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van Ettinger-Veenstra H, Boehme R, Ghafouri B, Olausson H, Wicksell RK, Gerdle B. Exploration of Functional Connectivity Changes Previously Reported in Fibromyalgia and Their Relation to Psychological Distress and Pain Measures. J Clin Med 2020; 9:E3560. [PMID: 33167371 PMCID: PMC7694394 DOI: 10.3390/jcm9113560] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022] Open
Abstract
Neural functional connectivity changes in the default mode network (DMN), Central executive network (CEN), and insula have been implicated in fibromyalgia (FM) but stem from a sparse set of small-scale studies with limited power for the investigation of confounding effects. We investigated whether anxiety, depression, pain sensitivity, and pain intensity modulated functional connectivity related to DMN nodes, CEN nodes, and insula. Resting-state functional magnetic resonance imaging data were collected from 31 females with FM and 28 age-matched healthy controls. Connectivity was analysed with a region-based connectivity analysis between DMN nodes in ventromedial prefrontal cortex (vmPFC) and posterior cingulate cortex, CEN nodes in the intraparietal sulcus (IPS), and bilateral insula. FM patients displayed significantly higher levels of anxiety and depressive symptoms than controls. The right IPS node of the CEN showed a higher level of connectivity strength with right insula in FM with higher pain intensity compared to controls. More anxiety symptoms in FM correlated with higher levels of connectivity strength between the vmPFC DMN node and right sensorimotor cortex. These findings support the theory of altered insular connectivity in FM and also suggest altered IPS connectivity in FM. Interestingly, no change in insular connectivity with DMN was observed.
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Affiliation(s)
- Helene van Ettinger-Veenstra
- Department of Clinical Neuroscience, Karolinska Institute, S-171 77 Stockholm, Sweden;
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
| | - Rebecca Boehme
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
- Center for Social and Affective Neuroscience (CSAN), Linköping University, S-581 85 Linköping, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, S-581 85 Linköping, Sweden;
| | - Håkan Olausson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
- Center for Social and Affective Neuroscience (CSAN), Linköping University, S-581 85 Linköping, Sweden
| | - Rikard K. Wicksell
- Department of Clinical Neuroscience, Karolinska Institute, S-171 77 Stockholm, Sweden;
| | - Björn Gerdle
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, S-581 85 Linköping, Sweden;
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102
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Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol 2020; 16:645-660. [DOI: 10.1038/s41584-020-00506-w] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/20/2022]
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103
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Pagliai G, Colombini B, Dinu M, Whittaker A, Masoni A, Danza G, Amedei A, Ballerini G, Benedettelli S, Sofi F. Effectiveness of a Khorasan Wheat-Based Replacement on Pain Symptoms and Quality of Life in Patients with Fibromyalgia. PAIN MEDICINE 2020; 21:2366-2372. [PMID: 32488245 DOI: 10.1093/pm/pnaa134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the effects of a replacement diet with Khorasan wheat products in patients with fibromyalgia, in comparison with a similar replacement diet with control products made from organic semi-whole-grain modern wheat. DESIGN Randomized, double-blinded crossover trial. SETTING Outpatient clinic. SUBJECTS Twenty subjects (19 female and one male, mean age = 48.9 ± 12.3 years) with fibromyalgia. METHODS Participants were randomly assigned to consume either Khorasan or control wheat products (pasta, bread, crackers, biscuits) for eight weeks and then crossed. Validated self-administered questionnaires were collected from each subject at the beginning and end of each intervention period. RESULTS A general linear model for repeated measurement, adjusted for potential confounders, showed that the overall score reported from each questionnaire improved after both intervention and control periods, but the effect was more evident after the intervention with Khorasan. In particular, a statistically significant difference in Widespread Pain Index (WPI) + Severity Scale (SS) and Functional Outcome of Sleep Questionnaire (FOSQ) was observed, which decreased significantly by 21.5% and 11.7% respectively, only after the Khorasan period, while no statistically significant variations were reported after the control period. Similarly, FM Impact Questionnaire scores decreased significantly only after the Khorasan period, with a reduction that was significantly different between the intervention and control periods (-22.5% vs -0.3%, P = 0.037). The improvement was even greater in people with higher symptom severity. CONCLUSIONS A dietary intervention with Khorasan wheat products seems to benefit patients with fibromyalgia, especially those with greater symptom severity.
