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Ma J, Zhang T, Li X, Chen X, Zhao Q. Effects of aquatic physical therapy on clinical symptoms, physical function, and quality of life in patients with fibromyalgia: A systematic review and meta-analysis. Physiother Theory Pract 2024; 40:205-223. [PMID: 36062580 DOI: 10.1080/09593985.2022.2119906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/23/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The main feature of fibromyalgia syndrome is extensive musculoskeletal pain and tenderness. It not only has a significant impact on patients but also brings a huge burden to families and society. Exercise is considered to be the most important part of the fibromyalgia treatment, and aquatic physical therapy can be considered one of the most recommended interventions. Therefore, the effects of aquatic physical therapy on fibromyalgia patients were discussed in this article. OBJECTIVE The purpose of this study was to evaluate the effects of aquatic physical therapy on clinical symptoms, physical function, and quality of life in patients with fibromyalgia. METHODS Eight databases were retrieved. "Fibromyalgia," "Aquatic Therapy," "Aquatic Exercise," and "Hydrotherapy" was used for retrieval. Randomized controlled trials of the effects of aquatic physical therapy on patients with fibromyalgia were included. The Cochrane risk of bias tool to assess research quality. Meta-analysis was performed by Revman version 5.3. RESULTS Finally, 14 articles (762 patients) were included in the analysis. Compared with other exercises or no exercise, aquatic physical therapy has more significant effects. There were significant differences in visual analogue scale (MD: - 0.98, 95%CI: - 1.36 to - 0.60, Z = 5.03, P < .00001), six minute walk test (MD: 38.12, 95%CI: 13.65 to 62.59, Z = 3.05, P = .002), fibromyalgia impact questionnaire total scores(MD: - 7.35, 95%CI: - 13.05 to - 1.65, Z = 2.53, P = .01), vitality of short form 36 (MD: 9.53, 95%CI: 0.62 to 18.43, Z = 2.10, P = .04) and general health of short form 36 (MD: 10.39, 95%CI: 1.42 to 19.36, Z = 2.27, P = .02). CONCLUSIONS Aquatic physical therapy may have some benefits on the clinical symptoms, physical function, and quality of life of patients with fibromyalgia.
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Affiliation(s)
- Ji Ma
- Orthopaedic Spinal Ward, Shanxi Provincial People's Hospital, Taiyuan, P.R. China
| | - Teng Zhang
- School of Nursing, Shanxi Medical University, Taiyuan, P.R. China
| | - Xin Li
- School of Nursing, Shanxi Medical University, Taiyuan, P.R. China
| | - Xiaoyu Chen
- School of Nursing, Shanxi University of Traditional Chinese Medicine, Jinzhong, P.R. China
| | - Qian Zhao
- Department of Nursing, Shanxi Provincial People's Hospital, Taiyuan, P.R.China
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Ketenci S, Uzuner B, Durmuş D, Polat M. Frequency of idiopathic intracranial hypertension with ultrasound in patients with fibromyalgia: Relation with function, central sensitization, and neuropathic pain. Int J Rheum Dis 2024; 27:e15066. [PMID: 38334253 DOI: 10.1111/1756-185x.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The purpose of this study was to evaluate the prevalence of idiopathic intracranial hypertension (IIH) in fibromyalgia (FMS) patients by utilizing ultrasound to measure the optic nerve sheath diameter (ONSD), a marker of elevated intracranial pressure and also to investigate the relationship with function, fatigue, quality of life (QOL), central sensitization (CS) and neuropathic pain. METHODS The study encompassed 80 female FMS patients and 75 healthy controls. Ultrasound was employed to measure the average ONSD in both groups. Conditions potentially elevating intracranial pressure were ruled out following neurological assessments. Pain (via visual analog scale, VAS), function (revised Fibromyalgia Impact Questionnaire, r-FIQ), QOL (Short Form-36, SF-36), fatigue (fatigue severity scale, FACIT), CS (Central Sensitization Scale), and neuropathic pain (Douleur Neuropathique-4) were evaluated. RESULTS The average ONSD was significantly higher in the patient group than the control group. Patients with ONSD >5.5 mm consistent with IIH were categorized as Group 1 (n = 54, 67.5%), while those with a diameter of 5.5 mm and below-formed Group 2. VAS pain (p = .033) and FIQ-R scores (p = .033) were significantly higher in Group 1 than Group 2. Headache was found more common in Group 1. CONCLUSION This study unveils a substantial occurrence (67.5%) of IIH in FMS patients, suggesting shared pathophysiological mechanisms contributing to symptoms like fatigue, headache, and cognitive dysfunction. Additionally, these findings implicate heightened functional impairment, CS, headache, and fatigue in FMS patients with IIH.
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Affiliation(s)
- Sertaç Ketenci
- Department of Physical Medicine and Rehabilitation and Department of Rheumatology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Bora Uzuner
- Department of Physical Medicine and Rehabilitation and Department of Algology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Durmuş
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Murat Polat
- Department of Neurology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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D'Onghia M, Ursini F, Cinotti E, Calabrese L, Tognetti L, Cartocci A, Lazzeri L, Frediani B, Rubegni P, Trovato E. Psoriasis and Fibromyalgia: A Systematic Review. J Pers Med 2024; 14:165. [PMID: 38392598 PMCID: PMC10890434 DOI: 10.3390/jpm14020165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/21/2024] [Accepted: 01/28/2024] [Indexed: 02/24/2024] Open
Abstract
Psoriasis is a chronic inflammatory cutaneous condition characterized by several comorbidities, including musculoskeletal disorders. While the association with psoriatic arthritis has been widely addressed in literature, the aim of the present systematic review was to identify all available evidence on the relationship between psoriasis and fibromyalgia, a musculoskeletal syndrome primarily characterized by chronic widespread pain. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and MedLine and Web of Science (WOS) databases were searched for literature up to March 2023. After the removal of duplicate records, a total of 11 articles were deemed eligible for inclusion in a qualitative synthesis. Our results suggested that psoriatic patients had a higher prevalence of fibromyalgia (8-30%), with a very high impact on symptoms of psoriasis. Moreover, fibromyalgic patients had a slightly increased prevalence of psoriasis (2.2-6.7%) compared to the control groups. Finally, several studies demonstrated the substantial impact of fibromyalgia on psoriatic outcome measures in patients with concomitant psoriatic arthritis. In conclusion, available data support a potential interplay between psoriasis and fibromyalgia, but further research is encouraged in this area.
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Affiliation(s)
- Martina D'Onghia
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Francesco Ursini
- Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Laura Calabrese
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Alessandra Cartocci
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Laura Lazzeri
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Emanuele Trovato
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
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Wang S, Du SH, Wang XQ, Lu JY. Mechanisms of transcranial direct current stimulation (tDCS) for pain in patients with fibromyalgia syndrome. Front Mol Neurosci 2024; 17:1269636. [PMID: 38356687 PMCID: PMC10865494 DOI: 10.3389/fnmol.2024.1269636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Fibromyalgia syndrome (FMS) is a recurrent pain condition that can be challenging to treat. Transcranial direct current stimulation (tDCS) has become a promising non-invasive therapeutic option in alleviating FMS pain, but the mechanisms underlying its effectiveness are not yet fully understood. In this article, we discuss the most current research investigating the analgesic effects of tDCS on FMS and discuss the potential mechanisms. TDCS may exert its analgesic effects by influencing neuronal activity in the brain, altering cortical excitability, changing regional cerebral blood flow, modulating neurotransmission and neuroinflammation, and inducing neuroplasticity. Overall, evidence points to tDCS as a potentially safe and efficient pain relief choice for FMS by multiple underlying mechanisms. This article provides a thorough overview of our ongoing knowledge regarding the mechanisms underlying tDCS and emphasizes the possibility of further studies to improve the clinical utility of tDCS as a pain management tool.
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Affiliation(s)
- Shan Wang
- Department of Health School, Shanghai Normal University Tianhua College, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jun-Yan Lu
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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Tobajas Y, Alemany-Fornés M, Samarra I, Romero-Giménez J, Cuñé-Castellana J, Tintoré M, del Pino A, Canela N, del Bas JM, Ortega-Olivé N, de Lecea C, Escoté X. Exploring the Relationship between Diamine Oxidase and Psychotropic Medications in Fibromyalgia Treatment, Finding No Reduction in Diamine Oxidase Levels and Activity except with Citalopram. J Clin Med 2024; 13:792. [PMID: 38337486 PMCID: PMC10856182 DOI: 10.3390/jcm13030792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Histamine intolerance manifests when there is an imbalance between the production of histamine and the body's capacity to metabolise it. Within the gastrointestinal tract, diamine oxidase (DAO) plays a pivotal role in breaking down ingested histamine. Insufficient levels of DAO have been linked to various diseases affecting the respiratory, cardiovascular, nervous, muscular, and digestive systems; some of these symptoms are evidenced in fibromyalgia syndrome. This underscores the crucial role of DAO in maintaining the histamine balance and highlights its association with diverse physiological systems and health conditions. The management of fibromyalgia commonly involves the use of psychotropic medications; however, their potential interactions with DAO remain not fully elucidated. Methods: This study delved into the influence of various psychotropic medications on DAO activity through in vitro experiments. Additionally, we explored their impact on the human intestinal cell line Caco-2, examining alterations in DAO expression at both the mRNA and protein levels along with DAO activity. Results: Notably, the examined drugs-sertraline, pregabalin, paroxetine, alprazolam, and lorazepam-did not exhibit inhibitory effects on DAO activity or lead to reductions in DAO levels. In contrast, citalopram demonstrated a decrease in DAO activity in in vitro assays without influencing DAO levels and activity in human enterocytes. Conclusions: These findings imply that a collaborative approach involving psychotropic medications and DAO enzyme supplementation for individuals with fibromyalgia and a DAO deficiency could offer potential benefits for healthcare professionals in their routine clinical practice.
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Affiliation(s)
- Yaiza Tobajas
- Eurecat, Centre Tecnològic de Catalunya, Nutrition and Health, 43204 Reus, Spain; (Y.T.); (J.R.-G.); (N.O.-O.)
| | - Marc Alemany-Fornés
- DR Healthcare-AB Biotek HNH, 43204 Reus, Spain; (M.A.-F.); (J.C.-C.); (M.T.); (C.d.L.)
| | - Iris Samarra
- Centre for Omic Sciences (COS), Joint Unit URV-Eurecat, Unique Scientific and Technical Infrastructures (ICTS), Eurecat, Centre Tecnològic de Catalunya, 43204 Reus, Spain; (I.S.); (A.d.P.); (N.C.)
| | - Jordi Romero-Giménez
- Eurecat, Centre Tecnològic de Catalunya, Nutrition and Health, 43204 Reus, Spain; (Y.T.); (J.R.-G.); (N.O.-O.)
| | - Jordi Cuñé-Castellana
- DR Healthcare-AB Biotek HNH, 43204 Reus, Spain; (M.A.-F.); (J.C.-C.); (M.T.); (C.d.L.)
| | - Maria Tintoré
- DR Healthcare-AB Biotek HNH, 43204 Reus, Spain; (M.A.-F.); (J.C.-C.); (M.T.); (C.d.L.)
| | - Antoni del Pino
- Centre for Omic Sciences (COS), Joint Unit URV-Eurecat, Unique Scientific and Technical Infrastructures (ICTS), Eurecat, Centre Tecnològic de Catalunya, 43204 Reus, Spain; (I.S.); (A.d.P.); (N.C.)
| | - Núria Canela
- Centre for Omic Sciences (COS), Joint Unit URV-Eurecat, Unique Scientific and Technical Infrastructures (ICTS), Eurecat, Centre Tecnològic de Catalunya, 43204 Reus, Spain; (I.S.); (A.d.P.); (N.C.)
| | - Josep M. del Bas
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, 43204 Reus, Spain;
| | - Nàdia Ortega-Olivé
- Eurecat, Centre Tecnològic de Catalunya, Nutrition and Health, 43204 Reus, Spain; (Y.T.); (J.R.-G.); (N.O.-O.)
| | - Carlos de Lecea
- DR Healthcare-AB Biotek HNH, 43204 Reus, Spain; (M.A.-F.); (J.C.-C.); (M.T.); (C.d.L.)
| | - Xavier Escoté
- Eurecat, Centre Tecnològic de Catalunya, Nutrition and Health, 43204 Reus, Spain; (Y.T.); (J.R.-G.); (N.O.-O.)
- Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Campus Sescelades, 43007 Tarragona, Spain
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Bongiorno G, Tomasi A, Vigni G, Rizzardo A, Biancuzzi H, Dal Mas F, Bednarova R, Miceli L. Case report: Movement analysis in oncological rehabilitation: proposal of a kinematic and surface electromyographic protocol in breast oncology. Front Hum Neurosci 2024; 17:1272027. [PMID: 38328676 PMCID: PMC10848327 DOI: 10.3389/fnhum.2023.1272027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction Breast cancer disease often affects the ipsilateral shoulder joint, with pain and joint limitation. Proper pain management, which can be obtained using, for example, pulsed radiofrequency of the suprascapular nerve, can help the physiotherapist mitigate patient pain. The modern technologies of kinematic analysis and surface electromyography of movement analysis can give further support in building a personalized rehabilitation program, based on the quantitative study of movement, in this case of the upper limb. Methods A brief case report was conceived to develop and test the evolution of a shoulder joint analysis protocol based on an inertial accelerometer and non-invasive surface electromyography. Results An analysis algorithm was defined to adapt to the needs of patients operated on at the breast based on a kinematic component (ROM - range of movement - and Jerk index) and an electromyographic one (study of muscle behavior in groups of four). The coactivations were also evaluated, both as an average value and in graphical form, to offer the physiotherapist a complete overview of the movement of the upper limb. Discussion The promising protocol results underline its strengths, including the simplicity of use, combined with the reduced time required for processing the reports and the portability of the PC-sensors complex, making these analyses potentially valuable for patient care.
