Journal of Rheumatic Diseases

Korean College of Rheumatology (대한류마티스학회)
권호 표지
DOI QR코드

DOI QR Code

Fibromyalgia Syndrome

섬유근통 증후군

  • Kim, Seong-Ho (Department of Internal Medicine, Dongguk University College of Medicine)
  • 김성호 (동국대학교 의과대학 내과학교실)
  • Published : 2009.03.30
⟨ Previous Next ⟩

Abstract

Fibromyalgia syndrome is a major cause of chronic widespread pain and this affects 2.2% of all Koreans. Evidence exists for a genetic contribution to fibromyalgia. Those people who are predisposed to develop fibromyalgia may have this condition "triggered" by a variety of environmental "stressors," including certain types of infections, physical trauma and catastrophic events. Some patients with fibromyalgia have been found to have abnormalities in a number of the body's "stress response" systems, including the hypothalamus-pituitary-adrenal axis and the autonomic nervous system. The most consistently detected objective abnormalities in fibromyalgia involve the pain-processing systems. Patients with fibromyalgia have displayed quantitative abnormalities in pain perception under experimental conditions. Fibromyalgia may be related to a decrease in the activity of the descending, antinociceptive pathways. In addition to neurobiologic mechanisms, psychologic and behavioral factors also play a role for many patients for the different symptoms they express. Diagnosing and treating these patients is especially challenging due to the limited knowledge of the etiology of this disease and the poor response to conventional pain treatments. Strict adherence to the ACR classification criteria in clinical practice is not required to effectively treat patients with fibromyalgia. The treatments of fibromyalgia should be targeted to the central pain and the neuropsychological symptoms. Current evidence advocates a multifaceted program that emphasizes patient education, medications for improving symptoms and aggressive use of exercise and cognitive-behavioral therapy to restore function.

