In the mind or in the brain? Scientific evidence for central sensitisation in chronic fatigue syndrome
Article first published online: 27 JUL 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 42, Issue 2, pages 203–212, February 2012
How to Cite
Nijs, J., Meeus, M., Van Oosterwijck, J., Ickmans, K., Moorkens, G., Hans, G. and De Clerck, L. S. (2012), In the mind or in the brain? Scientific evidence for central sensitisation in chronic fatigue syndrome. European Journal of Clinical Investigation, 42: 203–212. doi: 10.1111/j.1365-2362.2011.02575.x
- Issue published online: 6 JAN 2012
- Article first published online: 27 JUL 2011
- Accepted manuscript online: 1 JUL 2011 11:43PM EST
- Received 7 May 2011; accepted 28 June 2011
- Central nervous system;
- chronic pain;
Eur J Clin Invest 2011
Background Central sensitisation entails several top-down and bottom-up mechanisms, all contributing to the hyperresponsiveness of the central nervous system to a variety of inputs. In the late nineties, it was first hypothesised that chronic fatigue syndrome (CFS) is characterised by hypersensitivity of the central nervous system (i.e. central sensitisation). Since then, several studies have examined central sensitisation in patients with CFS. This study provides an overview of such studies.
Materials and Methods Narrative review.
Results Various studies showed generalised hyperalgesia in CFS for a variety of sensory stimuli, including electrical stimulation, mechanical pressure, heat and histamine. Various tissues are affected by generalised hyperalgesia: the skin, muscle tissue and the lungs. Generalised hyperalgesia in CFS is augmented, rather than decreased, following various types of stressors like exercise and noxious heat pain. Endogenous inhibition is not activated in response to exercise and activation of diffuse noxious inhibitory controls following noxious heat application to the skin is delayed.
Conclusions The observation of central sensitisation in CFS is in line with our current understanding of CFS. The presence of central sensitisation in CFS corroborates with the presence of several psychological influences on the illness, the presence of infectious agents and immune dysfunctions and the dysfunctional hypothalamus–pituitary–adrenal axis as seen in these severely debilitated patients.