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Affiliation(s)
- Giulia Bongiorno
- Friuli Riabilitazione Rehabilitation Center, Roveredo in Piano (PN), Italy
| | | | - Giulio Vigni
- Papa Giovanni XXIII Hospital, Monastier (TV), Italy
| | | | - Helena Biancuzzi
- Department of Economics, Ca Foscari University of Venice, Venice, Italy
| | - Francesca Dal Mas
- Department of Management, Ca Foscari University of Venice, Venice, Italy
- Collegium Medicum University of Social Sciences, Łódź, Poland
| | - Rym Bednarova
- Pain Medicine, Hospital of Latisana (UD), Latisana, Italy
| | - Luca Miceli
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
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Ye G, Miao R, Chen J, Huang J, Jiang M. Effectiveness of Complementary and Alternative Medicine in Fibromyalgia Syndrome: A Network Meta-Analysis. J Pain Res 2024; 17:305-319. [PMID: 38268732 PMCID: PMC10807275 DOI: 10.2147/jpr.s439906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
Objective Fibromyalgia (FM) is a prevalent chronic disorder characterized by widespread skeletal muscle pain. In recent years, complementary and alternative medicine (CAM) has increasingly been recognized for its potential in treating FM symptoms. This study aims to assess the efficacy of CAM therapies in mitigating the symptoms of FM. Methods This systematic review was registered with INPLASY. A thorough search of both English and Chinese databases was undertaken from their inception until April 15, 2023. The search criteria focused on prospective controlled trials examining CAM therapies in FM patients. The statistical analysis employed mean values and standard deviations. Additionally, an evaluation of the literature's quality and potential biases was conducted. Results The search yielded 41 articles, encompassing 2877 FM patients and involving 20 different interventions. All studies were randomized controlled trials (RCTs). The results of the network meta-analysis (NMA) indicated that a combination of Acupuncture and Massage therapy, as well as Navel Needling therapy, effectively alleviated pain symptoms in FM patients. Furthermore, Abdominal Acupuncture and Electroacupuncture were found to be beneficial in improving patients' mood and sleep quality. Conclusion Acupuncture + Massage and Umbilical Acupuncture emerged as the most efficacious therapies in relieving pain symptoms in FM patients. Abdominal Acupuncture and Electroacupuncture demonstrated their effectiveness in enhancing mood and sleep quality. Overall, CAM therapies exhibited a high safety profile for patients with fibromyalgia.
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Affiliation(s)
- Guancheng Ye
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Ruiheng Miao
- Department of TCM, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jiaqi Chen
- Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine, Beijing, People’s Republic of China
| | - Jian Huang
- Department of Acupuncture, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Min Jiang
- Department of TCM, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China
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Tenti M, Raffaeli W, Paroli M, Gamberi G, Vincis R, Suzzi B, Fagnani C, Camoni L, Toccaceli V. An Italian Survey and Focus Groups on Fibromyalgia Impairment: Impact on Work and Possible Reasonable Accommodations. Healthcare (Basel) 2024; 12:216. [PMID: 38255103 PMCID: PMC10815387 DOI: 10.3390/healthcare12020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Fibromyalgia symptoms affect the sufferers' working life; however, through reasonable accommodations in workplaces, they can continue to work satisfactorily. There are no Italian studies on factors that facilitate or hinder fibromyalgia-affected people's working life. Our objective was to explore, in a pre-pandemic setting, the quality of working life of fibromyalgia sufferers and reasonable accommodations to improve it. Quantitative and qualitative methods were applied; a survey-questionnaire, participatory-developed, was online-administered to a sample of self-reported FM sufferers (N = 1176). Then, two Focus Groups (FGs), involving 15 fibromyalgia-affected women, were held. Data were analyzed by a thematic analysis approach. Among survey-respondents, 20% were unemployed and only 14% went to work gladly. Variability of pain (84%) and fatigue (90%) were the most perceived reasons for difficulties at work. Negative relationships at work were reported by most participants. The FGs' discussions addressed different strategies for overcoming the main obstacle of "not being believed by colleagues and employers" and reasonable accommodations. However, a negative hopeless attitude towards the solution of problems at work was also apparent. Different critical issues in the workplace emerged from the survey and the FGs. Coordinated actions, according to a transdisciplinary approach, are needed to manage fibromyalgia-induced difficulties in the workplace.
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Affiliation(s)
- Michael Tenti
- ISAL Foundation, Institute for Research on Pain, 47921 Rimini, Italy;
| | - William Raffaeli
- ISAL Foundation, Institute for Research on Pain, 47921 Rimini, Italy;
| | - Mery Paroli
- Anesthesiology and Pain Therapy Unit, Santa Chiara University Hospital, 56126 Pisa, Italy;
| | | | - Riccardo Vincis
- ASPHI Foundation Onlus, 40126 Bologna, Italy; (G.G.); (R.V.)
| | - Barbara Suzzi
- Comitato Fibromialgici Uniti (CFU) Odv, 40055 Castenaso (Bologna), Italy;
| | - Corrado Fagnani
- Centre of Reference for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), 00161 Rome, Italy; (C.F.); (L.C.); (V.T.)
| | - Laura Camoni
- Centre of Reference for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), 00161 Rome, Italy; (C.F.); (L.C.); (V.T.)
| | - Virgilia Toccaceli
- Centre of Reference for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), 00161 Rome, Italy; (C.F.); (L.C.); (V.T.)
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Nuguri SM, Hackshaw KV, de Lamo Castellvi S, Bao H, Yao S, Aziz R, Selinger S, Mikulik Z, Yu L, Osuna-Diaz MM, Sebastian KR, Giusti MM, Rodriguez-Saona L. Portable Mid-Infrared Spectroscopy Combined with Chemometrics to Diagnose Fibromyalgia and Other Rheumatologic Syndromes Using Rapid Volumetric Absorptive Microsampling. Molecules 2024; 29:413. [PMID: 38257325 PMCID: PMC10821365 DOI: 10.3390/molecules29020413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
The diagnostic criteria for fibromyalgia (FM) have relied heavily on subjective reports of experienced symptoms coupled with examination-based evidence of diffuse tenderness due to the lack of reliable biomarkers. Rheumatic disorders that are common causes of chronic pain such as rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, and chronic low back pain are frequently found to be comorbid with FM. As a result, this can make the diagnosis of FM more challenging. We aim to develop a reliable classification algorithm using unique spectral profiles of portable FT-MIR that can be used as a real-time point-of-care device for the screening of FM. A novel volumetric absorptive microsampling (VAMS) technique ensured sample volume accuracies and minimized the variation introduced due to hematocrit-based bias. Blood samples from 337 subjects with different disorders (179 FM, 158 non-FM) collected with VAMS were analyzed. A semi-permeable membrane filtration approach was used to extract the blood samples, and spectral data were collected using a portable FT-MIR spectrometer. The OPLS-DA algorithm enabled the classification of the spectra into their corresponding classes with 84% accuracy, 83% sensitivity, and 85% specificity. The OPLS-DA regression plot indicated that spectral regions associated with amide bands and amino acids were responsible for discrimination patterns and can be potentially used as spectral biomarkers to differentiate FM and other rheumatic diseases.
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Affiliation(s)
- Shreya Madhav Nuguri
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (S.M.N.); (S.d.L.C.); (H.B.); (M.M.G.); (L.R.-S.)
| | - Kevin V. Hackshaw
- Department of Internal Medicine, Division of Rheumatology, Dell Medical School, The University of Texas, 1601 Trinity St., Austin, TX 78712, USA
| | - Silvia de Lamo Castellvi
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (S.M.N.); (S.d.L.C.); (H.B.); (M.M.G.); (L.R.-S.)
- Campus Sescelades, Departament d’Enginyeria Química, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain
| | - Haona Bao
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (S.M.N.); (S.d.L.C.); (H.B.); (M.M.G.); (L.R.-S.)
| | - Siyu Yao
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210019, China;
| | - Rija Aziz
- Department of Internal Medicine, Dell Medical School, The University of Texas, 1601 Trinity St., Austin, TX 78712, USA; (R.A.); (S.S.); (M.M.O.-D.); (K.R.S.)
| | - Scott Selinger
- Department of Internal Medicine, Dell Medical School, The University of Texas, 1601 Trinity St., Austin, TX 78712, USA; (R.A.); (S.S.); (M.M.O.-D.); (K.R.S.)
| | - Zhanna Mikulik
- Department of Internal Medicine, Division of Immunology and Rheumatology, The Ohio State University, 480 Medical Center Dr, Columbus, OH 43210, USA;
| | - Lianbo Yu
- Center of Biostatistics and Bioinformatics, The Ohio State University, Columbus, OH 43210, USA;
| | - Michelle M. Osuna-Diaz
- Department of Internal Medicine, Dell Medical School, The University of Texas, 1601 Trinity St., Austin, TX 78712, USA; (R.A.); (S.S.); (M.M.O.-D.); (K.R.S.)
| | - Katherine R. Sebastian
- Department of Internal Medicine, Dell Medical School, The University of Texas, 1601 Trinity St., Austin, TX 78712, USA; (R.A.); (S.S.); (M.M.O.-D.); (K.R.S.)
| | - M. Monica Giusti
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (S.M.N.); (S.d.L.C.); (H.B.); (M.M.G.); (L.R.-S.)
| | - Luis Rodriguez-Saona
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (S.M.N.); (S.d.L.C.); (H.B.); (M.M.G.); (L.R.-S.)
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Casas-Barragán A, Muñoz-Revilla A, Tapia-Haro RM, Molina F, Correa-Rodríguez M, Aguilar-Ferrándiz ME. Vasodilatory Peripheral Response and Pain Levels following Radiofrequency Stressor Application in Women with Fibromyalgia. Biomedicines 2024; 12:142. [PMID: 38255247 PMCID: PMC10813501 DOI: 10.3390/biomedicines12010142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Fibromyalgia (FM) is a syndrome of unknown pathogenesis that presents, among other symptoms, chronic widespread musculoskeletal pain. This study aims to analyze the effects of radiofrequency on core body temperature and the peripheral temperature of the dorsal surfaces and palms of the hands and its association with pain levels in patients with FM. A case-control observational study was conducted with a total of twenty-nine women diagnosed with FM and seventeen healthy women. Capacitive monopolar radiofrequency was applied to the palms of the hands using the Biotronic Advance Develops device. Peripheral hand temperature was analyzed using a thermographic camera, and core body temperature was analyzed with an infrared scanner. Pressure pain thresholds (PPTs) and electrical pain were recorded with an algometer and a Pain Matcher device, respectively. A significant decrease was observed in women with FM in pain electrical threshold (95% CI [0.01-3.56], p = 0.049), electrical pain (95% CI [2.87-10.43], p = 0.002), dominant supraspinatus PPT (95% CI [0.04-0.52], p = 0.023), non-dominant supraspinatus PPT (95% CI [0.03-0.60], p = 0.029), and non-dominant tibial PPT (95% CI [0.05-0.89], p = 0.031). Women with FM have increased hypersensitivity to pain as well as increased peripheral temperature after exposure to a thermal stimulus, such as radiofrequency, which could indicate disorders of their neurovascular response.
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Affiliation(s)
- Antonio Casas-Barragán
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (A.C.-B.); (R.M.T.-H.); (F.M.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Alba Muñoz-Revilla
- Biomedicine Program, Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18071 Granada, Spain;
| | - Rosa María Tapia-Haro
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (A.C.-B.); (R.M.T.-H.); (F.M.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Francisco Molina
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (A.C.-B.); (R.M.T.-H.); (F.M.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Ave. de la Ilustración, 60, 18016 Granada, Spain
| | - María Encarnación Aguilar-Ferrándiz
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (A.C.-B.); (R.M.T.-H.); (F.M.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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de Souza VS, Medeiros LF, Stein DJ, de Oliveira CL, Medeiros HR, Dussan-Sarria JA, Caumo W, de Souza A, Torres ILS. Transcranial direct current stimulation is more effective than pregabalin in controlling nociceptive and anxiety-like behaviors in a rat fibromyalgia-like model. Scand J Pain 2024; 24:sjpain-2023-0038. [PMID: 38557595 DOI: 10.1515/sjpain-2023-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Despite the fact that fibromyalgia, a widespread disease of the musculoskeletal system, has no specific treatment, patients have shown improvement after pharmacological intervention. Pregabalin has demonstrated efficacy; however, its adverse effects may reduce treatment adherence. In this context, neuromodulatory techniques such as transcranial direct current stimulation (tDCS) may be employed as a complementary pain-relieving method. Consequently, the purpose of this study was to evaluate the effect of pregabalin and tDCS treatments on the behavioral and biomarker parameters of rats submitted to a fibromyalgia-like model. METHODS Forty adult male Wistar rats were divided into two groups: control and reserpine. Five days after the end of the administration of reserpine (1 mg/kg/3 days) to induce a fibromyalgia-like model, rats were randomly assigned to receive either vehicle or pregabalin (30 mg/kg) along with sham or active- tDCS treatments. The evaluated behavioral parameters included mechanical allodynia by von Frey test and anxiety-like behaviors by elevated plus-maze test (time spent in opened and closed arms, number of entries in opened and closed arms, protected head-dipping, unprotected head-dipping [NPHD], grooming, rearing, fecal boluses). The biomarker analysis (brain-derived neurotrophic factor [BDNF] and tumor necrosis factor-α [TNF-α]) was performed in brainstem and cerebral cortex and in serum. RESULTS tDCS reversed the reduction in the mechanical nociceptive threshold and the decrease in the serum BDNF levels induced by the model of fibromyalgia; however, there was no effect of pregabalin in the mechanical threshold. There were no effects of pregabalin or tDCS found in TNF-α levels. The pain model induced an increase in grooming time and a decrease in NPHD and rearing; while tDCS reversed the increase in grooming, pregabalin reversed the decrease in NPHD. CONCLUSIONS tDCS was more effective than pregabalin in controlling nociception and anxiety-like behavior in a rat model-like fibromyalgia. Considering the translational aspect, our findings suggest that tDCS could be a potential non-pharmacological treatment for fibromyalgia.