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Affiliation(s)
- Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Anne Whittaker
- Department of Agrifood Production and Environmental Sciences, University of Florence, Florence, Italy
| | - Alberto Masoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanna Danza
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanna Ballerini
- Multidisciplinary Center for Pain Therapy, Reference Center for Fibromyalgia, Piero Palagi Hospital, USL Toscana Centro, Florence, Italy
| | - Stefano Benedettelli
- Department of Agrifood Production and Environmental Sciences, University of Florence, Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy.,Don Carlo Gnocchi Foundation Italy, Onlus IRCCS, Florence, Italy
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104
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Abdel Fattah YH, Elnemr R. Efficacy of pregabalin as a monotherapy versus combined pregabalin and milnacipran in the management of fibromyalgia. Int J Rheum Dis 2020; 23:1474-1480. [PMID: 32886447 DOI: 10.1111/1756-185x.13953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/06/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
AIM To compare the efficacy and tolerability of combined pregabalin (PGB) and milnacipran (MLN) in female patients with fibromyalgia (FM) versus PGB as a monotherapy. METHODS The present randomized open study included 58 female patients diagnosed with FM (registered on 4/2/19: NCT03905486). Patients were randomly divided into 2 groups (2:2); group 1 included 29 patients who received PGB monotherapy (150 mg twice daily) and group 2 included 29 patients who received combined PGB (150 mg twice daily) and MLN (50 mg twice daily) for 3 months. At the initial visit, patients were subjected to demographic data collection and assessed by the visual analog scale (VAS) for pain and the FM impact questionnaire (FIQ). Outcome measures after 3 months: FIQ, VAS and Leeds Sleep Evaluation Questionnaire. RESULTS The median disease duration was 2 years in group 1 (6 months to 5 years) and 2 years in group 2 (6 months to 12 years). The dropout rate was 20.7% in group 1 (n = 6) and 10.3% in group 2 (n = 3). At the follow-up evaluation, a statistically significant improvement was observed in VAS and FIQ scores in both groups (P < 0.001). Although the percentage of patients demonstrating significant improvement in pain, disease impact and sleep pattern were higher in group 2, this did not reach statistical significance. CONCLUSION Although PGB as a monotherapy and in combination with MLN have both shown adequate efficacy in the treatment of patients with FM, the combined therapy did not demonstrate superiority over the monotherapy.
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Affiliation(s)
- Yousra Hisham Abdel Fattah
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rehab Elnemr
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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105
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Nutritional Interventions in the Management of Fibromyalgia Syndrome. Nutrients 2020; 12:nu12092525. [PMID: 32825400 PMCID: PMC7551285 DOI: 10.3390/nu12092525] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023] Open
Abstract
Fibromyalgia (FM) is a multifactorial syndrome of unknown etiology, characterized by widespread chronic pain and various somatic and psychological manifestations. The management of FM requires a multidisciplinary approach combining both pharmacological and nonpharmacological strategies. Among nonpharmacological strategies, growing evidence suggests a potential beneficial role for nutrition. This review summarizes the possible relationship between FM and nutrition, exploring the available evidence on the effect of dietary supplements and dietary interventions in these patients. Analysis of the literature has shown that the role of dietary supplements remains controversial, although clinical trials with vitamin D, magnesium, iron and probiotics' supplementation show promising results. With regard to dietary interventions, the administration of olive oil, the replacement diet with ancient grains, low-calorie diets, the low FODMAPs diet, the gluten-free diet, the monosodium glutamate and aspartame-free diet, vegetarian diets as well as the Mediterranean diet all appear to be effective in reducing the FM symptoms. These results may suggest that weight loss, together with the psychosomatic component of the disease, should be taken into account. Therefore, although dietary aspects appear to be a promising complementary approach to the treatment of FM, further research is needed to provide the most effective strategies for the management of FM.
