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Mnogi bolniki imajo tudi kognitivne težave,<ref name="Update"/><ref name=p17092441>{{cite journal | author = Glass JM | title = Cognitive dysfunction in fibromyalgia and chronic fatigue syndrome: new trends and future directions | journal = Curr Rheumatol Rep | volume = 8 | issue = 6 | pages = 425–429 | date = december 2006 | pmid = 17092441 | doi = 10.1007/s11926-006-0036-0 }}</ref> ki se kažejo kot motnje koncentracije,<ref name=pmid17041327>{{cite journal |vauthors=Leavitt F, Katz RS, Mills M, Heard AR | title = Cognitive and Dissociative Manifestations in Fibromyalgia | journal = J Clin Rheumatol | volume = 8 | issue = 2 | pages = 77–84 | year = 2002 | pmid = 17041327 | doi = 10.1097/00124743-200204000-00003 }}</ref> težave s [[kratkoročni spomin|kratkoročnim]]<ref name=pmid17041327/><ref name=pmid17894922>{{cite journal |vauthors=Buskila D, Cohen H | title = Comorbidity of fibromyalgia and psychiatric disorders | journal = Curr Pain Headache Rep | volume = 11 | issue = 5 | pages = 333–338 | date = oktober 2007 | pmid = 17894922 | doi = 10.1007/s11916-007-0214-4 | url = }}</ref> in [[dolgoročni spomin|dolgoročnim spominom]], nezmožnost večopravilnosti, kognitivna preobremenitev<ref name=pmid17041327/><ref name=pmid17894922/> zmanjšana zmožnost pozornosti. Pogosto jo spremljajo simptomi [[tesnoba|tesnobe]] in [[depresija|depresije]].<ref name=pmid17894922/>
Nekateri simptomi se povezujejo s fibromialgijo ali pa so posledica pridruženih bolezni. Mednje spadajo na primer [[miofascialna bolečina]], [[sindrom razdražljivega črevesja]], [[intersticijski cistitis]] in drugi simptomi sečil in spolovil ... Fibromialgijo sicer opredeljuje razpršena kronična bolečina , lahko pa so prisotne tudi lokalizirane bolečine, na primer v [[rama|ramenih]], [[vrat]]u, [[ledja|ledjih]], [[kolk]]ih in drugje po telesu. Pogosto imajo bolniki bolečine v [[čeljustni sklep|čeljustnem sklepu]]. 20–30 % bolnikov z [[revmatoidni artritis|revmatoidnim artritisom]] ali [[sistemski eritematozni lupus|sistemskim eritematoznim lupusom]] izkazuje tudi simptome fibromialgije.<ref name="PMID 17602995">{{cite journal | author = Yunus MB | title = Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain | journal = Best Pract Res Clin Rheumatol | volume = 21 | issue = 3 | pages = 481–97 | date = June 2007 | pmid = 17602995 | doi = 10.1016/j.berh.2007.03.006 }}</ref>
==Vzroki==
TheVzrok causefibromialgije ofše fibromyalgiani ispojasnjen, unknown.strokovnjaki However,pa severalso hypothesespredlagali haveveč beenteorij. developedEna includingod "centralnjih sensitization"je »teorija centralne senzitizacije«.<ref name="Update"/> ThisPo theorytej proposesteoriji thatimajo peoplebolniki withs fibromyalgiafibromialgijo havenižji a[[prag lowerbolečine]] thresholdzaradi forpovečane painodzivnosti becausena ofbolečino increasedobčutljivih reactivity[[živčna ofcelica|živčnih pain-sensitivecelic]] nervev cells[[hrbtenjača|hrbtenjači]] in the spinal cordali or brain[[možgani]]h.