型。纳特。Rheumatol牧师19,44-60(2023))1.我们认为建议的模型严重超过了纤维肌痛的复杂病理生理学,并不适用于所有甚至大多数患有这种疾病的人。我们担心,尽管几十年的研究已经开始阐明纤维肌痛和其他慢性疼痛条件下的神经生物学机制,但这一理论可能会无意中推动这一领域的倒退。我们的主要观点在这里概述。首先,我们不同意心理压力是纤维肌痛的唯一原因。暗示这是纤维肌痛的主要原因机制是不恰当的,也是无效的。许多纤维肌痛患者没有创伤史、精神共病史,甚至没有特别的压力。因此,这些人不会从这种不准确的、可能使人耻辱的纤维肌痛概念化中受益,反而可能受到伤害。
(Pinto, AM et al. Emotion regulation and the salience network: a hypothetical integrative model of fibromyalgia. Nat. Rev. Rheumatol. 19, 44–60 (2023)) 1. We feel that the proposed model severely overfits the complicated pathophysiology of fibromyalgia and is not applicable to all or even most individuals with this condition. We are concerned that this theory could inadvertently drive the field backwards despite several decades of research that has begun to illuminate neurobiological mechanisms underlying fibromyalgia and other chronic pain conditions. Our main points are outlined here.First and foremost, we disagree that psychological stress is the sole cause of fibromyalgia. It is inappropriate and invalidating to imply this is the predominant causal mechanism in fibromyalgia. Many individuals with fibromyalgia do not have a history of trauma, psychiatric comorbidity or even extraordinary stress. Thus, these individuals will not benefit from and may be harmed by this inaccurate and potentially stigmatizing conceptualization of fibromyalgia.
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