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Myasthenia Gravis: Overview and Treatment

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
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A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
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Fibromyalgia: an overview.

Daniel J Clauw1

  • 1Chronic Pain & Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan 48106, USA. dclauw@med.umich.edu

The American Journal of Medicine
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Summary
This summary is machine-generated.

Fibromyalgia involves chronic widespread pain due to central pain processing issues, not inflammation. Understanding these mechanisms improves treatments for fibromyalgia and related chronic pain disorders.

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Area of Science:

  • Neuroscience
  • Rheumatology
  • Pain Medicine

Background:

  • Fibromyalgia is diagnosed in patients with chronic widespread musculoskeletal pain without identifiable causes like inflammation.
  • It is increasingly understood as a central pain processing disorder, leading to hyperalgesia and allodynia.
  • Aberrant central pain processing is linked to other chronic pain conditions like irritable bowel syndrome and chronic low back pain.

Purpose of the Study:

  • To elucidate the central pain processing mechanisms underlying fibromyalgia.
  • To explore the role of neurotransmitter deficiencies and excesses in fibromyalgia pathogenesis.
  • To highlight the connection between fibromyalgia and co-occurring chronic pain disorders.

Main Methods:

  • Review of current understanding of fibromyalgia pathophysiology.
  • Analysis of neurotransmitter systems implicated in central pain processing.
  • Examination of genetic and environmental factors contributing to fibromyalgia.

Main Results:

  • Fibromyalgia and related disorders are associated with deficiencies in serotonergic and noradrenergic neurotransmission.
  • Increased levels of pronociceptive neurotransmitters like glutamate and substance P contribute to heightened pain.
  • Genetic and environmental factors play a role in the development of fibromyalgia.

Conclusions:

  • Central pain processing dysfunction is a key mechanism in fibromyalgia and related chronic pain conditions.
  • Understanding these mechanisms has led to advancements in both pharmacologic and non-pharmacologic therapies.
  • Accurate diagnosis is achievable through careful clinical examination despite overlapping symptoms.