Keywords

References

  1. Gran JT. The epidemiology of chronic generalized musculoskeletal pain. Best Pract Res Clin Rheumatol 2003;17:547-61. https://doi.org/10.1016/S1521-6942(03)00042-1
  2. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 1990;33:160-72. https://doi.org/10.1002/art.1780330203
  3. Nisenbaum R, Reyes M, Mawle AC, Reeves WC. Factor analysis of unexplained severe fatigue and interrelated symptoms: overlap with criteria for chronic fatigue syndrome. Am J Epidemiol 1998;148:72-7. https://doi.org/10.1093/oxfordjournals.aje.a009562
  4. Clauw DJ. Fibromyalgia. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 4th ed. p.701-11, New York, Mosby, 2007.
  5. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol 1995;22:151-6. https://doi.org/10.1093/rheumatology/22.3.151
  6. Kim SH, Bae GR, Lim HS. Prevalence and risk factors of fibromyalgia syndrome and chronic widespread pain in two communities in Korea - First report in Korean. J Korean Rheumatism Assoc 2006;13:18-25.
  7. Kim SH. Prevalence of chronic widespread pain and chronic fatigue syndrome in young Korean adults. J Musculoskelet Pain 2008;16:149-53. https://doi.org/10.1080/10582450802161838
  8. Kim SH, Lee K, Lim HS. Prevalence of chronic widespread pain and chronic fatigue syndrome in Korean livestock raisers. J Occup Health 2008;50:525-8. https://doi.org/10.1539/joh.M8001
  9. Makela M, Heliovaara M. Prevalence of primary fibromyalgia in the Finnish population. Br Med J 1991;303:216-9. https://doi.org/10.1136/bmj.303.6796.216
  10. Leveille SG, Ling S, Hochberg MC, Resnick HE, Bandeen-Roche KJ, Won A, et al. Widespread musculoskeletal pain and the progression of disability in older disabled women. Ann Intern Med 2001;135:1038-46. https://doi.org/10.7326/0003-4819-135-12-200112180-00007
  11. Andersson HI, Ejlertsson G, Leden I. Widespread musculoskeletal chronic pain associated with smoking: an epidemiological study in a general rural population. Scand J Rehab Med 1998;30:185-91. https://doi.org/10.1080/003655098444129
  12. Petzke F, Gracely RH, Park KM, Ambrose K, Clauw DJ. What do tender points measure? Influence of distress on 4 measures of tenderness. J Rheumatol 2003;30:567-74.
  13. Dadabhoy D, Clauw DJ. The fibromyalgia syndrome. In: Klippel JH, Stone JH, Crofford LJ, White PH, eds. Primer on the rheumatic diseases. 13th ed. p.87-93, New York, Springer, 2007.
  14. Katz RS, Wolfe F, Michaud K. Fibromyalgia diagnosis. A comparison of clinical, survey, and American College of Rheumatology criteria. Arthritis Rheum 2006;54:169-76. https://doi.org/10.1002/art.21533
  15. Clauw DJ. Fibromyalgia: correcting the misconceptions. J Musculoskel Med 2003;20:467-72.
  16. Arnold LM, Hudson JI, Hess EV, Ware AE, Fritz DA, Auchenbach MB, et al. Family study of fibromyalgia. Arthritis Rheum 2004;50:944-52. https://doi.org/10.1002/art.20042
  17. Offenbaecher M, Bondy B, de Jonge S, Glatzeder K, Kruger M, Schoeps P, et al. Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region. Arthritis Rheum 1999;42:2482-8. https://doi.org/10.1002/1529-0131(199911)42:11<2482::AID-ANR27>3.0.CO;2-B
  18. Gursoy S, Erdal E, Herken H, Madenci E, Alaşehirli B, Erdal N. Significance of catechol-O-methyltransferase gene polymorphism in fibromyalgia syndrome. Rheumatol Int 2003;23:104-7.
  19. Clauw DJ, Chrousos GP. Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation 1997;4:134-53. https://doi.org/10.1159/000097332
  20. Pillemer SR, Bradley LA, Crofford LJ, Moldofsky H, Chrousos GP. The neuroscience and endocrinology of fibromyalgia. Arthritis Rheum 1997;40:1928-39. https://doi.org/10.1002/art.1780401103
  21. McLean SA, Williams DA, Harris RE, Kop WJ, Groner KH, Ambrose K, et al. Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia. Arthritis Rheum 2005;52:3660-9. https://doi.org/10.1002/art.21372