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106
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Xu Z, Wang F, Adekkanattu P, Bose B, Vekaria V, Brandt P, Jiang G, Kiefer RC, Luo Y, Pacheco JA, Rasmussen LV, Xu J, Alexopoulos G, Pathak J. Subphenotyping depression using machine learning and electronic health records. Learn Health Syst 2020; 4:e10241. [PMID: 33083540 PMCID: PMC7556423 DOI: 10.1002/lrh2.10241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/08/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022] Open
Abstract
Objective To identify depression subphenotypes from Electronic Health Records (EHRs) using machine learning methods, and analyze their characteristics with respect to patient demographics, comorbidities, and medications. Materials and Methods Using EHRs from the INSIGHT Clinical Research Network (CRN) database, multiple machine learning (ML) algorithms were applied to analyze 11 275 patients with depression to discern depression subphenotypes with distinct characteristics. Results Using the computational approaches, we derived three depression subphenotypes: Phenotype_A (n = 2791; 31.35%) included patients who were the oldest (mean (SD) age, 72.55 (14.93) years), had the most comorbidities, and took the most medications. The most common comorbidities in this cluster of patients were hyperlipidemia, hypertension, and diabetes. Phenotype_B (mean (SD) age, 68.44 (19.09) years) was the largest cluster (n = 4687; 52.65%), and included patients suffering from moderate loss of body function. Asthma, fibromyalgia, and Chronic Pain and Fatigue (CPF) were common comorbidities in this subphenotype. Phenotype_C (n = 1452; 16.31%) included patients who were younger (mean (SD) age, 63.47 (18.81) years), had the fewest comorbidities, and took fewer medications. Anxiety and tobacco use were common comorbidities in this subphenotype. Conclusion Computationally deriving depression subtypes can provide meaningful insights and improve understanding of depression as a heterogeneous disorder. Further investigation is needed to assess the utility of these derived phenotypes to inform clinical trial design and interpretation in routine patient care.
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Affiliation(s)
- Zhenxing Xu
- Weill Cornell Medicine New York New York USA
| | - Fei Wang
- Weill Cornell Medicine New York New York USA
| | | | | | | | | | | | | | - Yuan Luo
- Northwestern University Chicago Illinois USA
| | | | | | - Jie Xu
- Weill Cornell Medicine New York New York USA
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107
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Alioshkin Cheneguin A, Salvat Salvat I, Romay Barrero H, Torres Lacomba M. How good is online information on fibromyalgia? An analysis of quality and readability of websites on fibromyalgia in Spanish. BMJ Open 2020; 10:e037065. [PMID: 32624475 PMCID: PMC7337882 DOI: 10.1136/bmjopen-2020-037065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To assess the content, quality and readability of websites with information on fibromyalgia in Spanish. METHODS Websites were retrieved entering the keyword 'fibromyalgia' in Google, Yahoo! and Bing, and by searching records of patients associations in Spain and Latin America. The Bermúdez-Tamayo and DISCERN questionnaires were employed for evaluating quality and content, and INFLESZ for readability. Statistical analysis was conducted using IBM SPSSV.24 (Chicago, USA). RESULTS Three hundred and five websites were found. After applying the exclusion criteria, 73 websites were analysed. Websites retrieved by search engines obtained median scores of 27.0 (interquartile interval (IQI): 24.5-32.0) with DISCERN, 35.0 (IQI: 31.0-40.5) with Bermúdez-Tamayo and 53.7 (IQI: 47.4-56.2) with INFLESZ, whereas those from patients associations scored 21.0 (IQI: 19.2-23.8), 26.0 (IQI: 25.0-31.0) and 51.7 (IQI: 47.9-55.1), respectively. In general, content was not up-to-date. CONCLUSIONS Overall quality was medium-low, content quality was very low and readability was poor. Further effort is needed to guarantee meeting quality criteria and accessing updated, relevant, and legible information.This study exposes the quality and readability of websites on fibromyalgia in Spanish, which can help healthcare workers to better appraise this resource and its potential influence on the development of the pathology.
