{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T13:34:38Z","timestamp":1745933678067},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"22","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n            Epidemiologie und Pathophysiologie Das Fibromyalgiesyndrom (FMS) ist bei Menschen mit rheumatologischen Erkrankungen deutlich h\u00e4ufiger als in der Allgemeinbev\u00f6lkerung. Es kann aber auch unabh\u00e4ngig von anderen Erkrankungen auftreten. Es handelt sich um eine multifaktorielle Erkrankung: Physische und psychosoziale Faktoren wirken bei der Genese zusammen. Pathophysiologisch relevant scheint insbesondere eine gest\u00f6rte Schmerzverarbeitung zu sein. Ob eine Small-Fiber-Neuropathie (SFN) urs\u00e4chlich ist, muss weiter untersucht werden. Aktuell gibt es erstmals experimentelle Hinweise darauf, dass es sich beim FMS um eine transferierbare (Autoimmun-)Erkrankung handeln k\u00f6nnte.<\/jats:p><jats:p>\n            Symptome und Diagnostik Es handelt sich beim FMS um eine klinische Diagnose: Neben generalisierten Schmerzen bestehen h\u00e4ufig Schlafst\u00f6rungen und eine Ersch\u00f6pfungsneigung \u2013 auch eine Assoziation mit einer depressiven Erkrankung kann bestehen. Bei der Diagnose und der Beurteilung des Schweregrads helfen der Widespread-Pain-Index (WPI) und der Symptome-Severity-Score (SSS).<\/jats:p><jats:p>\n            Therapie Neben der Aufkl\u00e4rung \u00fcber die Gutartigkeit der Erkrankung stehen nicht-medikament\u00f6se Verfahren wie Bewegung, physikalische Therapie und kognitive Verhaltenstherapie im Vordergrund. Bei schwer zu behandelnden Verl\u00e4ufen kann eine multimodale Therapie indiziert sein. Analgetika, insbesondere Opioide, sollen allenfalls nachrangig und kurzfristig zum Einsatz kommen. Der Opioidantagonist Naltrexon ist ein vielversprechender Kandidat zur medikament\u00f6sen Therapie. M\u00f6glicherweise kann auch die TENS-Nutzung hilfreich sein. Im Hinblick auf den therapeutischen Einsatz von Cannabinoiden gibt es positive Beobachtungsstudien, es fehlt aber weiterhin an Evidenz aus kontrollierten Studien.<\/jats:p>","DOI":"10.1055\/a-1965-6870","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T23:50:23Z","timestamp":1698969023000},"page":"1467-1472","source":"Crossref","is-referenced-by-count":1,"title":["Das Fibromyalgiesyndrom als Schmerzsyndrom in der Rheumatologie"],"prefix":"10.1055","volume":"148","author":[{"given":"Marco","family":"Krasselt","sequence":"additional","affiliation":[{"name":"Endokrinologie, Nephrologie und Rheumatologie, Department f\u00fcr Innere Medizin, Neurologie und Dermatologie, Medizinische Klinik III, Universit\u00e4tsklinikum Leipzig A\u00f6R, Leipzig"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Baerwald","sequence":"additional","affiliation":[{"name":"Universit\u00e4res Zentrum f\u00fcr seltene Erkrankungen, Universit\u00e4tsklinikum Leizpig A\u00f6R, Leipzig"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101423","DOI":"10.1016\/j.berh.2019.06.005","article-title":"The prevalence and impact of comorbid fibromyalgia in inflammatory arthritis","volume":"33","author":"SS Zhao","year":"2019","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"S 105","key":"ref2","first-page":"28","article-title":"Fibromyalgia prevalence and associated factors in primary Sjogren\u2019s syndrome patients in a large cohort from the Spanish Society of Rheumatology registry (SJOGRENSER)","volume":"35","author":"V Torrente-Segarra","year":"2017","journal-title":"Clin Exp Rheumatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"640618","DOI":"10.3389\/fimmu.2021.640618","article-title":"Higher Risk for Sjogren\u2019s Syndrome in Patients With Fibromyalgia: A Nationwide Population-Based Cohort Study","volume":"12","author":"SY Gau","year":"2021","journal-title":"Front Immunol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1055\/a-1182-5630","article-title":"Update Fibromyalgiesyndrom","volume":"45","author":"W H\u00e4user","year":"2020","journal-title":"Aktuelle Rheumatologie"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3042","DOI":"10.1093\/rheumatology\/keaa061","article-title":"Diagnosis of fibromyalgia: comparison of the 2011\/2016 ACR and AAPT criteria and validation of the modified Fibromyalgia Assessment Status","volume":"59","author":"F Salaffi","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.semarthrit.2018.08.003","article-title":"A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia: Implications for a new paradigm in fibromyalgia etiopathogenesis","volume":"48","author":"R Grayston","year":"2019","journal-title":"Semin Arthritis Rheum"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1097\/j.pain.0000000000000311","article-title":"What is the meaning of \u201csmall fiber neuropathy\u201d in fibromyalgia?","volume":"156","author":"DJ Clauw","year":"2015","journal-title":"Pain"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1179573518771703","DOI":"10.1177\/1179573518771703","article-title":"Small Fiber Neuropathy: Disease Classification Beyond Pain and Burning","volume":"10","author":"TD Levine","year":"2018","journal-title":"J Cent Nerv Syst Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e144201","DOI":"10.1172\/JCI144201","article-title":"Passive transfer of fibromyalgia symptoms from patients to mice","volume":"131","author":"A Goebel","year":"2021","journal-title":"J Clin Invest"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e001735","DOI":"10.1136\/rmdopen-2021-001735","article-title":"Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? 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