Pain is a diagnostic criterion for Gulf War Illness (GWI), Chronic Fatigue Syndrome (CFS), and fibromyalgia (FM). The physical sign of systemic hyperalgesia (tenderness) was assessed in 920 women who were stratified by 2000 Kansas GWI, 1994 CFS, and 1990 FM criteria. Pressure was applied by dolorimetry at 18 traditional tender points and the average pressure causing pain determined. GWI women were the most tender (2.9 ± 1.6 kg, mean ± SD, n = 70), followed by CFS/FM (3.1 ± 1.4 kg, n = 196), FM (3.9 ± 1.4 kg, n = 56), and CFS (5.8 ± 2.1 kg, n = 170) compared to controls (7.2 ± 2.4 kg, significantly highest by Mann-Whitney tests p < 0.0001, n = 428). Receiver operating characteristics set pressure thresholds of 4.0 kg to define GWI and CFS/FM (specificity 0.85, sensitivities 0.80 and 0.83, respectively), 4.5 kg for FM, and 6.0 kg for CFS. Pain, fatigue, quality of life, and CFS symptoms were equivalent for GWI, CFS/FM and CFS. Dolorimetry correlated with symptoms in GWI but not CFS or FM. Therefore, women with GWI, CFS and FM have systemic hyperalgesia compared to sedentary controls. The physical sign of tenderness may complement the symptoms of the Kansas criteria as a diagnostic criterion for GWI females, and aid in the diagnosis of CFS. Molecular mechanisms of systemic hyperalgesia may provide new insights into the neuropathology and treatments of these nociceptive, interoceptive and fatiguing illnesses.

中文翻译：

---

患有海湾战争疾病，慢性疲劳综合症和纤维肌痛的女性的全身性痛觉过敏。

疼痛是海湾战争疾病（GWI），慢性疲劳综合症（CFS）和纤维肌痛（FM）的诊断标准。根据2000年堪萨斯GWI，1994 CFS和1990 FM标准对920名女性进行了系统性痛觉过敏（压痛）的体征评估。通过比色法在18个传统压痛点施加压力，并确定引起疼痛的平均压力。GWI女性最嫩（2.9±1.6 kg，平均±SD，n = 70），其次是CFS / FM（3.1±1.4 kg，n = 196），FM（3.9±1.4 kg，n = 56）和CFS（5.8±2.1 kg，n = 170）与对照组相比（7.2±2.4 kg，Mann-Whitney试验显着最高p <0.0001，n = 428）。接收器的工作特性将压力阈值设置为4.0 kg，以定义GWI和CFS / FM（特异性为0.85，灵敏度分别为0.80和0.83），FM为4.5 kg和CFS为6.0 kg。疼痛，疲劳，生活质量和CFS症状与GWI，CFS / FM和CFS相当。测色法与GWI中的症状相关，但与CFS或FM不相关。因此，与久坐的对照组相比，患有GWI，CFS和FM的女性有全身性痛觉过敏。压痛的体征可补充堪萨斯州标准的症状，作为GWI女性的诊断标准，并有助于CFS的诊断。全身性痛觉过敏的分子机制可以为这些伤害性，感受性和疲劳性疾病的神经病理学和治疗方法提供新的见解。压痛的体征可补充堪萨斯州标准的症状，作为GWI女性的诊断标准，并有助于CFS的诊断。全身性痛觉过敏的分子机制可能为这些伤害性，感受性和疲劳性疾病的神经病理学和治疗方法提供新的见解。压痛的体征可补充堪萨斯州标准的症状，作为GWI女性的诊断标准，并有助于CFS的诊断。全身性痛觉过敏的分子机制可以为这些伤害性，感受性和疲劳性疾病的神经病理学和治疗方法提供新的见解。