  22. Mountz JM, Bradley LA, Modell JG, Alexander RW, Triana-Alexander M, Aaron LA, et al. Fibromyalgia in women: abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthritis Rheum 1995;38:926-38. https://doi.org/10.1002/art.1780380708
  23. Arroyo JF, Cohen ML. Abnormal responses to electrocutaneous stimulation in fibromyalgia. J Rheumatol 1993;20:1925-31.
  24. Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 2002;46:1333-43. https://doi.org/10.1002/art.10225
  25. Desmeules JA, Cedraschi C, Rapiti E, Baumgartner E, Finckh A, Cohen P, et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum 2003;48:1420-9. https://doi.org/10.1002/art.10893
  26. Cook DB, Lange G, Ciccone DS, Liu WC, Steffener J, Natelson BH. Functional imaging of pain in patients with primary fibromyalgia. J Rheumatol 2004;31:364-78. https://doi.org/10.1093/rheumatology/31.6.364
  27. Kuchinad A, Schweinhardt P, Seminowicz DA, Wood PB, Chizh BA, Bushnell MC. Accelerated brain gray matter loss in fibromyalgia patients: premature aging of the brain? J Neurosci 2007;27:4004-7. https://doi.org/10.1523/JNEUROSCI.0098-07.2007
  28. Lutz J, Jager L, de Quervain D, Krauseneck T, Padberg F, Wichnalek M, et al. White and gray matter abnormalities in the brain of patients with fibromyalgia: a diffusion-tensor and volumetric imaging study. Arthritis Rheum 2008;58:3960-9. https://doi.org/10.1002/art.24070
  29. Russell IJ, Orr MD, Littman B, Vipraio GA, Alboukrek D, Michalek JE, et al. Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum 1994;37:1593-601. https://doi.org/10.1002/art.1780371106
  30. Sarchielli P, Alberti A, Floridi A, Gallai V. Levels of nerve growth factor in cerebrospinal fluid of chronic daily headache patients. Neurology 2001;57:132-4. https://doi.org/10.1212/WNL.57.1.132
  31. Alpar EK, Onuoha G, Killampalli VV, Waters R. Management of chronic pain in whiplash injury. J Bone Joint Surg Br 2002;84:807-11. https://doi.org/10.1302/0301-620X.84B6.12738
  32. Harris RE, Sundgren PC, Pang Y, Hsu M, Petrou M, Kim SH, et al. Dynamic levels of glutamate within the insula are associated with improvements in multiple pain domains in fibromyalgia. Arthritis Rheum 2008;58:903-7. https://doi.org/10.1002/art.23223
  33. Kosek E, Ekholm J, Hansson P. Sensory dysfunction in fibromyalgia patients with implications for pathogenic mechanisms. Pain 1996;68:375-83. https://doi.org/10.1016/S0304-3959(96)03188-0
  34. Julien N, Goffaux P, Arsenault P, Marchand S. Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain 2005;114:295-302. https://doi.org/10.1016/j.pain.2004.12.032
  35. Vaeroy H, Nyberg F, Terenius L. No evidence for endorphin deficiency in fibromyalgia following investigation of cerebrospinal fluid (CSF) dynorphin A and Met-enkephalin-Arg6-Phe7. Pain 1991;46:139-43. https://doi.org/10.1016/0304-3959(91)90068-9
  36. Russell IJ, Vaeroy H, Javors M, Nyberg F. Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum 1992;35:550-6. https://doi.org/10.1002/art.1780350509
  37. Abeles AM, Pillinger MH, Solitar BM, Abeles M. Narrative review: the pathophysiology of fibromyalgia. Ann Intern Med 2007;146:726-34. https://doi.org/10.7326/0003-4819-146-10-200705150-00006
  38. Gronemann ST, Ribel-Madsen S, Bartels EM, Danneskiold-Samsoe B, Bliddal H. Collagen and muscle pathology in fibromyalgia patients. Rheumatology (Oxford) 2004;43:27-31. https://doi.org/10.1093/rheumatology/keg452
  39. Sprott H, Salemi S, Gay RE, Bradley LA, Alarcon GS, Oh SJ, et al. Increased DNA fragmentation and ultrastructural changes in fibromyalgic muscle fibres. Ann Rheum Dis 2004;63:245-51. https://doi.org/10.1136/ard.2002.004762
  40. Ribel-Madsen S, Gronemann ST, Bartels EM, Danneskiold-Samsoe B, Bliddal H. Collagen structure in skin from fibromyalgia patients. Int J Tissue React 2005;27:75-82.
  41. Kim SH, Jang TJ, Moon IS. Increased expression of N-methyl-D-aspartate receptor subunit 2D in the skin of patients with fibromyalgia. J Rheumatol 2006;33:785-8.