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Affiliation(s)
- Vanessa Silva de Souza
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Liciane Fernandes Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Universidade La Salle, Canoas, RS, 92010-000, Brazil
- Post graduate program in Biological Sciences: Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Dirson João Stein
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Post graduate Program in Medicine: Medical Science, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Camila Lino de Oliveira
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Helouise Richardt Medeiros
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Post graduate Program in Medicine: Medical Science, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | | | - Wolnei Caumo
- Post graduate Program in Medicine: Medical Science, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Andressa de Souza
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Iraci L S Torres
- Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Pain Pharmacology and Neuromodulation: Preclinical Investigations - Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
- Department of Pharmacology, Universidade Federal Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
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Tural Balsak BÖ, Faki S, Polat ŞB, Orhan K, Koparal SS, Keskin M, Topaloğlu O, Ersoy R, Çakir B. Insulin Resistance in Patients with Polycystic Ovary Syndrome is a Predictor of Fibromyalgia. Reprod Sci 2024; 31:239-247. [PMID: 37715066 DOI: 10.1007/s43032-023-01347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/30/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE This study aims to investigate the frequency of fibromyalgia and its predictors in women with polycystic ovary syndrome (PCOS) and its relationship with insulin resistance, and to assess the effect of fibromyalgia on the anxiety and depressive symptoms in PCOS patients, and how the quality of life was affected by this combination. MEASUREMENTS The study was conducted with 74 women with PCOS according to the Rotterdam criteria, which applied to our tertiary care clinic between January 2021 and January 2022, and 51 controls. Endocrinologic and rheumatologic examinations, biochemical and hormonal analyses, and radiologic imaging are made. Hospital anxiety and depression scale (HADs) and Short Form 36 (SF-36) quality of life scale were applied. RESULTS There was no statistical difference between patients (n = 74 (23%)) and controls (n = 51 (13.7%)) in terms of fibromyalgia frequency. This frequency was 41.4% in PCOS patients with insulin resistance. The presence of insulin resistance was significantly higher in patients with PCOS and fibromyalgia (70.4%, 12 of 17 patients with fibromyalgia for the PCOS group; 8.3%, 1 of 7 patients with fibromyalgia for the control group) (χ2 = 9.130, p=0.003). Higher HOMA-IR levels (B = 1.278, p = 0.034) and age (B = 1.134, p = 0.022) were significant predictors of fibromyalgia in PCOS patients. Physical functioning (U = 1.960, P = 0.050), bodily pain subscales (U = 2.765, p = 0.006), and physical health summary measure (U = 2.296, p = 0.022) were significantly lower, VAS pain (U = 5.145, p < 0.0001) and fatigue (U = 5.997, p < 0.0001) scale scores were higher in PCOS patients with fibromyalgia. CONCLUSIONS Our results show that fibromyalgia is frequent in PCOS patients with insulin resistance.
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Affiliation(s)
| | - Sevgül Faki
- Department of Endocrinology, Ankara City Hospital, Ankara, 06000, Turkey
| | - Şefika Burçak Polat
- Faculty of Medicine, Department of Endocrinology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Kevser Orhan
- Department of Rheumatology, Ankara City Hospital, Ankara, 06000, Turkey
| | | | - Müge Keskin
- Department of Endocrinology, Ankara City Hospital, Ankara, 06000, Turkey
| | - Oya Topaloğlu
- Faculty of Medicine, Department of Endocrinology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Reyhan Ersoy
- Faculty of Medicine, Department of Endocrinology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bekir Çakir
- Faculty of Medicine, Department of Endocrinology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Kerzhner O, Berla E, Har-Even M, Ratmansky M, Goor-Aryeh I. Consistency of inconsistency in long-COVID-19 pain symptoms persistency: A systematic review and meta-analysis. Pain Pract 2024; 24:120-159. [PMID: 37475709 DOI: 10.1111/papr.13277] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/29/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Individuals recovering from acute COVID-19 episodes may continue to suffer from various ongoing symptoms, collectively referred to as Long-COVID. Long-term pain symptoms are amongst the most common and clinically significant symptoms to be reported for this post-COVID-19 syndrome. OBJECTIVES This systematic review and meta-analysis aimed to evaluate the proportions of persisting pain symptoms experienced by individuals past the acute phase of COVID-19 and to identify their associated functional consequences and inflammatory correlates. METHODS Two online databases were systematically searched from their inception until 31 March 2022. We searched primary research articles in English, which evaluated individuals after laboratory-confirmed COVID-19 acute phase resolution and specifically reported on pain symptoms and their inflammatory and/or functional outcomes. RESULTS Of the 611 identified articles, 26 were included, used for data extraction, and assessed for their methodological quality and risk of bias by two independent reviewers. Pain symptoms were grouped under one of six major pain domains, serving as our primary co-outcomes. Proportional meta-analyses of pooled logit-transformed values of single proportions were performed using the random-effects-restricted maximum-likelihood model. An estimated 8%, 6%, 18%, 18%, 17%, and 12% of individuals continued to report the persistence of chest, gastrointestinal, musculoskeletal joint, musculoskeletal muscle, general body, and nervous system-related pain symptoms, respectively, for up to one year after acute phase resolution of COVID-19. Considerable levels of heterogeneity were demonstrated across all results. Functional and quality-of-life impairments and some inflammatory biomarker elevations were associated with the persistence of long-COVID pain symptoms. CONCLUSION This study's findings suggest that although not well characterized, long-COVID pain symptoms are being experienced by non-negligible proportions of those recovering from acute COVID-19 episodes, thus highlighting the importance of future research efforts to focus on this aspect.
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Affiliation(s)
- Oleg Kerzhner
- Loewenstein Rehabilitation Medical Center, Ra'anana, Israel
| | - Einat Berla
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Meirav Har-Even
- Department of Anatomy and Anthropology, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Motti Ratmansky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pain Clinic, Sheba Medical Center, Ramat Gan, Israel
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Rus A, López-Sánchez JA, Martínez-Martos JM, Ramírez-Expósito MJ, Molina F, Correa-Rodríguez M, Aguilar-Ferrándiz ME. Predictive Ability of Serum Amino Acid Levels to Differentiate Fibromyalgia Patients from Healthy Subjects. Mol Diagn Ther 2024; 28:113-128. [PMID: 37843759 DOI: 10.1007/s40291-023-00677-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Fibromyalgia is a complex illness to diagnose and treat. OBJECTIVES To evaluate a broad range of circulating free amino acid (AA) levels in fibromyalgia patients as well as the ability of the AAs to differentiate fibromyalgia patients from healthy subjects. DESIGN We carried out a case-control study to evaluate AA levels in 62 patients with fibromyalgia and 78 healthy subjects. This study adheres to the STROBE guidelines. METHODS AAs content was assayed by HPLC in serum samples. The predictive value of AA levels in fibromyalgia was determined by receiver operating characteristic (ROC) curve and forward binary logistic regression analyses. RESULTS Fibromyalgia patients showed higher serum levels of aspartic acid, glutamic acid, aminoadipic acid, asparagine, histidine, 3-methyl-histidine, 5-methyl-histidine, glycine, threonine, taurine, tyrosine, valine, methionine, isoleucine, phenylalanine, leucine, ornithine, lysine, branched chain AAs (BCAAs), large neutral AAs, essential AAs (EAAs), non-essential AAs (NEAAs), basic AAs, EAAs/NEAAs ratio, phenylalanine/tyrosine ratio, and global arginine bioavailability ratio than the controls. Serum alanine levels were lower in patients than in controls. According to ROC analysis, most of these AAs may be good markers for differentiating individuals with fibromyalgia from healthy subjects. Results of logistic regression showed that the combination of glutamic acid, histidine, and alanine had the greatest predictive ability to diagnose fibromyalgia. CONCLUSIONS Our results show an imbalance in serum levels of most AAs in patients with fibromyalgia, which suggest a metabolic disturbance. The determination of serum levels of these AAs may aid in the diagnosis of fibromyalgia, in combination with clinical data of the patient.
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Affiliation(s)
- Alma Rus
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
| | - José Alberto López-Sánchez
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
| | | | | | - Francisco Molina
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain.
| | - María Encarnación Aguilar-Ferrándiz
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
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Jonsson K, Pikwer A, Olsson EMG, Peterson M. Hypocapnia in women with fibromyalgia. Scand J Pain 2024; 24:sjpain-2024-0003. [PMID: 38907689 DOI: 10.1515/sjpain-2024-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/27/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVES The purpose of this study was to investigate whether people with fibromyalgia (FM) have dysfunctional breathing by examining acid-base balance and comparing it with healthy controls. METHODS Thirty-six women diagnosed with FM and 36 healthy controls matched for age and gender participated in this cross-sectional study. To evaluate acid-base balance, arterial blood was sampled from the radial artery. Carbon dioxide, oxygen, bicarbonate, base excess, pH and lactate were analysed for between-group differences. Blood gas analyses were performed stepwise on each individual to detect acid-base disturbance, which was categorized as primary respiratory and possible compensation indicating chronicity. A three-step approach was employed to evaluate pH, carbon dioxide and bicarbonate in this order. RESULTS Women with FM had significantly lower carbon dioxide pressure (p = 0.013) and higher lactate (p = 0.038) compared to healthy controls at the group level. There were no significant differences in oxygen pressure, bicarbonate, pH and base excess. Employing a three-step acid-base analysis, 11 individuals in the FM group had a possible renally compensated mild chronic hyperventilation, compared to only 4 among the healthy controls (p = 0.042). CONCLUSIONS In this study, we could identify a subgroup of individuals with FM who may be characterized as mild chronic hyperventilators. The results might point to a plausible dysfunctional breathing in some women with FM.
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Affiliation(s)
- Kent Jonsson
- Department of Rehabilitation Medicine, Nykoping Hospital, Nykoping, Sweden
- Department of Public Health and Caring Sciences, Section of Family Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
| | - Andreas Pikwer
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
- Department of Anesthesia, Eskilstuna County Hospital, Eskilstuna, Sweden
| | - Erik M G Olsson
- Department of Women's and Children's Health, Healthcare Science and e-health, Uppsala University, Uppsala, Sweden
| | - Magnus Peterson
- Department of Public Health and Caring Sciences, Section of Family Medicine, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
- Academic Primary Health Care, Region Uppsala, Uppsala, Sweden
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Metyas C, Aung TT, Cheung J, Joseph M, Ballester AM, Metyas S. Diet and Lifestyle Modifications for Fibromyalgia. Curr Rheumatol Rev 2024; 20:405-413. [PMID: 38279728 PMCID: PMC11107431 DOI: 10.2174/0115733971274700231226075717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 01/28/2024]
Abstract
Fibromyalgia (FM) is a complex, widespread pain disorder characterized by symptoms such as fatigue, sleep deprivation, mental fog, mood swings, and headaches. Currently, there are only three FDA-approved medications for FM patients: duloxetine, milnacipran, and pregabalin, with outcomes frequently being inadequate. This research team aims to investigate the effects of diet and lifestyle modifications on FM, with emphasis on anti-inflammatory diet, antioxidants, and gluten-free diets, as well as supplementation with Magnesium, CQ10, and Vitamin D, microbiome, sleep, exercise, and cognitive behavioral therapy. We reviewed the pathophysiology of certain foods that can be proinflammatory with the release of cytokines leading to activation of pain, fatigue and aggravation of the majority of Fibromyalgia symptoms. A literature review was performed by identifying FM articles published between 1994 and 2022 via PubMed and EMBASE databases, with particular emphasis on randomized controlled trials, meta-analysis, and evidence-based treatment guidelines. This review article was completed by a comprehensive narrative review process, in which our team systematically examined relevant scientific literature to provide a comprehensive overview of the significant role that diet and other lifestyle modifications play in mediating symptoms of Fibromyalgia. We propose that diet modifications and lifestyle changes, such as sleep, exercise, and weight loss, can be important steps in managing FM.