<ref name="pmid21303476" /> NeuropathicFibromialgijo painpogosto andspremljajo majornevropatske depressivebolečine disorderin oftenvelika co-occurdepresivna withmotnja, fibromyalgiakar –kaže thena reasonmožno forgenetsko thispovezanost comorbidityin appearsprizadetost torazličnih benevrohormonskih duesignalnih topoti. sharedVpletene geneticbi abnormalities,lahko whichbile leads to impairments in [[monoaminergic]]monoaminergične, [[glutamatergic]]glutamatergične, [[neurotrophic]]nevrotropne, [[opioid]]opioidne andali [[proinflammatoryprovnetne cytokine]]citokinske signalne signalingpoti. InPri thesedovzetnih vulnerableposameznikih individuals,lahko psihični psychologicalstres stressali orbolezen illnesspovzročita cananomalije causev abnormalitiesvnetnih in inflammatorystresnih andodzivih, stresski pathwaysvplivajo whichna regulaterazpoloženje moodin andzaznavanje painbolečine. Eventually,Zaradi asenzitizacije sensitizationin andaktivacije kindlingdoločenih effectživčnih occurcelic inbi certainlahko [[neuron]]sv leadingtakih tookoliščinah theprivedlo establishmentdo offibromialgije fibromyalgiain andv sometimesnekaterih aprimerih moodtudi disorderdo [[motnja razpoloženja|motenj razpoloženja]].<ref name="Maletic-2009">{{cite journal |vauthors=Maletic V, Raison CL | title = Neurobiology of depression, fibromyalgia and neuropathic pain | journal = Front Biosci | volume = 14 | issue = | pages = 5291–3385291–5338 | year = 2009 | pmid = 19482616 | doi = 10.2741/3598 }}</ref> TheS evidencepoenostavljenim suggestsbesednjakom thatbi thelahko pain in fibromyalgia results primarily from pain-processing pathways functioning abnormally. In simple termsrekli, itda canse bepri describedprizadeti asosebi thev volumeosrednjem ofživčevju thebolečinske neuronsživčne beingpoti setpretirano toovzdražijo, highmedtem andko thisso hyper-excitabilitypoti, ofki pain-processingzavirajo pathwayszaznavanje andbolečine, under-activitypremalo ofaktivne. inhibitoryNekatere painnevrokemične pathwaysanomalije, inprepoznane thepri brainfibromialgiji, resultsuravnavajo intudi the affected individual experiencing pain. Some neurochemical abnormalities thatrazpoloženje, occurspanje in fibromyalgiaobčutek alsotelesne regulate moodenergije, sleep,kar and energy,bi thuslahko explainingpojasnilo whyrazpoloženjske moodmotnje, sleep,težave ands fatiguespancem problemsin areutrujenost commonlypri co-morbidbolnikih withs fibromyalgiafibromialgijo.<ref name="Clauw-2011"/>
===Dedni dejavniki===
Ni še znano, na kak način se nagnjenost k fibromialgiji deduje, podatki pa kažejo, da je vpletenih več [[gen]]ov.<ref name="Buskila-2006"/> Raziskave so pokazale morebitno povezanost fibromialgije s [[polimorfizem|polimorfizmom]] genov, vpletenih v [[serotonin]]ski,<ref>{{cite journal |vauthors=Cohen H, Buskila D, Neumann L, Ebstein RP | title = Confirmation of an association between fibromyalgia and serotonin transporter promoter region (5- HTTLPR) polymorphism, and relationship to anxiety-related personality traits | journal = Arthritis Rheum. | volume = 46 | issue = 3 | pages = 845–847 | date = marec 2002 | pmid = 11920428 | doi = 10.1002/art.10103 }}</ref> [[dopamin]]ergični<ref>{{cite journal |vauthors=Buskila D, Dan B, Cohen H, Hagit C, Neumann L, Lily N, Ebstein RP | title = An association between fibromyalgia and the dopamine D4 receptor exon III repeat polymorphism and relationship to novelty seeking personality traits | journal = Mol. Psychiatry | volume = 9 | issue = 8 | pages = 730–731 | date = avgust 2004 | pmid = 15052273 | doi = 10.1038/sj.mp.4001506 }}</ref> in [[kateholamin]]ergični sistem.<ref>{{cite journal |vauthors=Zubieta JK, Heitzeg MM, Smith YR, Bueller JA, Xu K, Xu Y, Koeppe RA, Stohler CS, Goldman D | title = COMT val158met genotype affects mu-opioid neurotransmitter responses to a pain stressor | journal = Science | volume = 299 | issue = 5610 | pages = 1240–1243 | date = februar 2003 | pmid = 12595695 | doi = 10.1126/science.1078546 }}</ref>