  42. Kim SH, Kim DH, Oh DH, Clauw DJ. Characteristic electron microscopic findings in skin of patients with fibromyalgia. Clin Rheumatol 2008;27:407-11. https://doi.org/10.1007/s10067-007-0807-7
  43. Kim SH. Skin biopsy findings: implications for the pathophysiology of fibromyalgia. Med Hypotheses 2007;69:141-4. https://doi.org/10.1016/j.mehy.2006.10.057
  44. Alvarez Lario B, Alonso Valdivielso JL, Alegre Lopez J, Martel Soteres C, Viejo Banuelos JL, Maranon Cabello A. Fibromyalgia syndrome: overnight falls in arterial oxygen saturation. Am J Med 1996;101:54-60. https://doi.org/10.1016/S0002-9343(96)00067-8
  45. Altindag O, Celik H. Total antioxidant capacity and the severity of the pain in patients with fibromyalgia. Redox Rep 2006;11:131-5. https://doi.org/10.1179/135100006X116628
  46. Kim SH, Moon IS. Hypoxia - a possibility in fibromyalgia syndrome pathogenesis? J Korean Rheumatism Assoc 2006;13:218-25.
  47. White KP, Nielson WR, Harth M, Ostbye T, Speechley M. Chronic widespread musculoskeletal pain with or without fibromyalgia: psychological distress in a representative community adult sample. J Rheumatol 2002;29:588-94.
  48. McBeth J, Macfarlane GJ, Hunt IM, Silman AJ. Risk factors for persistent chronic widespread pain: a community-based study. Rheumatology (Oxford) 2001;40:95-101.
  49. Gracely RH, Geisser ME, Giesecke T, Grant MA, Petzke F, Williams DA, et al. Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 2004;127:835-43. https://doi.org/10.1093/brain/awh098
  50. Giesecke T, Williams DA, Harris RE, Cupps TR, Tian X, Tian TX, et al. Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors. Arthritis Rheum 2003;48:2916-22. https://doi.org/10.1002/art.11272
  51. Dadabhoy D, Crofford LJ, Spaeth M, Russell IJ, Clauw DJ. Biology and therapy of fibromyalgia. Evidence-based biomarkers for fibromyalgia syndrome. Arthritis Res Ther 2008;10:211. https://doi.org/10.1186/ar2443
  52. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA 2004;292:2388-95. https://doi.org/10.1001/jama.292.19.2388
  53. White KP, Nielson WR, Harth M, Ostbye T, Speechley M. Does the label "fibromyalgia" alter health status, function, and health service utilization? A prospective, within-group comparison in a community cohort of adults with chronic widespread pain. Arthritis Rheum 2002;47:260-5. https://doi.org/10.1002/art.10400
  54. Kranzler JD, Gendreau JF, Rao SG. The psychopharmacology of fibromyalgia: a drug development perspective. Psychopharmacol Bull 2002;36:165-213.
  55. Bennett RM. Pharmacological treatment of fibromyalgia. J Funct Syn 2001;1:79-92.
  56. Nishishinya B, Urrutia G, Walitt B, Rodriguez A, Bonfill X, Alegre C, et al. Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy. Rheumatology (Oxford) 2008;47:1741-6. https://doi.org/10.1093/rheumatology/ken317
  57. Capaci K, Hepguler S. Comparison of the effects of amitriptyline and paroxetine in the treatment of fibromyalgia syndrome. Pain Clin 2002;14:223-8. https://doi.org/10.1163/156856902320761423
  58. Anderberg UM, Marteinsdottir I, Von Knorring L. Citalopram in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study. Eur J Pain 2000;4:27-35. https://doi.org/10.1053/eujp.1999.0148
  59. Norregaard J, Volkmann H, Danneskiold-Samsoe B. A randomized, controlled trial of citalopram in the treatment of fibromyalgia. Pain 1995;61:445-9. https://doi.org/10.1016/0304-3959(94)00218-4
  60. Mattia C, Paoletti F, Coluzzi F, Boanelli A. New antidepressants in the treatment of neuropathic pain: a review. Minerva Anestesiol 2002;68:105-14.
  61. Adelman LC, Adelman JU, Von Seggern R, Mannix LK. Venlafaxine extended release (XR) for the prophylaxis of migraine and tension-type headache: a retrospective study in a clinical setting. Headache 2000;40:572-80. https://doi.org/10.1046/j.1526-4610.2000.00089.x