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Affiliation(s)
- Caroline Metyas
- Department of Rheumatology, Covina Arthritis Clinic, 500 West San Bernadino Rd, Suite A, United States
| | - Tun Tun Aung
- Department of Rheumatology, Covina Arthritis Clinic, 500 West San Bernadino Rd, Suite A, United States
| | - Jennifer Cheung
- Department of Rheumatology, Covina Arthritis Clinic, 500 West San Bernadino Rd, Suite A, United States
| | - Marina Joseph
- Department of Rheumatology, Covina Arthritis Clinic, 500 West San Bernadino Rd, Suite A, United States
| | - Andrew M Ballester
- Department of Rheumatology, Covina Arthritis Clinic, 500 West San Bernadino Rd, Suite A, United States
| | - Samy Metyas
- Department of Rheumatology, Covina Arthritis Clinic, 500 West San Bernadino Rd, Suite A, United States
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Yilmaz E. Secondary fibromyalgia: An entity to be remembered-A case series with axial spondyloarthritis. Mod Rheumatol Case Rep 2023; 8:26-32. [PMID: 37249440 DOI: 10.1093/mrcr/rxad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/12/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2023]
Abstract
Fibromyalgia (FM) is a clinical syndrome characterised by chronic widespread musculoskeletal pain, stiffness, and tenderness in addition to a variety of physical and mental symptoms such as fatigue, sleep disturbances, depression, anxiety, cognitive dysfunction, headaches, and digestive problems. FM can be associated with or coexist with other inflammatory rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, and spondyloarthritis. This phenomenon is called secondary FM. Although FM cannot be considered an autoimmune disease, it may in some cases be an early sign of an autoimmune disease. Therefore, clinicians should be cautious in these situations. This case series presents three patients diagnosed with axial spondyloarthritis coexisted with FM symptoms.
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Affiliation(s)
- Ebru Yilmaz
- Department of Physical Medicine and Rehabilitation, Bezmialem Vakıf University, İstanbul, Turkey
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68
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Behnoush AH, Khalaji A, Khanmohammadi S, Alehossein P, Saeedian B, Shobeiri P, Teixeira AL, Rezaei N. Brain-derived neurotrophic factor in fibromyalgia: A systematic review and meta-analysis of its role as a potential biomarker. PLoS One 2023; 18:e0296103. [PMID: 38127937 PMCID: PMC10734974 DOI: 10.1371/journal.pone.0296103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a form of chronic pain disorder accompanied by several tender points, fatigue, sleeping and mood disturbances, cognitive dysfunction, and memory problems. Brain-derived neurotrophic factor (BDNF) is also a mediator of neurotrophin for many activity-dependent processes in the brain. Despite numerous research studies investigating BDNF in FM, contradictory results have been reported. Thus, we investigated the overall effect shown by studies to find the association between peripheral BDNF concentrations and its gene polymorphisms with FM. METHODS A systematic search in online international databases, including PubMed, Cochrane Library, Embase, the Web of Science, and Scopus was performed. Relevant studies assessing BDNF levels or gene polymorphism in patients with FM and comparing them with controls were included. Case reports, reviews, and non-English studies were excluded. We conducted the random-effect meta-analysis to estimate the pooled standardized mean difference (SMD) or odds ratio (OR) and 95% confidence interval (CI). RESULTS Twenty studies were found to be included composed of 1,206 FM patients and 1,027 controls. The meta-analysis of 15 studies indicated that the circulating BDNF levels were significantly higher in FM (SMD 0.72, 95% CI 0.12 to 1.31; p-value = 0.02). However, no difference between the rate of Val/Met carrier status at the rs6265 site was found (p-value = 0.43). Using meta-regression, the sample size and age variables accounted for 4.69% and 6.90% of the observed heterogeneity of BDNF level analysis, respectively. CONCLUSION Our meta-analysis demonstrated that FM is correlated with increased peripheral BDNF levels. This biomarker's diagnostic and prognostic value should be further investigated in future studies.
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Affiliation(s)
- Amir Hossein Behnoush
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children’s Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Khalaji
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children’s Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Khanmohammadi
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children’s Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parsa Alehossein
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children’s Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Behrad Saeedian
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children’s Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children’s Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Antonio L. Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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69
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Lei X, Song X, Fan Y, Chen Z, Zhang L. The Role and Potential Mechanism of Complement Factor D in Fibromyalgia Development. J Pain Res 2023; 16:4337-4351. [PMID: 38145036 PMCID: PMC10748666 DOI: 10.2147/jpr.s439689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/04/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose Fibromyalgia (FM) is a syndrome characterized by chronic musculoskeletal pain. Its clinical symptoms include both somatic and psychiatric symptoms, making the treatment of FM extremely challenging. The cause of FM is still unknown, and some patients do not improve their symptoms even after long-term active treatment. Thus, the development of new targeted therapies is important to reduce pain and improve quality of life for FM patients. Methods In this study, we screened genes and secreted factors that play key roles in FM through bioinformatics and big data analysis. Furthermore, we performed CCK-8, qRT-PCR, glucose, ATP and lactate content testing, dual luciferase reporter gene assay to investigate the potential mechanism of complement factor D in fibromyalgia development. Results In bioinformatics and big data analysis, we identified CFD was negatively correlated with the pro-inflammatory factor IL-6 and positively correlated with the anti-inflammatory factor IL-4, which suggested that CFD may be an anti-inflammatory factor. Through cellular assays, we verified that CFD reversed the decrease in IL-4 expression and the increase in IL-6 expression in BV2 cells caused by ATP. Conclusion In summary, based on bioinformatic methods and big data mining we obtained a new target CFD for FM, and further experiments verified that CFD has significant inhibition of ATP-induced neuropathic pain. These findings provide a new theoretical basis for the clinical translation of CFD.
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Affiliation(s)
- Xinhuan Lei
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Taizhou, Zhejiang, People’s Republic of China
| | - Xiaoting Song
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Taizhou, Zhejiang, People’s Republic of China
| | - Yongyong Fan
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Taizhou, Zhejiang, People’s Republic of China
| | - Zhen Chen
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Taizhou, Zhejiang, People’s Republic of China
| | - Liwei Zhang
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Zhejiang University, Taizhou, Zhejiang, People’s Republic of China
- Bone Metabolism and Development Research Center, Taizhou Hospital of Zhejiang Province, Zhejiang University, Taizhou, Zhejiang, People’s Republic of China
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70
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Vicente-Campos D, Sánchez-Jorge S, Martí L, Buffet J, Mendoza-Laiz N, Rodriguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Chicarro JL, Calvo-Lobo C. Skin Bioimpedance Analysis to Determine Cellular Integrity by Phase Angle in Women with Fibromyalgia: A Cross-Sectional Study. Biomedicines 2023; 11:3321. [PMID: 38137542 PMCID: PMC10741687 DOI: 10.3390/biomedicines11123321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Oxidative stress has been proposed as a significant part of the pathogenesis of fibromyalgia, and the phase angle in bioelectrical impedance analysis has been explored as a potential technique to screen oxidative abnormalities. This study recruited 35 women with fibromyalgia and 35 healthy women, who underwent bioelectrical impedance analysis and maximum isometric handgrip strength tests. Women with fibromyalgia showed lower bilateral handgrip strength (right hand: 16.39 ± 5.87 vs. 27.53 ± 4.09, p < 0.001; left hand: 16.31 ± 5.51 vs. 27.61 ± 4.14, p < 0.001), as well as higher body fat mass (27.14 ± 10.21 vs. 19.94 ± 7.25, p = 0.002), body fat percentage (37.80 ± 8.32 vs. 30.63 ± 7.77, p < 0.001), and visceral fat area (136.76 ± 55.31 vs. 91.65 ± 42.04, p < 0.01) compared with healthy women. There was no statistically significant difference in muscle mass between groups, but women with fibromyalgia showed lower phase angles in all body regions when compared with healthy control women (right arm: 4.42 ± 0.51 vs. 4.97 ± 0.48, p < 0.01; left arm: 4.23 ± 0.48 vs. 4.78 ± 0.50, p < 0.001; trunk: 5.62 ± 0.77 vs. 6.78 ± 0.84, p < 0.001; right leg: 5.28 ± 0.56 vs. 5.81 ± 0.60, p < 0.001; left leg: 5.07 ± 0.51 vs. 5.69 ± 0.58, p < 0.001; whole body: 4.81 ± 0.47 vs. 5.39 ± 0.49, p < 0.001). Moreover, whole-body phase-angle reduction was only predicted by the presence of fibromyalgia (R2 = 0.264; β = 0.639; F(1,68) = 24.411; p < 0.001). Our study revealed significantly lower phase angle values, lower handgrip strength, and higher fat levels in women with fibromyalgia compared to healthy controls, which are data of clinical relevance when dealing with such patients.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Sandra Sánchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Luis Martí
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Jorge Buffet
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Nuria Mendoza-Laiz
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - J. L. Chicarro
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
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Alme TN, Andreasson A, Asprusten TT, Bakken AK, Beadsworth MBJ, Boye B, Brodal PA, Brodwall EM, Brurberg KG, Bugge I, Chalder T, Due R, Eriksen HR, Fink PK, Flottorp SA, Fors EA, Jensen BF, Fundingsrud HP, Garner P, Havdal LB, Helgeland H, Jacobsen HB, Johnson GE, Jonsjö M, Knoop H, Landmark L, Launes G, Lekander M, Linnros H, Lindsäter E, Liira H, Linnestad L, Loge JH, Lyby PS, Malik S, Malt UF, Moe T, Norlin AK, Pedersen M, Pignatiello SE, Rask CU, Reme SE, Roksund G, Sainio M, Sharpe M, Thorkildsen RF, van Roy B, Vandvik PO, Vogt H, Wyller HB, Wyller VBB. Chronic fatigue syndromes: real illnesses that people can recover from. Scand J Prim Health Care 2023; 41:372-376. [PMID: 37740918 PMCID: PMC11001335 DOI: 10.1080/02813432.2023.2235609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/07/2023] [Indexed: 09/25/2023] Open
Abstract
The 'Oslo Chronic Fatigue Consortium' consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation.Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them.
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Affiliation(s)
- The Oslo Chronic Fatigue Consortium
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
- Department of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
- General Practitioner, Hjelmeland, Norway
- VID Specialized University, Oslo, Norway
- St. Olavs Hospital, Trondheim, Norway
- Tropical and infectious Disease Unit, Royal Liverpool University Hospital. Liverpool University Hospitals Foundation Trust, Liverpool, UK
- Department of Behavioral Medicine, University of Oslo, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, Oslo, Norway
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Research Clinic for Functional Disorders and Psychosomatics. Aarhus University Hospital, Aarhus, Denmark
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, General Practitioner Research Unit, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Nydalen Helsehus, Oslo, Norway
- The Child & Adolescent Health Services, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, England
- Department of Behavior Medicine, Karolinskal University Hospital, Stockholm, Sweden
- National Advisory Unit on Psychosomatic Disorders in Children and Adolescents. Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, Oslo, Norway
- Department of Pain management and research, Oslo University Hospital, Oslo, Norway
- CatoSenteret Rehabilitation Center, Son, Norway
- University of Oslo, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
- Department of Medical Psychology, Amsterdam University Medical Centres, Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychology, NTNU, Trondheim, Norway
- University of Bergen, Bergen, Norway
- Stress Research Institute, Department of psychology, Stockholm University, Division of Psychology/Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Health, Medicine, and Caring Sciences Pain and Rehabilitation Center, Linköping University Hospital, Linköping, Sweden
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Helsinki University Hospital, Helsinki, Finland
- Saglia medical center, Vestby, Norway
- Division of Clinical Neuroscience. Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Chief Physician, Falck Norge, Oslo, Norway
- Unit Psychosomatic medicine and CL psychiatry, Rikshospitalet, Oslo University Hospital, Oslo, Norway
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
- The Mind Body Lab, Department of Psychology, University of Oslo
- General Practitioner, Klosterhagen Legesenter, Norway
- Outpatient Clinic for Functional Disorders, Helsinki University Hospital, Helsinki, Finland
- Psychological Medicine, University of Oxford, Oxford, UK
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Community Medicine and Global Health, Institute for Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Clinical Psychologist, Oslo, Norway
| | - Tomas Nordheim Alme
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Anna Andreasson
- Department of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Anne Karen Bakken
- VID Specialized University, Oslo, Norway
- St. Olavs Hospital, Trondheim, Norway
| | - Michael BJ Beadsworth
- Tropical and infectious Disease Unit, Royal Liverpool University Hospital. Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - Birgitte Boye
- Department of Behavioral Medicine, University of Oslo, Oslo, Norway
- Unit Psychosomatic medicine and CL psychiatry, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Per Alf Brodal
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Elias Myrstad Brodwall
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Ingrid Bugge
- Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, Oslo, Norway
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England
| | - Reidar Due
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Hege Randi Eriksen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Per Klausen Fink
- Research Clinic for Functional Disorders and Psychosomatics. Aarhus University Hospital, Aarhus, Denmark
| | - Signe Agnes Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Egil Andreas Fors
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, General Practitioner Research Unit, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | | | - Paul Garner
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, England
| | - Lise Beier Havdal
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Helene Helgeland
- National Advisory Unit on Psychosomatic Disorders in Children and Adolescents. Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, Oslo, Norway
| | - Henrik Børsting Jacobsen
- Department of Pain management and research, Oslo University Hospital, Oslo, Norway
- The Mind Body Lab, Department of Psychology, University of Oslo
| | | | - Martin Jonsjö
- Department of Behavior Medicine, Karolinskal University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centres, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Live Landmark
- Department of Psychology, NTNU, Trondheim, Norway
- The Mind Body Lab, Department of Psychology, University of Oslo
| | | | - Mats Lekander
- Stress Research Institute, Department of psychology, Stockholm University, Division of Psychology/Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hannah Linnros
- Department of Health, Medicine, and Caring Sciences Pain and Rehabilitation Center, Linköping University Hospital, Linköping, Sweden
| | - Elin Lindsäter
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Jon Håvard Loge
- Department of Behavioral Medicine, University of Oslo, Oslo, Norway
| | | | - Sadaf Malik
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Ulrik Fredrik Malt
- Division of Clinical Neuroscience. Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Moe
- Chief Physician, Falck Norge, Oslo, Norway
| | - Anna-Karin Norlin
- Department of Health, Medicine, and Caring Sciences Pain and Rehabilitation Center, Linköping University Hospital, Linköping, Sweden
| | - Maria Pedersen
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siv Elin Pignatiello
- Unit Psychosomatic medicine and CL psychiatry, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - Silje Endresen Reme
- Department of Pain management and research, Oslo University Hospital, Oslo, Norway
- The Mind Body Lab, Department of Psychology, University of Oslo
| | - Gisle Roksund
- General Practitioner, Klosterhagen Legesenter, Norway
| | - Markku Sainio
- Outpatient Clinic for Functional Disorders, Helsinki University Hospital, Helsinki, Finland
| | - Michael Sharpe
- Psychological Medicine, University of Oxford, Oxford, UK
| | | | - Betty van Roy
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Per Olav Vandvik
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Henrik Vogt
- Department of Community Medicine and Global Health, Institute for Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Vegard Bruun Bratholm Wyller
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Oh A, Koehler A, Yonker M, Troester M. Sleep Disorders and Chronic Pain Syndromes in the Pediatric Population. Semin Pediatr Neurol 2023; 48:101085. [PMID: 38065632 DOI: 10.1016/j.spen.2023.101085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/18/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023]
Abstract
Sleep problems are widespread in children and adolescents suffering from chronic pain disorders. Sleep loss intensifies the experience of pain and is detrimental to the budding self-efficacy of a young individual with limitless horizons. Addressing sleep disorders may prevent the chronification of pain and prevent adverse health outcomes, such as functional impairment, psychiatric comorbidities and overall poor quality of life. This review will explore the cyclical nature between sleep, pain and mood, as well as the functional impact of this relationship on children and adolescents. There will be a discussion about sleep assessment and diagnostic testing, followed by a description of sleep disturbances found in specific pain conditions, ranging from headache, musculoskeletal/abdominal pain, to rheumatologic disorders. Finally, there will be a brief review of pharmacologic and behavioral interventions designed to improve sleep quality, and when possible, to alleviate pain.
