[Fibromyalgia (generalized tendomyopathy): defect of a program of movements and their realization]

It was established that fulfillment of any motor action implies a design of the program of action in CNS and its realization by peripheral elements of locomotor system. A program includes an acceptor of the result of action and efferent synthesis on a central level (parietal-premotor area, pallidostriatal system, lymbico-reticular complex, ex cetera). A very motor act is realized by the activity of a segmental apparatus of the spinal cord and skeletal muscles. Acceptor of the result of action provides a control of the coincidence between afferent parameters of the result of an action and its real characteristics by means of the reverse feed-back (P.K. Anokhin, 1975). Incoordination of its parameters is a condition for the existence of a physiologic functional system for the construction of the necessary movement, while a coincidence of their indices resulted in the disintegration of this system. Appearance of myofascicular hypertonus in this system distorts a real parameters of the movement because of a deficit and imbalance of the proprioception in a segmental apparatus and central formations. A proprioceptive desafferentation promotes disinhibition of the neurons and formation of the generators of pathologically increased irritation with positive feed-back on rubro-segmental (A), pallido-thalamic (B), strio-piramidal (C) and parietal-premotor (D) levels of the construction of the movement according to N.A. Bernshtein (1966). Its appearance on the B and C levels prevents destruction of the physiologic system of organization after realization of its activity and promotes its reformation into the pathologic one. It manifested clinically in appearance of a pathologic dynamic stereotype. Additional integration of lymbico-reticular complex, and high centers of autonomic supplement into this system promotes a formation of the stable neurotic, depressive reactions and autonomic disorders. Such reactions are transitory and have adaptive character at normal program of construction and fulfillment of the motion, while at pathologic one they have desadaptive character. Clinically they are known as multiple psychoautonomic syndromes combined with muscular, fascial and ligamental pains of different location.