  62. Harvey AT, Rudolph RL, Preskorn SH. Evidence of the dual mechanisms of action of venlafaxine. Arch Gen Psychiatry 2000;57:503-9. https://doi.org/10.1001/archpsyc.57.5.503
  63. Vitton O, Gendreau M, Gendreau J, Kranzler J, Rao SG. A double-blind, placebo-controlled trial of milnacipran in the treatment of fibromyalgia. Hum Psychopharmacol 2004;19 Suppl 1:27-35S. https://doi.org/10.1002/hup.622
  64. Gendreau RM, Thorn MD, Gendreau JF, Kranzler JD, Ribeiro S, Gracely RH, et al. Efficacy of milnacipran in patients with fibromyalgia. J Rheumatol 2005;32:1975-85.
  65. Clauw DJ, Mease P, Palmer RH, Gendreau RM, Wang Y. Milnacipran for the treatment of fibromyalgia in adults: a 15-week, multicenter, randomized, double-blind, placebo-controlled, multiple-dose clinical trial. Clin Ther 2008;30:1988-2004. https://doi.org/10.1016/j.clinthera.2008.11.009
  66. Mease PJ, Clauw DJ, Gendreau RM, Rao SG, Kranzler J, Chen W, et al. The efficacy and safety of milnacipran for treatment of fibromyalgia. A randomized, double-blind, placebo-controlled trial. J Rheumatol 2009;36:398-409. https://doi.org/10.3899/jrheum.080734
  67. Arnold LM, Lu Y, Crofford LJ, Wohlreich M, Detke MJ, Iyengar S, et al. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum 2004;50:2974-84. https://doi.org/10.1002/art.20485
  68. Arnold LM, Rosen A, Pritchett YL, D'Souza DN, Goldstein DJ, Iyengar S, et al. A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain 2005;119:5-15. https://doi.org/10.1016/j.pain.2005.06.031
  69. Russell IJ, Mease PJ, Smith TR, Kajdasz DK, Wohlreich MM, Detke MJ, et al. Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: results from a 6-month, randomized, double-blind, placebocontrolled, fixed-dose trial. Pain 2008;136:432-44. https://doi.org/10.1016/j.pain.2008.02.024
  70. Wiffen P, Collins S, McQuay H, Carroll D, Jadad A, Moore A. Anticonvulsant drugs for acute and chronic pain. Cochrane Database Syst Rev 2005;3:CD001133.
  71. Crofford LJ, Rowbotham MC, Mease PJ, Russell IJ, Dworkin RH, Corbin AE, et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2005;52:1264-73. https://doi.org/10.1002/art.20983
  72. Mease PJ, Russell IJ, Arnold LM, Florian H, Young JP Jr, Martin SA, et al. A randomized, double-blind, placebo-controlled, phase III trial of pregabalin in the treatment of patients with fibromyalgia. J Rheumatol 2008;35:502-14.
  73. Crofford LJ, Mease PJ, Simpson SL, Young JP Jr, Martin SA, Haig GM, et al. Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): a 6-month, double-blind, placebocontrolled trial with pregabalin. Pain 2008;136:419-31. https://doi.org/10.1016/j.pain.2008.02.027
  74. Arnold LM, Russell IJ, Diri EW, Duan WR, Young JP Jr, Sharma U, et al. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain 2008;9:792-805. https://doi.org/10.1016/j.jpain.2008.03.013
  75. Redillas C, Solomon S. Prophylactic pharmacological treatment of chronic daily headache. Headache 2000;40:83-102. https://doi.org/10.1046/j.1526-4610.2000.00014.x
  76. Arnold LM, Goldenberg DL, Stanford SB, Lalonde JK, Sandhu HS, Keck PE Jr, et al. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum 2007;56:1336-44. https://doi.org/10.1002/art.22457
  77. Hening WA. Restless legs syndrome. Curr Treat Options Neurol 1999;1:309-19. https://doi.org/10.1007/s11940-999-0021-9
  78. Hannonen P, Malminiemi K, Yli-Kerttula U, Isomeri R, Roponen P. A randomized, double-blind, placebocontrolled study of moclobemide and amitriptyline in the treatment of fibromyalgia in females without psychiatric disorder. Br J Rheumatol 1998;37:1279-86. https://doi.org/10.1093/rheumatology/37.12.1279
  79. Krishnan KR, France RD, Pelton S, McCann UD, Davidson J, Urban BJ. Chronic pain and depression. II: symptoms of anxiety in chronic low back pain patients and their relationship to subtypes of depression. Pain 1985;22:289-94. https://doi.org/10.1016/0304-3959(85)90029-6