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Affiliation(s)
- Ann Oh
- Division of Neurology, UCSF Pediatric Headache Center, University of California, San Francisco, UCSF Benioff Children's Hospital, Mission Hall, 550 16th Street, 5th Floor, San Francisco, CA 94158, USA.
| | - Angelina Koehler
- Division of Neurology, Pediatric Headache Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Marcy Yonker
- Division of Neurology, Pediatric Headache Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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Gupta R, Bhar S. Maintenance IV Ketamine Therapy in the Fibromyalgia Patient: A Case Report. Health Psychol Res 2023; 11:89640. [PMID: 38033618 PMCID: PMC10686815 DOI: 10.52965/001c.89640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Introduction Fibromyalgia is a complex disorder characterized by distributed and persistent pain often associated with fatigue and depression. The underlying causal agents of this dysfunction are not clear. Ketamine has been used to treat chronic pain in a variety of pain syndromes, including fibromyalgia, but the dosing protocols used are neither standardized nor consistent across cases. The current case presents an opportunity to contribute to a progression towards a consensus on ketamine dosing for fibromyalgia. Case Presentation A 60-year-old female presented with indications of fibromyalgia and was administered a 9-session IV ketamine treatment for pain. The initial dosing was 50 mg, with a concentration of 1.0 mg/ml at an infusion rate of 0.8 mg/kg/hr. This was increased to 200 mg and eventually to 240 mg, maintaining a ketamine concentration 4.0-4.8 mg/ml at an infusion rate of 1.5 mg/kg/hr. Management and Outcomes Following the first 9-session therapy, the patient reported >50% pain relief from pre-infusion levels and was placed on a maintenance regimen in perpetuity. This regimen involves two monthly IV ketamine infusions, one day apart for two hours at a maintenance rate of 4.8 mg/kg/hr. Conclusion Ketamine by IV is an effective option for pain management in patients with fibromyalgia. Compared to previous case studies, it is recommended that increased total dose, frequent administration, and longer duration of infusions all may be necessary for ketamine to maximize its beneficial effects.
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Affiliation(s)
- Ruchir Gupta
- Pain Division Mountain View Headache and Spine Institute
| | - Supurna Bhar
- Pain Division Mountain View Headache and Spine Institute
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Costa V, Gianlorenço AC, Daibes M, Queiroz F, Lacerda G, Martinez-Magallanes D, Camargo L, Alves LG, Andrade MF, Dodurgali MR, Pacheco-Barrios K, Fregni F. Physical Conditioning, Obesity and Fibromyalgia: Causal Relationship or Confounding? PRINCIPLES AND PRACTICE OF CLINICAL RESEARCH (2015) 2023; 9:63-68. [PMID: 38433877 PMCID: PMC10906936 DOI: 10.21801/ppcrj.2023.93.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Affiliation(s)
- Valton Costa
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Laboratory of Neuroscience and Neurological Rehabilitation, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
| | - Anna Carolyna Gianlorenço
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Laboratory of Neuroscience and Neurological Rehabilitation, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
| | - Marianna Daibes
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Fernanda Queiroz
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Guilherme Lacerda
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Institute of Physical and Rehabilitation Medicine, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | - Daniela Martinez-Magallanes
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Lucas Camargo
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Luana Gola Alves
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Maria Fernanda Andrade
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mustafa Reha Dodurgali
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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75
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Shephard S, Dahlenburg K, Kilgour A. Drawing on lessons learnt in allied health & medicine: Exploring pain science in radiography practice. J Med Imaging Radiat Sci 2023; 55:101343. [PMID: 38016853 DOI: 10.1016/j.jmir.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Sophie Shephard
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Wagga Wagga NSW 2678, Australia.
| | - Kate Dahlenburg
- Radiographer - Department of Medical Imaging, Logan Hospital, Meadowbrook, QLD 4131, Australia
| | - Andrew Kilgour
- Medical Radiations and Assistant Associate Dean, Medical Radiations, School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora VIC 3083, Australia
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Mesci E, Dogruoz B, Mesci N, Icagasioglu A. Ultrasonographic evaluation of muscle thickness in female patients with fibromyalgia and its relationship with clinical parameters. North Clin Istanb 2023; 10:718-725. [PMID: 38328726 PMCID: PMC10846583 DOI: 10.14744/nci.2023.04382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/13/2022] [Accepted: 01/07/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The aim of this study was to compare the ultrasonographic thickness of selected major muscles of patients with fibromyalgia syndrome (FMS) and asymptomatic control subjects and to evaluate the relationship between muscle thickness and muscle strength, physical performance, kinesiophobia, and clinical variables. METHODS Twenty-two FMS patients and 18 asymptomatic control cases who applied to the physical medicine and rehabilitation outpatient clinic were included. The thickness of the gastrocnemius medialis/lateralis, trapezius, and upper arm muscle was evaluated with ultrasonography. Muscle strength was evaluated with hand grip strength, muscle performance with chair stand test (CST), walking performance with 10 m walking test, disease severity with Fibromyalgia Impact Questionnaire-Revised, pain severity with VAS, and kinesiophobia with TAMPA kinesiophobia scale. RESULTS The mean thickness values of all the muscles measured were significantly decreased in the FMS group compared with the control (p<0.05). There were positive correlations between gastrocnemius medialis/lateralis and upper arm muscle thickness with hand grip strength (p<0.01, r=0.602, r=0.663, r=0.567, respectively) and positive correlations between gastrocnemius medialis/lateralis muscle thickness with CST (p<0.05, r=0.507, r=0.512, respectively). TAMPA was significantly negatively correlated with gastrocnemius medialis/lateralis and upper arm muscle thickness. CONCLUSION Muscle thickness, strength, and performance decrease in FMS patients. This reduction in muscle strength, performance, and size is associated with kinesiophobia. Strengthening exercises should be included in the management of FMS patients. However, caution should be exercised when prescribing exercises that require extreme muscle performance, considering that it may cause kinesiophobia.
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Affiliation(s)
- Erkan Mesci
- Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkiye
| | - Bilinc Dogruoz
- Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkiye
| | - Nilgun Mesci
- Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkiye
| | - Afitap Icagasioglu
- Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkiye
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77
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del Amo LL, Durán-González E, Ramírez-Tejero JA, Martínez-Lara A, Cotán D. Study protocol for FIBROKIT: a new tool for fibromyalgia diagnosis and patient follow-up. Front Neurol 2023; 14:1286539. [PMID: 38073622 PMCID: PMC10710143 DOI: 10.3389/fneur.2023.1286539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/06/2023] [Indexed: 02/27/2024] Open
Abstract
Fibromyalgia (FM) is a complex disease that is characterized by chronic musculoskeletal pain and has great economic impact. FM prevalence is about 2% to 4% worldwide, affecting mainly middle-aged women, and its complex pathophysiology complicates diagnosis, treatment and the findings of solid biomarkers. Previous studies have suggested an association between the disease and oxidative stress, mitochondrial metabolism, intestinal microbiota and inflammation, providing sufficient data to support the multifactorial origin of FM. Hence, the objective of this randomized, prospective, low-interventional, double-blinded and placebo-controlled clinical trial is the development of a specific panel of FM biomarkers and the evaluation of their response to a six-month nutritional intervention based on the Mediterranean diet supplemented with extra virgin olive oil (EVOO). For this purpose, the experimental design implies the recruitment of a large cohort of female Spanish patients. Middle-aged women who meet the diagnostic criteria for FM according to the American College of Rheumatology (ACR) will be eligible, along with age-matched healthy women. Both groups will be randomly divided into placebo (olive oil, OO) and treatment groups (extra virgin olive oil, EVOO), and will provide samples at the beginning (T0), after 3 months of nutritional intervention (T1), at the end of the nutritional intervention in 6 months (T2), and 6 months after the end of nutritional intervention (TF), being enrolled for 1 year. Data will be collected through health questionnaires, and whole blood and stool samples will be taken and analyzed. Blood will be used for western-blotting and proteomic analysis of mitochondrial homeostasis and plasma proteome, while stool will undergo metagenomic analysis, respectively. This study represents the first low-interventional investigation with more than 200 participants focused on exploring the association of oxidative stress, mitochondrial metabolism, intestinal microbiota and related pathways with a nutritional intervention in the context of FM. As a result, the outcomes of this study will significantly contribute to the development of a comprehensive and robust panel of diagnostic biomarkers, and will shed some light on their modulation with non-pharmacological therapies such as nutrition. Clinical trial registration: https://clinicaltrials.gov/study/NCT05921409, identifier: NCT05921409.
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78
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Reale M, Borlongan C, Carta AR, Greig NH. Genetic and Molecular Regulations of Neuronal Activity. Int J Mol Sci 2023; 24:16191. [PMID: 38003381 PMCID: PMC10671438 DOI: 10.3390/ijms242216191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
This Special Issue of the International Journal of Molecular Sciences (IJMS) focuses on 'Genetic and Molecular Regulations of Neuronal Activity' [...].
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Affiliation(s)
- Marcella Reale
- Department of Innovative Technologies in Medicine and Dentistry, Unit of Immunodiagnostic and Molecular Pathology, University “G.d’Annunzio”, 66100 Chieti, Italy
| | - Cesar Borlongan
- Department of Neurosurgery, University of South Florida College Medicine, MDC 78, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA;
| | - Anna R. Carta
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Nigel H. Greig
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA;
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79
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Aliper A, Kudrin R, Polykovskiy D, Kamya P, Tutubalina E, Chen S, Ren F, Zhavoronkov A. Prediction of Clinical Trials Outcomes Based on Target Choice and Clinical Trial Design with Multi-Modal Artificial Intelligence. Clin Pharmacol Ther 2023; 114:972-980. [PMID: 37483175 DOI: 10.1002/cpt.3008] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
Drug discovery and development is a notoriously risky process with high failure rates at every stage, including disease modeling, target discovery, hit discovery, lead optimization, preclinical development, human safety, and efficacy studies. Accurate prediction of clinical trial outcomes may help significantly improve the efficiency of this process by prioritizing therapeutic programs that are more likely to succeed in clinical trials and ultimately benefit patients. Here, we describe inClinico, a transformer-based artificial intelligence software platform designed to predict the outcome of phase II clinical trials. The platform combines an ensemble of clinical trial outcome prediction engines that leverage generative artificial intelligence and multimodal data, including omics, text, clinical trial design, and small molecule properties. inClinico was validated in retrospective, quasi-prospective, and prospective validation studies internally and with pharmaceutical companies and financial institutions. The platform achieved 0.88 receiver operating characteristic area under the curve in predicting the phase II to phase III transition on a quasi-prospective validation dataset. The first prospective predictions were made and placed on date-stamped preprint servers in 2016. To validate our model in a real-world setting, we published forecasted outcomes for several phase II clinical trials achieving 79% accuracy for the trials that have read out. We also present an investment application of inClinico using date stamped virtual trading portfolio demonstrating 35% 9-month return on investment.
