Neuroendocrine changes and maladaptations in fibromyalgia. Pathogenetic findings

This contribution presents the psychosocial, psychopathological, psycho- and elektrophysiological as well as endocrine results in the aetiopathogenesis of fibromyalgia syndrome (FMS). Three subgroups could be differentiated based on psychosocial learning processes. They differ in pain intensity and interference, affective distress, activity and spouse responses. They influence pain behavior and CNS activity in the sense of operant conditioning. The relationship between dysregulated pain modulation in the CNS and endocrine dysregulation of the HPA-axis, which seems to be relevant for the autonome hypo-reaction of muscle and blood pressure, are discussed. The "dynamic processing model for FMS" is presented.