  80. Lautenschlager J. Present state of medication therapy in fibromyalgia syndrome. Scand J Rheumatol 2000;113 Suppl:32-6S.
  81. Russell IJ, Perkins AT, Michalek JE, the Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome. A randomized, doubleblind, placebo-controlled, multicenter clinical trial. Arthritis Rheum 2009;60:299-309. https://doi.org/10.1002/art.24142
  82. Holman AJ, Myers RR. A randomized, double-blind, placebocontrolled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum 2005;52:2495-505. https://doi.org/10.1002/art.21191
  83. Russell IJ, Michalek J, Xiao Y. Therapy with a central alpha 2-adrenergic agonist (tizanidine) decreases cerebrospinal fluid substance P, and may reduce serum hyaluronic acid as it improves the clinical symptoms of the fibromyalgia syndrome. Arthritis Rheum 2002;46 Suppl:614S.
  84. Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci 2007;27:10000-6. https://doi.org/10.1523/JNEUROSCI.2849-07.2007
  85. Russell IJ. Fibromyalgia syndrome: approach to management. CNS Spectr 2008;13 Suppl 5:27-33S.
  86. Clauw DJ. Pharmacotherapy for patients with fibromyalgia. J Clin Psychiatry 2008;69 Suppl 2:25-9S. https://doi.org/10.4088/JCP.0908e25
  87. Goldenberg DL, Felson DT, Dinerman H. A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. Arthritis Rheum 1986;29:1371-7. https://doi.org/10.1002/art.1780291110
  88. Goldenberg D, Mayskiy M, Mossey C, Ruthazer R, Schmid C. A randomized, double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia. Arthritis Rheum 1996;39:1852-9. https://doi.org/10.1002/art.1780391111
  89. Ozerbil O, Okudan N, Gokbel H, Levendoglu F. Comparison of the effects of two antidepressants on exercise performance of the female patients with fibromyalgia. Clin Rheumatol 2006;25:495-7. https://doi.org/10.1007/s10067-005-0076-2
  90. Sluka KA, Kalra A, Moore SA. Unilateral intramuscular injections of acidic saline produce a bilateral, long-lasting hyperalgesia. Muscle Nerve 2001;24:37-46. https://doi.org/10.1002/1097-4598(200101)24:1<37::AID-MUS4>3.0.CO;2-8
  91. Harte SE, Kim SH, Clauw DJ, Morrow TJ. Altered regional cerebral blood flow at rest in an animal model of fibromyalgia. Arthritis Rheum 2007;56 Suppl:92S.
  92. Kim SH, Lee J. Altered pain-associated molecules in the brain of an animal model of fibromyalgia - preliminary data. Ann Rheum Dis 2008;67 Suppl:254S.
  93. Kim SH, Choi NH, Park IS, Nam KS. Serotonin changes in specific brain regions of fibromyalgia animal model after deep-sea water drinking. J Korean Rheumatism Assoc 2008;15:110-7. https://doi.org/10.4078/jkra.2008.15.2.110
  94. Kim SH, Song J, Mun H, Park KU. Effect of the combined use of tramadol and milnacipran on the pain threshold in fibromyalgia animal model. Korean J Intern Med. In press 2009.
  95. Williams DA, Cary MA, Groner KH, Chaplin W, Glazer LJ, Rodriguez AM, et al. Improving physical functional status in patients with fibromyalgia: a brief cognitive behavioral intervention. J Rheumatol 2002;29:1280-6.
  96. National Institutes of Health. Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. NIH Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia. JAMA 1996;276:313-8. https://doi.org/10.1001/jama.276.4.313
  97. Assefi NP, Sherman KJ, Jacobsen C, Goldberg J, Smith WR, Buchwald D. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med 2005;143:10-9. https://doi.org/10.7326/0003-4819-143-1-200507050-00005
  98. Clauw DJ, Witter J. Pain and rheumatology: thinking outside the joint. Arthritis Rheum 2009;60:321-4. https://doi.org/10.1002/art.24326

Cited by

  1. 섬유근통증후군 환자의 질병관련 특성과 일상생활장애의 상관관계 vol.11, pp.7, 2009, https://doi.org/10.5392/jkca.2011.11.7.239
  2. Applying the ACR Preliminary Diagnostic Criteria in the Diagnosis and Assessment of Fibromyalgia vol.25, pp.3, 2009, https://doi.org/10.3344/kjp.2012.25.3.173
  3. 섬유근통에 대한 국내 임상 연구 동향 및 중재 방향 vol.15, pp.2, 2020, https://doi.org/10.30581/jcmm.2020.15.2.43