A mode of inheritance is currently unknown, but it is most probably [[polygenic]].<ref name="Buskila-2006"/> Research has also demonstrated that fibromyalgia is potentially associated with polymorphisms of genes in the [[serotoninergic]],<ref>{{cite journal |vauthors=Cohen H, Buskila D, Neumann L, Ebstein RP | title = Confirmation of an association between fibromyalgia and serotonin transporter promoter region (5- HTTLPR) polymorphism, and relationship to anxiety-related personality traits | journal = Arthritis Rheum. | volume = 46 | issue = 3 | pages = 845–7 | date = March 2002 | pmid = 11920428 | doi = 10.1002/art.10103 }}</ref> [[dopaminergic]]<ref>{{cite journal |vauthors=Buskila D, Dan B, Cohen H, Hagit C, Neumann L, Lily N, Ebstein RP | title = An association between fibromyalgia and the dopamine D4 receptor exon III repeat polymorphism and relationship to novelty seeking personality traits | journal = Mol. Psychiatry | volume = 9 | issue = 8 | pages = 730–1 | date = August 2004 | pmid = 15052273 | doi = 10.1038/sj.mp.4001506 }}</ref> and [[catecholaminergic]] systems.<ref>{{cite journal |vauthors=Zubieta JK, Heitzeg MM, Smith YR, Bueller JA, Xu K, Xu Y, Koeppe RA, Stohler CS, Goldman D | title = COMT val158met genotype affects mu-opioid neurotransmitter responses to a pain stressor | journal = Science | volume = 299 | issue = 5610 | pages = 1240–3 | date = February 2003 | pmid = 12595695 | doi = 10.1126/science.1078546 }}</ref> However, these polymorphisms are not specific for fibromyalgia and are associated with a variety of allied disorders (e.g. [[chronic fatigue syndrome]],<ref>{{cite journal |vauthors=Narita M, Nishigami N, Narita N, Yamaguti K, Okado N, Watanabe Y, Kuratsune H | title = Association between serotonin transporter gene polymorphism and chronic fatigue syndrome | journal = Biochem. Biophys. Res. Commun. | volume = 311 | issue = 2 | pages = 264–6 | date = November 2003 | pmid = 14592408 | doi = 10.1016/j.bbrc.2003.09.207 }}</ref> irritable bowel syndrome<ref>{{cite journal |vauthors=Camilleri M, Atanasova E, Carlson PJ, Ahmad U, Kim HJ, Viramontes BE, McKinzie S, Urrutia R | title = Serotonin-transporter polymorphism pharmacogenetics in diarrhea-predominant irritable bowel syndrome | journal = Gastroenterology | volume = 123 | issue = 2 | pages = 425–32 | date = August 2002 | pmid = 12145795 | doi = 10.1053/gast.2002.34780 }}</ref>) and with depression.<ref>{{cite journal |vauthors=Hudson JI, Mangweth B, Pope HG, De Col C, Hausmann A, Gutweniger S, Laird NM, Biebl W, Tsuang MT | title = Family study of affective spectrum disorder | journal = Arch. Gen. Psychiatry | volume = 60 | issue = 2 | pages = 170–7 | date = February 2003 | pmid = 12578434 | doi = 10.1001/archpsyc.60.2.170 }}</ref> Individuals with the [[5-HT2A receptor]] 102T/C [[Polymorphism (biology)|polymorphism]] have been found to be at increased risk of developing fibromyalgia.<ref name="pmid21120487">{{cite journal |vauthors=Lee YH, Choi SJ, Ji JD, Song GG | title = Candidate gene studies of fibromyalgia: a systematic review and meta-analysis | journal = Rheumatol. Int. | volume = 32 | issue = 2 | pages = 417–26 | date = February 2012 | pmid = 21120487 | doi = 10.1007/s00296-010-1678-9 | url = }}</ref>
===Življenjski slog in travmatski dejavniki===
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