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Affiliation(s)
- Alex Aliper
- Insilico Medicine AI Ltd, Masdar City, Abu Dhabi, United Arab Emirates
| | - Roman Kudrin
- Insilico Medicine AI Ltd, Masdar City, Abu Dhabi, United Arab Emirates
| | | | - Petrina Kamya
- Insilico Medicine Canada Inc., Quebec, Montreal, Canada
| | - Elena Tutubalina
- Insilico Medicine Hong Kong Ltd, New Territories, Pak Shek Kok, Hong Kong
| | - Shan Chen
- Insilico Medicine Shanghai Ltd, Pudong New District, Shanghai, China
| | - Feng Ren
- Insilico Medicine Shanghai Ltd, Pudong New District, Shanghai, China
| | - Alex Zhavoronkov
- Insilico Medicine AI Ltd, Masdar City, Abu Dhabi, United Arab Emirates
- Insilico Medicine Hong Kong Ltd, New Territories, Pak Shek Kok, Hong Kong
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80
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Nunna B, Parihar P, Wanjari M, Shetty N, Bora N. High-Resolution Imaging Insights into Shoulder Joint Pain: A Comprehensive Review of Ultrasound and Magnetic Resonance Imaging (MRI). Cureus 2023; 15:e48974. [PMID: 38111406 PMCID: PMC10725840 DOI: 10.7759/cureus.48974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.
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Affiliation(s)
- Bhagyasri Nunna
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratap Parihar
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Neha Shetty
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikita Bora
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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81
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Nagakura Y, Hayashi M, Kajioka S. Analysis of Japanese nationwide health datasets: association between lifestyle habits and prevalence of neuropathic pain and fibromyalgia with reference to dementia-related diseases and Parkinson's disease. Scand J Pain 2023; 23:662-669. [PMID: 37439280 DOI: 10.1515/sjpain-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES Chronic pain is defined as pain that persists or recurs for more than 3 months. This study focuses on neuropathic pain (NP) and fibromyalgia (FM) which are chronic pain states, and aims to identify lifestyle habits associated with their prevalence. Other neurological disorders are also analyzed as references. METHODS Association between the variable referring to disease prevalence (number of claims for reimbursement of marker drugs) and the variable for lifestyle habits/health examination results (collected from insured individuals aged 40-74 years) was determined by analyzing Japanese nationwide datasets, which were collected in 2018 and aggregated by prefecture. Pregabalin, donepezil, and levodopa were used as marker drugs for the chronic pain states, dementia-related diseases (Alzheimer's disease and Lewy body dementia) and Parkinson's disease (PD), respectively. Pearson's correlation analysis and multiple linear regression analysis were conducted. RESULTS Variables showing correlation coefficient (|r|)>0.5 were put into the multiple linear regression. Exercise habits (ꞵ=-0.3182), smoking habits (0.3218), daily drinking (0.2683), and alanine aminotransferase>51 U/L (0.2309) were finally incorporated in the equation for pregabalin (R 2=0.7268). Walking speed (-0.4543) and daily drinking (0.5077) were incorporated in the equation for donepezil (R 2=0.5718). CONCLUSIONS The prevalence of chronic pain states is associated with lifestyle habits, just like the dementia-related diseases. Exercise in daily life is negatively associated with the prevalence of the chronic pain states, although excessive alcohol drinking, smoking, and high serum ALT are positively associated with it. The prevalence of PD seems less associated with lifestyle habits.
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Affiliation(s)
- Yukinori Nagakura
- School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa-City, Fukuoka, Japan
| | - Maya Hayashi
- The Ministry of Justice in Japan, Correction Bureau, Tokyo, Japan
| | - Shunichi Kajioka
- School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa-City, Fukuoka, Japan
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82
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Horita M, Yasuhira A, Hirakawa M, Watanabe A, Higaki N, Nishihara T, Yorozuya T. Efficacy of high-frequency spinal cord stimulation for fibromyalgia syndrome in two cases: case reports. JA Clin Rep 2023; 9:68. [PMID: 37864610 PMCID: PMC10590350 DOI: 10.1186/s40981-023-00660-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Reports on the effectiveness of spinal cord stimulation (SCS) for the alleviation of fibromyalgia syndrome (FMS) pain are scarce. We report two cases of effective high-frequency SCS at 1000 Hz against upper- and lower-limb pain in patients with FMS. CASE PRESENTATION Two women with widespread pain were diagnosed with FMS and the pain gradually worsened. A 1-week SCS trial was conducted in each patient. In both cases, the patients complained of unpleasant sensations during 10-Hz SCS. However, the pain was alleviated after 1000-Hz stimulation without irritation. Therefore, leads and a generator were implanted, after which they felt almost no pain. Moreover, the dose of the oral medication could be reduced and the patients returned to their daily lives. CONCLUSION SCS at 1000 Hz may effectively treat pain associated with FMS. Therefore, performing an SCS trial for patients with FMS with intractable pain might be worthwhile.
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Affiliation(s)
- Mikiko Horita
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
| | - Ayumi Yasuhira
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
| | - Mikako Hirakawa
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
| | - Aisa Watanabe
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
| | - Nobuhiro Higaki
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
| | - Tasuku Nishihara
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan.
| | - Toshihiro Yorozuya
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
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83
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Benebo FO, Lukic M, Jakobsen MD, Braaten TB. Lifestyle risk factors of self-reported fibromyalgia in the Norwegian Women and Cancer (NOWAC) study. BMC Public Health 2023; 23:1967. [PMID: 37821848 PMCID: PMC10566054 DOI: 10.1186/s12889-023-16773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND While the aetiology of fibromyalgia syndrome (FM) remains unknown, lifestyle factors have been linked to the disorder. However, there are few studies on the association between lifestyle factors and FM, thus we examine the risk of self-reported fibromyalgia given selected lifestyle factors. METHODS We used data from 75,485 participants in the Norwegian Women and Cancer study. Information on FM and the lifestyle factors body mass index (BMI), physical activity level, smoking status/intensity, and alcohol consumption were obtained from baseline and follow-up questionnaires. We used Cox proportional hazards model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS After a median follow-up time of 10 years, we observed 2,248 cases of self-reported fibromyalgia. Overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women had a relative risk of 1.34 (95% CI 1.21-1.47) and 1.62 (95% CI 1.41-1.87), respectively, compared to women with normal weight (BMI 18.5-24.9 kg/m2). Very low physical activity level (1-2) was associated with a 31% higher risk of self-reported fibromyalgia (HR 1.31, 95% CI 1.09-1.57) when compared to moderate physical activity level (5-6). There was a strong dose-response relationship between smoking status/intensity and self-reported fibromyalgia (p for trend < 0.001). Compared with moderate alcohol consumption (4.0-10 g/day), the risk of self-reported FM was 72% (HR 1.72; 95% CI 1.45-2.03) higher among teetotallers, and 38% (HR 1.38, 95% CI 1.23-1.54) higher among those with low consumption (0.1-3.9 g/day). CONCLUSIONS Overweight and obesity, very low physical activity level, smoking, and alcohol consumption were associated with an increased risk of self-reported FM.
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Affiliation(s)
- Faith Owunari Benebo
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Marko Lukic
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
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84
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Okutan G, Sánchez Niño GM, Terrén Lora A, López Oliva S, San Mauro Martín I. Exogenous Supplementation with DAO Enzyme in Women with Fibromyalgia: A Double-Blind Placebo-Controlled Clinical Trial. J Clin Med 2023; 12:6449. [PMID: 37892588 PMCID: PMC10607251 DOI: 10.3390/jcm12206449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Fibromyalgia (FM) is characterized by chronic musculoskeletal pain, muscle tension, joint mobility loss, and several psychological symptoms severely affecting patient well-being. Histamine is naturally degraded in the small intestine by diamine oxidase (DAO). Hereditary or acquired DAO deficiency causes extracellular histamine accumulation, leading to symptoms similar to those of individuals diagnosed with FM. Thus, this study aimed to assess the efficacy of adding DAO supplementation for 8 weeks to their standard therapy. We randomly assigned 100 women with FM (age: 33-61 years) to the supplementation and control groups. The Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS), and intensity scales were applied for a series of clinical symptoms together with the Bristol scale to assess the added value of DAO supplementation. Patients in both groups were receiving complete pharmacological support but some differences in the number of subjects receiving analgesics, antidepressants, and anxiolytics was noted. Patients in both study groups experienced favorable changes during the evaluation period as indicated by their final FIQ and PCS scores, particularly in the DAO group in the latter questionnaire. Qualitatively, the patients assigned to the DAO treatment group had lower scores for fatigue, anxiety, depression, burning and for rumination, magnification, and helplessness.
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Affiliation(s)
| | | | | | | | - Ismael San Mauro Martín
- Research Centers in Nutrition and Health (CINUSA Group), Paseo de la Habana 43, 28036 Madrid, Spain; (G.O.); (G.M.S.N.); (A.T.L.); (S.L.O.)
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85
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Mueller C, Fang YHD, Jones C, McConathy JE, Raman F, Lapi SE, Younger JW. Evidence of neuroinflammation in fibromyalgia syndrome: a [ 18 F]DPA-714 positron emission tomography study. Pain 2023; 164:2285-2295. [PMID: 37326674 PMCID: PMC10502894 DOI: 10.1097/j.pain.0000000000002927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 06/17/2023]
Abstract
ABSTRACT This observational study aimed to determine whether individuals with fibromyalgia (FM) exhibit higher levels of neuroinflammation than healthy controls (HCs), as measured with positron emission tomography using [ 18 F]DPA-714, a second-generation radioligand for the translocator protein (TSPO). Fifteen women with FM and 10 HCs underwent neuroimaging. Distribution volume (V T ) was calculated for in 28 regions of interest (ROIs) using Logan graphical analysis and compared between groups using multiple linear regressions. Group (FM vs HC) was the main predictor of interest and TSPO binding status (high- vs mixed-affinity) was added as a covariate. The FM group had higher V T in the right postcentral gyrus ( b = 0.477, P = 0.033), right occipital gray matter (GM; b = 0.438, P = 0.039), and the right temporal GM ( b = 0.466, P = 0.042). The FM group also had lower V T than HCs in the left isthmus of the cingulate gyrus ( b = -0.553, P = 0.014). In the subgroup of high-affinity binders, the FM group had higher V T in the bilateral precuneus, postcentral gyrus, parietal GM, occipital GM, and supramarginal gyrus. Group differences in the right parietal GM were associated with decreased quality of life, higher pain severity and interference, and cognitive problems. In support of our hypothesis, we found increased radioligand binding (V T ) in the FM group compared with HCs in several brain regions regardless of participants' TSPO binding status. The ROIs overlapped with prior reports of increased TSPO binding in FM. Overall, increasing evidence supports the hypothesis that FM involves microglia-mediated neuroinflammation in the brain.
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Affiliation(s)
| | - Yu-Hua D. Fang
- Radiology and Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Chloe Jones
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jonathan E. McConathy
- Department of Radiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Fabio Raman
- Department of Radiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Suzanne E. Lapi
- Department of Radiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jarred W. Younger
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
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86
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De Benedittis G. The Challenge of Fibromyalgia Efficacy of Hypnosis in Alleviating the Invisible Pain: A Narrative Review. Int J Clin Exp Hypn 2023; 71:276-296. [PMID: 37611143 DOI: 10.1080/00207144.2023.2247443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 08/25/2023]
Abstract
Fibromyalgia syndrome (FMS) is a multifaceted and incapacitating functional pain syndrome characterized by continuous, severe, widespread musculoskeletal pain. FMS is associated with other symptoms such as fatigue, nonrestorative sleep, cognitive/emotional dysfunction, and diminished health-related quality of life. The pathogenesis of FMS is still not fully understood, but an increasing amount of evidence supports the link between childhood/adulthood emotional, physical, sexual abuse or neglect and the development of FMS. Managing and treating FMS patients can be challenging because the syndrome is refractory to most treatments. However, psychological interventions, particularly hypnotherapy, have been shown to be effective in the cognitive modulation of fibromyalgic pain. FMS patients may benefit from hypnotherapy alone or in combination with standard medical therapy. Symptom-oriented hypnosis aims to reduce pain, fatigue, sleep problems, anxiety, and depression, while hypnotherapy focuses on resolving emotional conflicts and unresolved traumas associated with FMS. In conclusion, hypnosis may be a useful and safe adjunct tool for managing chronic pain and dysfunctional symptoms in challenging fibromyalgic patients.
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Affiliation(s)
- Giuseppe De Benedittis
- Interdepartmental Pain Center, Department of Pathophysiology and Transplants, University of Milan, Italy
- Italian Society of Hypnosis (ISH), Rome, Italy
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87
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Atamer Y, Sarac S, Asık HK, Sahbaz T. Serum paraoxonase activities, nitric oxide, and malondialdehyde levels are altered in patients with primary fibromyalgia syndrome. Ir J Med Sci 2023; 192:2541-2547. [PMID: 36689069 DOI: 10.1007/s11845-023-03280-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Fibromyalgia patients who are exposed to extreme oxidative stress may face more severe clinical features or oxidative stress may be increased by the severity of the disease. AIM The purpose of these investigation were to determine serum paraoxonase activities (PON-1) and nitric oxide (NO) activities and malondialdehyde (MDA) level in fibromyalgia and whether there were any associations between these enzymes activities, MDA level, and clinical parameters. METHODS The study groups were consisted of 30 primer fibromyalgia patients and 30 healthy subjects. Clinical findings, pain severity, functional disability, general health status, anxiety, and depression assessed, and serum PON-1 activity, MDA, and NO levels were measured. RESULTS The primer fibromyalgia group had significantly higher MDA, low density lipoprotein-cholesterol (LDL-C), and decreased PON-1 activity, NO, and high density lipoprotein-cholesterol (HDL-C) with respect to controls. The paraoxonase activity was negatively correlated with MDA, LDL-C, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire score (FIQ score), tender point score, age, and BDI score, while positively correlated with NO and HDL-C. MDA level was positively correlated with VAS, FIQ score, tender point score, age, and negatively correlated with NO level. CONCLUSION These results suggest that FMS patients have an alteration in levels of MDA, NO, and PON-1 activities. We think that impaired oxidant/antioxidant status may affect the symptoms of the disease. Also, they may be of importance in the complex physiopathologic mechanism behind the development of FMS.
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Affiliation(s)
- Yildiz Atamer
- Department of Medical Biochemistry, Faculty of Medicine, Beykent University, Istanbul, Turkey
| | - Serdar Sarac
- Department of Physical Medicine and Rehabilitation, Private Erenköy Physical Therapy Center, Istanbul, Turkey
| | - Hatice Kubra Asık
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Beykent University, Istanbul, Turkey
| | - Tugba Sahbaz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Beykent University, Istanbul, Turkey.
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88
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Latifoglou E, Çınar E, Tanıgör G, On AY. Coexistence of fibromyalgia and post-polio syndrome in persons with prior poliomyelitis in Turkey: the relations with symptoms, polio-related impairments, and quality of life. Disabil Rehabil 2023; 45:3511-3518. [PMID: 36169616 DOI: 10.1080/09638288.2022.2127931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate the prevalence of fibromyalgia(FM) and to show its relations with symptoms, polio-related impairments (PRI), and quality of life (QoL) in persons with prior paralytic poliomyelitis (PsPP) with and without post-polio syndrome (PPS). MATERIALS AND METHODS The study included 74 PsPP under 60 years of age, 60 of whom met the criteria for PPS. Presence and severity of FM were assessed by the American College of Rheumatology (ACR) 1990, 2010, and 2016 criteria, and Fibromyalgia Severity Score. PPS symptoms, PRI, and QoL were evaluated using the Self-Reported Impairments in Persons with Late Effects of Polio Rating Scale, Fatigue Severity Scale, and Nottingham Health Profile. Frequency, comparison, and correlation analyses were performed. RESULTS While 15% of PsPP with PPS met the criteria of ACR 1990, 32% of ACR 2010, and 35% of ACR 2016, none of those without PPS met any of the criteria for FM. Severity of PPS symptoms and PRI were significantly higher, and QoL was significantly lower in those with co-existing FM. FM severity was found to be significantly associated with severity of PPS symptoms, PRI and reduced QoL. CONCLUSIONS FM frequently coexists in PsPP with PPS and may increase the burden of PPS.Implications for RehabilitationFibromyalgia (FM) is commonly seen in patients with post-polio syndrome (PPS).Co-existing FM may increase the burden of PPS, as it is associated with more severe symptoms, more polio-related impairments, and worse quality of life.Recognition, appropriate referral, and successful management of co-existing FM may allow for reduced symptoms or symptom severity and improved quality of life in persons with PPS.
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Affiliation(s)
- Emre Latifoglou
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
| | - Ece Çınar
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
| | - Göksel Tanıgör
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
| | - Arzu Yağız On
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
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89
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Beyaztas H, Aktas S, Guler EM, Ata E. Oxidative stress may be a contributing factor in fibromyalgia patients' pain mechanisms. Reumatismo 2023; 75. [PMID: 37721351 DOI: 10.4081/reumatismo.2023.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/29/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE The pathophysiology of fibromyalgia (FM), a continuously painful syndrome with no known origin, has been related to mitochondrial dysfunction, oxidative stress, and inflammation. Recent studies have shown that FM may be associated with an oxidative balance disorder. The objective of this study was to measure the levels of oxidative stress in FM patients and try to understand the association between FM and free radicals. METHODS This study was performed on 100 volunteers admitted to the University of Health Sciences, Sultan 2, Abdulhamid Han Health Application and Research Center Physical Therapy and Rehabilitation Clinic, including 50 healthy controls and 50 patients with FM. To analyze oxidative stress biomarkers, total oxidant status (TOS) and total antioxidant status (TAS) levels were measured. Total thiol (TT) and native thiol (NT) concentrations were measured to determine the relationship between thiol groups. Disulfide (DIS) and oxidative stress index (OSI) were calculated with mathematical formulas. RESULTS While TOS and OSI levels were statistically higher in FM patients, TAS levels were significantly lower compared to the healthy control group (p<0.001). In comparison to the healthy control group, FM patients had considerably decreased TT and NT levels. DIS levels were significantly higher in FM patients than in controls (p<0.001). CONCLUSIONS Reactive oxygen species have several negative impacts on the human body. As a result of the measurements we analyzed, the relationship between FM and oxidative stress should be studied in terms of disease progression and may help improve the treatment process.
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Affiliation(s)
- H Beyaztas
- Department of Medical Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul.
| | - S Aktas
- Department of Biostatistics and Medical Informatics, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul; Department of Biostatistics, Istanbul Cerrahpasa University .
| | - E M Guler
- Department of Medical Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul; Haydarpasa Numune Health Application and Research Center, University of Health Sciences, Istanbul .
| | - E Ata
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
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90
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Ikeda N, Kawasaki M, Baba K, Nishimura H, Fujitani T, Suzuki H, Matsuura T, Ohnishi H, Shimizu M, Sanada K, Nishimura K, Yoshimura M, Maruyama T, Conway-Campbell BL, Onaka T, Teranishi H, Hanada R, Ueta Y, Sakai A. Chemogenetic Activation of Oxytocin Neurons Improves Pain in a Reserpine-induced Fibromyalgia Rat Model. Neuroscience 2023; 528:37-53. [PMID: 37532013 DOI: 10.1016/j.neuroscience.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
Fibromyalgia (FM) is a syndrome characterized by chronic pain with depression as a frequent comorbidity. However, efficient management of the pain and depressive symptoms of FM is lacking. Given that endogenous oxytocin (OXT) contributes to the regulation of pain and depressive disorders, herein, we investigated the role of OXT in an experimental reserpine-induced FM model. In FM model, OXT-monomeric red fluorescent protein 1 (OXT-mRFP1) transgenic rats exhibited increased depressive behavior and sensitivity in a mechanical nociceptive test, suggesting reduced pain tolerance. Additionally, the development of the FM-like phenotype in OXT-mRFP1 FM model rats was accompanied by a significant reduction in OXT mRNA expression in the magnocellular neurons of the paraventricular nucleus. OXT-mRFP1 FM model rats also had significantly fewer tryptophan hydroxylase (TPH)- and tyrosine hydroxylase (TH)-immunoreactive (ir) neurons as well as reduced serotonin and norepinephrine levels in the dorsal raphe and locus coeruleus. To investigate the effects of stimulating the endogenous OXT pathway, rats expressing OXT-human muscarinic acetylcholine receptor (hM3Dq)-mCherry designer receptors exclusively activated by designer drugs (DREADDs) were also assessed in the FM model. Treatment of these rats with clozapine-N-oxide (CNO), an hM3Dq-activating drug, significantly improved characteristic FM model-induced pathophysiological pain, but did not alter depressive-like behavior. The chemogenetically induced effects were reversed by pre-treatment with an OXT receptor antagonist, confirming the specificity of action via the OXT pathway. These results indicate that endogenous OXT may have analgesic effects in FM, and could be a potential target for effective pain management strategies for this disorder.
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Affiliation(s)
- Naofumi Ikeda
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Makoto Kawasaki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Kazuhiko Baba
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Haruki Nishimura
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Teruaki Fujitani
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hitoshi Suzuki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takanori Matsuura
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hideo Ohnishi
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Makiko Shimizu
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kenya Sanada
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuaki Nishimura
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mitsuhiro Yoshimura
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takashi Maruyama
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Tatsushi Onaka
- Division of Brain and Neurophysiology, Department of Physiology, Jichi Medical University, Shimotsuke, Japan
| | - Hitoshi Teranishi
- Department of Neurophysiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Reiko Hanada
- Department of Neurophysiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yoichi Ueta
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akinori Sakai
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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91
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Yao M, Wang S, Han Y, Zhao H, Yin Y, Zhang Y, Zeng X. Micro-inflammation related gene signatures are associated with clinical features and immune status of fibromyalgia. J Transl Med 2023; 21:594. [PMID: 37670381 PMCID: PMC10478377 DOI: 10.1186/s12967-023-04477-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/26/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a multifaceted disease. Along with the genetic, environmental and neuro-hormonal factors, inflammation has been assumed to have role in the pathogenesis of FM. The aim of the present study was to explore the differences in clinical features and pathophysiology of FM patients under different inflammatory status. METHODS The peripheral blood gene expression profile of FM patients in the Gene Expression Omnibus database was downloaded. Differentially expressed inflammatory genes were identified, and two molecular subtypes were constructed according to these genes used unsupervised clustering analysis. The clinical characteristics, immune features and pathways activities were compared further between the two subtypes. Then machine learning was used to perform the feature selection and construct a classification model. RESULTS The patients with FM were divided into micro-inflammation and non-inflammation subtypes according to 54 differentially expressed inflammatory genes. The micro-inflammation group was characterized by more major depression (p = 0.049), higher BMI (p = 0.021), more active dendritic cells (p = 0.010) and neutrophils. Functional enrichment analysis showed that innate immune response and antibacterial response were significantly enriched in micro-inflammation subtype (p < 0.050). Then 5 hub genes (MMP8, ENPP3, MAP2K3, HGF, YES1) were screened thought three feature selection algorithms, an accurate classifier based on the 5 hub DEIGs and 2 clinical parameters were constructed using support vector machine model. Model scoring indicators such as AUC (0.945), accuracy (0.936), F1 score (0.941), Brier score (0.079) and Hosmer-Lemeshow goodness-of-fit test (χ2 = 4.274, p = 0.832) proved that this SVM-based classifier was highly reliable. CONCLUSION Micro-inflammation status in FM was significantly associated with the occurrence of depression and activated innate immune response. Our study calls attention to the pathogenesis of different subtypes of FM.
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Affiliation(s)
- Menghui Yao
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Shuolin Wang
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Yingdong Han
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - He Zhao
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Yue Yin
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Yun Zhang
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China.
| | - Xuejun Zeng
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China.
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92
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Puşuroğlu M, Topaloğlu MS, Hocaoğlu Ç, Yıldırım M. Expressing emotions, rejection sensitivity, and attachment in patients with fibromyalgia. Turk J Phys Med Rehabil 2023; 69:303-308. [PMID: 37674789 PMCID: PMC10478538 DOI: 10.5606/tftrd.2023.11440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/14/2022] [Indexed: 09/08/2023] Open
Abstract
Objectives This study aimed to examine emotional awareness, control of emotions, and the childhood attachment process in fibromyalgia patients. Patients and methods The observational study was conducted with 117 participants (14 males, 103 females; mean age: 43.9±9.0 years; range, 22 to 64 years) between February 20, 2022, and May 20, 2022. Sixty-one patients and 56 healthy control subjects filled out a form including sociodemographic data, such as age, sex, occupation, and educational status. In addition, the participants answered the Expressing Emotions Scale, Rejection Sensitivity Scale, and Experiences in Close Relationships Scale. Results In our study, Expressing Emotions Scale scores are significantly higher in the healthy control group than in the patient group (p<0.05). Rejection Sensitivity Scale scores are significantly higher in the patient group than in the healthy control group (p<0.05). In the Experiences in Close Relationships Scale, a significant difference was determined between the patient and control groups in the avoidant attachment subdimension (p<0.05). Similarly, a significant difference was observed between both groups in terms of the anxiety attachment subdimension (p<0.05). Conclusion The ability to express emotions is lower and avoidant and anxious attachment rates are higher in fibromyalgia patients.
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Affiliation(s)
- Meltem Puşuroğlu
- Department of Spirit Health and Patients, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Mehmet Serhat Topaloğlu
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Çiçek Hocaoğlu
- Department of Spirit Health and Patients, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Murat Yıldırım
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
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93
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Thomas C, Schneider BT, Verza CS, Fassina G, Weber LR, Moreira M, Fusinato PT, Forcelini CM. Prevalence of fibromyalgia in a Brazilian series of patients with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:803-808. [PMID: 37793402 PMCID: PMC10550347 DOI: 10.1055/s-0043-1772673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/05/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The prevalence of pain in patients with multiple sclerosis is remarkable. Fibromyalgia has been considered as one of the forms of chronic pain encompassed in multiple sclerosis, but data are restricted to studies from Europe and North America. OBJECTIVE To assess the prevalence of fibromyalgia in a series of Brazilian patients with multiple sclerosis and the characteristics of this comorbidity. METHODS The present cross-sectional study included 60 consecutive adult patients with multiple sclerosis. Upon consent, participants underwent a thorough evaluation for disability, fatigue, quality of life, presence of fibromyalgia, depression, and anxiety. RESULTS The prevalence of fibromyalgia was 11.7%, a figure similar to that observed in previous studies. Patients with the comorbidity exhibited worse scores on fatigue (median and interquartile range [IQR]: 68 [48-70] versus 39 [16.5-49]; p < 0.001), quality of life (mean ± standard deviation [SD]: 96.5 ± 35.9 versus 124.8 ± 28.8; p = 0.021), anxiety (mean ± SD: 22.7 ± 15.1 versus 13.8 ± 8.4; p = 0.021), and depression (median and IQR: 23 [6-28] versus 6 [3-12.5]; p = 0.034) indices than patients without fibromyalgia. There was a strong positive correlation between depression and anxiety scores with fatigue (r = 0.773 and r = 0.773, respectively; p < 0.001). Conversely, a moderate negative correlation appeared between the Expanded Disability Status Scale (EDSS), fatigue, and depression scores with quality of life (r= -0.587, r= -0.551, r= -0.502, respectively; p < 0.001). CONCLUSION Fibromyalgia is a comorbidity of multiple sclerosis that can enhance fatigue and decrease quality of life, although depression, anxiety, and disability are factors that can potentiate the impact of the comorbidity.
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Affiliation(s)
| | | | | | - Gabriel Fassina
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
| | - Laís Restel Weber
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
| | - Marlinton Moreira
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
| | | | - Cassiano Mateus Forcelini
- Hospital São Vicente de Paulo, Passo Fundo RS, Brazil.
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
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94
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Cracchiolo AN, Palma DM, Genco F, Palmeri M, Teresi A, Zummo L, Gigliuto C, Saporito EFG, Ferruzza A, Piccoli T. Fibromyalgia: Could hyperbaric oxygen therapy make the difference? Our experience. Clin Case Rep 2023; 11:e7812. [PMID: 37636871 PMCID: PMC10448139 DOI: 10.1002/ccr3.7812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/03/2023] [Accepted: 07/09/2023] [Indexed: 08/29/2023] Open
Abstract
Fibromyalgia is a rare disease, difficult to diagnose and to treat. We think that hyperbaric oxygen therapy could improve its signs and symptoms although more evidences have to be accumulated.
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Affiliation(s)
| | | | - Fabio Genco
- ARNAS Civico Di Cristina BenfratelliPalermoItaly
| | | | | | - Leila Zummo
- ARNAS Civico Di Cristina Benfratelli, Neurologia con Stroke UnitPalermoItaly
| | - Carmelo Gigliuto
- Umberto I di Siracusa Hospital, UOC Anestesia e Rianimazione Camera IperbaricaSiracusaItaly
| | | | | | - Tommaso Piccoli
- Neurology Unit, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of PalermoPalermoItaly
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95
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Yetkin D, Yılmaz İA, Ayaz F. Anti-inflammatory activity of bupropion through immunomodulation of the macrophages. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:2087-2093. [PMID: 36928557 DOI: 10.1007/s00210-023-02462-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
Depression might manifest itself with a chronic inflammation in different tissues and organs independent of the central nervous system. Psoriasis, Crohn's disease, and fibromyalgia are among these disorders accompanying the depression. The treatment options for these conditions are a combination of the anti-depressants and anti-inflammatory agents. Bupropion has been widely utilized as an anti-depressant. It has been preferred among the patients with Crohn's disease and psoriasis due to its anti-inflammatory role, as well. In this study, we aimed to decipher its target in the immune system. Macrophages were activated in the presence of LPS and increasing concentrations of the bupropion. TNF-α, IL-6, GM-CSF, and IL-12p40 cytokines' production levels were measured by ELISA to compare it to the control groups. These cytokines have been associated with the aggressive inflammation in different tissues. Moreover, p38 and PI3K proteins' phosphorylated levels were measured to examine whether bupropion acts through these pathways or not. Our results suggest that bupropion had anti-inflammatory action on the activated macrophages and its mechanism of action was partially dependent on p38 but independent of PI3K pathways.
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Affiliation(s)
- Derya Yetkin
- Advanced Technology, Research and Application Center, Mersin University, TR-33343, Mersin, Turkey
| | - İbrahim Arda Yılmaz
- Department of Neurology, Faculty of Medicine, Mersin University, TR-33343, Mersin, Turkey
- Mersin University Biotechnology Research and Application Center, Mersin University, TR-33343, Mersin, Turkey
| | - Furkan Ayaz
- Mersin University Biotechnology Research and Application Center, Mersin University, TR-33343, Mersin, Turkey.
- Department of Biotechnology, Faculty of Arts and Science, Mersin University, TR-33343, Mersin, Turkey.
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96
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Philippe S, Delay M, Macian N, Morel V, Pickering ME. Common miRNAs of Osteoporosis and Fibromyalgia: A Review. Int J Mol Sci 2023; 24:13513. [PMID: 37686318 PMCID: PMC10488272 DOI: 10.3390/ijms241713513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
A significant clinical association between osteoporosis (OP) and fibromyalgia (FM) has been shown in the literature. Given the need for specific biomarkers to improve OP and FM management, common miRNAs might provide promising tracks for future prevention and treatment. The aim of this review is to identify miRNAs described in OP and FM, and dysregulated in the same direction in both pathologies. The PubMed database was searched until June 2023, with a clear mention of OP, FM, and miRNA expression. Clinical trials, case-control, and cross-sectional studies were included. Gray literature was not searched. Out of the 184 miRNAs found in our research, 23 are shared by OP and FM: 7 common miRNAs are dysregulated in the same direction for both pathologies (3 up-, 4 downregulated). The majority of these common miRNAs are involved in the Wnt pathway and the cholinergic system and a possible link has been highlighted. Further studies are needed to explore this relationship. Moreover, the harmonization of technical methods is necessary to confirm miRNAs shared between OP and FM.
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Affiliation(s)
- Soline Philippe
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
| | - Marine Delay
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
- Inserm 1107, Neuro-Dol, University Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Nicolas Macian
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
| | - Véronique Morel
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
| | - Marie-Eva Pickering
- Rheumatology Department, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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Hong-Baik I, Úbeda-D’Ocasar E, Cimadevilla-Fernández-Pola E, Jiménez-Díaz-Benito V, Hervás-Pérez JP. The Effects of Non-Pharmacological Interventions in Fibromyalgia: A Systematic Review and Metanalysis of Predominants Outcomes. Biomedicines 2023; 11:2367. [PMID: 37760809 PMCID: PMC10525643 DOI: 10.3390/biomedicines11092367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Fibromyalgia (FM) is a chronic musculoskeletal condition with multiple symptoms primarily affecting women. An imbalance in cytokine levels has been observed, suggesting a chronic low-grade inflammation. The main aim of the meta-analysis was to examine the effect of multimodal rehabilitation on cytokine levels and other predominant variables in patients with FM. Furthermore, to examine which non-pharmacological tools have been used to investigate the effects that these can have on cytokines in FM patients. (2) Methods: Searches were conducted in PubMed, Scopus, Web of Science, Cochrane, and ScienceDirect databases. This systematic review and metanalysis followed the PRISMA statement protocol. The methodological quality of the studies was assessed using the PEDro scale, the risk of bias followed the Cochrane Manual 5.0.1, and the GRADE system was used for rating the certainty of evidence. (3) Results: Of 318 studies found, eight were finally selected, with a sample size of 320 women with a mean age of 57 ± 20. The proinflammatory cytokines IL-1β, IL-6, IL-8 and TNF-α were the most studied. Resistance exercise, aquatic exercise, dynamic contractions, cycling, treadmill, and infrared therapy were the main non-pharmacological tools used. (4) Conclusions: The systematic review with meta-analysis found evidence of elevated cytokine levels in patients with FM, suggesting low chronic inflammation and a possible contribution to central sensitization and chronic pain. However, the effects of physiotherapeutic interventions on cytokine levels are variable, highlighting the importance of considering different factors and the need for further research.
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Affiliation(s)
- Isabel Hong-Baik
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
| | - Edurne Úbeda-D’Ocasar
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
| | - Eduardo Cimadevilla-Fernández-Pola
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
| | - Victor Jiménez-Díaz-Benito
- Department of Sport Sciences, Faculty of Physical Activity and Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Madrid, Spain;
| | - Juan Pablo Hervás-Pérez
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
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Ćwirlej-Sozańska A, Sozański B, Łyko A, Łagowska A, Leszczyńska N, Kuduk B, Wilmowska-Pietruszyńska A. Psychometric properties and validation of the polish version of the Fibromyalgia Impact Questionnaire (FIQ-Pol). BMC Public Health 2023; 23:1477. [PMID: 37537582 PMCID: PMC10398978 DOI: 10.1186/s12889-023-16411-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, intestinal disorders, mood swings, and sleep disturbances. To the best of our knowledge, the questionnaire used for assessing problems and difficulties in the functioning of people with FM has not been translated and adapted in Poland so far. The aim of the study was to assess the psychometric properties of the Polish version of the Fibromyalgia Impact Questionnaire (FIQ-Pol). MATERIAL AND METHOD The study covered 150 people with FM living in Poland. The measurement reliability, internal structure, repeatability, and validity of the Polish version of the FIQ were examined. RESULTS The scale score reliability of the entire tool for the research group was very good. The alpha Cronbach's test result for the whole scale was 0.84. The repeatability of the scale measured by the test-retest method using the interclass correlation coefficients (ICC) was very good and amounted to 0.96. Internal structure suggested by FIQ-Pol authors was confirmed (Confirmatory factor analysis). After introducing modification indices for the entire scale, satisfactory parameter values were obtained, i.e.: RMSEA (0.06), CFI (0.97) and TLI (0.96). Theoretical validity was assessed by correlating the results of the Polish version of the FIQ with the results of the Beck's Depression Inventory (BDI). Both the FIQ-Pol total score and its domains showed strong positive correlations with BDI. CONCLUSION The Polish FIQ is a reliable and valid tool to measure the functional disability and health status of Polish people with FM.
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Affiliation(s)
- Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland.
| | - Bernard Sozański
- Institute of Medical Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Aleksandra Łyko
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Anna Łagowska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Natalia Leszczyńska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Barbara Kuduk
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
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Sarı İF, İlhanlı İ, Mızrak T, Kulaklı F, Kasap Z. The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial. J Clin Med 2023; 12:4989. [PMID: 37568391 PMCID: PMC10420003 DOI: 10.3390/jcm12154989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to investigate the effectiveness of posterior tibial nerve stimulation (PTNS) in reducing pain, improving quality of life, and decreasing disease severity in patients with fibromyalgia. This prospective, single-blind, randomized controlled trial included female patients newly diagnosed with fibromyalgia who had started duloxetine treatment (30 mg/day). The patients in the study group received six sessions of posterior tibial nerve stimulation, twice weekly, 3-4 days apart, in addition to duloxetine; the controls received duloxetine only. The patients were evaluated three times (at baseline, 1st month, and 3rd month). Pain was evaluated using a numeric rating scale, the short-form McGill Pain Questionnaire, and quality of life with a 36-item short-form health survey (SF-36). Patient functional status and disease severity were evaluated using the fibromyalgia impact questionnaire (FIQ). A total of 64 patients met the inclusion criteria: 22 were ultimately included in the study group and 30 in the control group. Statistical improvements in pain and FIQ scores were observed after treatment in both groups. The SF-36 scores indicated improved vitality only in the 1st month in both groups, with no significant changes in the other quality-of-life subscales in either group. There was no statistical difference between the two groups in terms of changes in pain, FIQ, and SF-36 scores compared with baseline at the 1st month and 3rd month. The addition of PTNS to pharmacological treatment did not contribute to the reduction in pain or improvement in quality of life in fibromyalgia either in the 1st or 3rd month. NIH Clinical Trial Registration Number NCT05937711.
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Affiliation(s)
- İlker Fatih Sarı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Gazipaşa Yerleşkesi Debboy Mevki Giresun/Türkiye, Giresun 28200, Turkey; (F.K.); (Z.K.)
| | - İlker İlhanlı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ondokuz Mayıs University, Samsun 55139, Turkey;
| | - Tuba Mızrak
- Havza Physical Therapy and Rehabilitation Center, Ondokuz Mayıs University, Samsun 55700, Turkey;
| | - Fazıl Kulaklı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Gazipaşa Yerleşkesi Debboy Mevki Giresun/Türkiye, Giresun 28200, Turkey; (F.K.); (Z.K.)
| | - Zerrin Kasap
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Gazipaşa Yerleşkesi Debboy Mevki Giresun/Türkiye, Giresun 28200, Turkey; (F.K.); (Z.K.)
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100
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Zhu M, Huang H. The Underlying Mechanisms of Sleep Deprivation Exacerbating Neuropathic Pain. Nat Sci Sleep 2023; 15:579-591. [PMID: 37533626 PMCID: PMC10392808 DOI: 10.2147/nss.s414174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Abstract
Pain disrupts sleep, and sleep deprivation or interference can alter pain perception in animals and humans, for example by increasing sensitivity to pain. However, the mechanism by which sleep affects neuropathic pain remains unclear. In this review, we discuss the available evidence from the epidemiologic, clinical, and human, as well as laboratory studies. In previous studies, we have found that sleep deprivation affects various injurious systems, including opioids, dopaminergic, immune, orexins, hypothalamic-pituitary-adrenal axis, and adenosine. At the same time, these systems play a crucial role in neuropathic pain regulation. In the complex interactions between these neurobiological systems, there may be potential regulatory pathways through which sleep deprivation amplifies neuropathic pain. Because of the impact sleep problems and neuropathic pain can have on the patients' quality of life, studying the link between sleep and neuropathic pain is important for neuropathic pain prevention and public health.
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Affiliation(s)
- Manmin Zhu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Guizhou, People’s Republic of China
| | - Hao Huang
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Guizhou, People’s Republic of China
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