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Affiliation(s)
| | - Isabel Salvat Salvat
- Department of Medicine and Surgery and Institute for Health Research Pere Virgili, Rovira i Virgili University, Tarragona, Catalunya, Spain
| | - Helena Romay Barrero
- Faculty of Physical Therapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
| | - María Torres Lacomba
- FPSM Research Group-Physical Therapy Department, University of Alcalá de Henares, Madrid, Spain
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108
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Mutlu P, Zateri C, Zohra A, Ozerdogan O, Mirici AN. Prevalence of obstructive sleep apnea in female patients with fibromyalgia. Saudi Med J 2020; 41:740-745. [PMID: 32601643 PMCID: PMC7502927 DOI: 10.15537/smj.2020.7.25165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: To determine the prevalence of obstructive sleep apnea in female patients with fibromyalgia (FM) presenting to physical therapy outpatient clinics. Methods: The 36-item short form health survey (SF-36) questionnaire, Berlin test, and epworth sleepiness scale were administered, along with a polysomnography to 38 female patients. This cross-sectional study comprised diagnosed with FM according to the diagnostic criteria of the American College of Rheumatology, between March 2017 and August 2019, at the Faculty of Medicine Hospital, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. Results: Of the participants, 65.9% were found to have obstructive sleep apnea (OSA). Patients with OSA were older and had a higher disease activity score for FM. A strong positive correlation was identified between the apnea-hypopnea index (AHI) and the FA disease activity score. A negative correlation was found between AHI and the subscales of SF-36. Conclusion: A clinical assessment of female patients with FM requires a multidisciplinary approach, and patients with excessive daytime sleepiness in particular are recommended to undergo polysomnography. The authors believe that the early detection and treatment of accompanying OSA will contribute not only to the quality of life, but also to the survival of patients with FM.
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Affiliation(s)
- Pinar Mutlu
- Department of Chest Diseases, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. E-mail.
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Andrade A, Steffens RDAK, Vilarino GT, Miranda R, Benetti M, Coimbra DR. Preferred exercise and mental health of the patients with fibromyalgia syndrome. Complement Ther Clin Pract 2020; 40:101195. [PMID: 32891275 DOI: 10.1016/j.ctcp.2020.101195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE Preferred exercise may be beneficial for the mental health of patients with fibromyalgia syndrome (FMS).This study aimed to investigate the effects of preferred exercise on the quality of life (Qol), depression, and mood states of the patients with FMS. MATERIALS AND METHODS This study was a nonrandomized controlled trial. The patients with FMS were divided into an experimental group (EG; n = 22) and a control group (CG; n = 14). The patients in the EG performed their preferred exercise (resistance, walking, or stretching) for 12 weeks. CG went to a waiting list. Fibromyalgia Impact Questionnaire, Beck Depression Inventory, and Brunel Mood Scale were used to evaluate the outcomes. RESULTS The EG exhibited a decrease in the total impact of FMS on the Qol, depression, tension, and mental confusion (p < 0.01). CONCLUSION Preferred exercises reduced the impact of FMS on the Qol, depression, and mental confusion of patients with FMS.
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Affiliation(s)
- Alexandro Andrade
- Department of Human Movement Science, Santa Catarina State University - UDESC, Florianópolis, Santa Catarina, Brazil.
| | | | - Guilherme Torres Vilarino
- Department of Human Movement Science, Santa Catarina State University - UDESC, Florianópolis, Santa Catarina, Brazil
| | - Renato Miranda
- Department of Physical Education, FAEFID, Juiz de Fora Federal University - UFJF, Juiz de Fora, Minas Gerais, Brazil
| | - Magnus Benetti
- Department of Human Movement Science, Santa Catarina State University - UDESC, Florianópolis, Santa Catarina, Brazil
| | - Danilo Reis Coimbra
- Departament of Physical Education, ICV, Juiz de Fora Federal University - UFJF, Governador Valadares, Minas Gerais, Brazil
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110
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Fatigue, Physical Activity, and Mental Health in People Living With Inflammatory Bowel Disease, Fibromyalgia, and in Healthy Controls: A Comparative Cross-Sectional Survey. Gastroenterol Nurs 2020; 43:172-185. [PMID: 32251219 DOI: 10.1097/sga.0000000000000415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
This study aimed to identify biopsychosocial factors associated with fatigue, physical activity, and perceived benefits of and barriers to exercise in adults with inflammatory bowel disease and to compare them with those with fibromyalgia and healthy controls. A cross-sectional online survey was conducted. Hierarchical linear regressions were used to examine correlates of fatigue and physical activity. Analysis of variance and Kruskal-Wallis tests were used to compare levels of fatigue and physical activity between the groups. Overall, 387 participants completed the study (inflammatory bowel disease: n = 232; fibromyalgia: n = 102; healthy controls: n = 53). Significant correlates of fatigue included pain catastrophizing (p = .006), sleep quality (p = .003), and depressive symptoms (p < .001). Perceived barriers to exercise were associated with depressive symptoms (p = .003). Correlates of perceived benefits of exercise included anxiety (p = .036), depressive symptoms (p = .014), coping (positive reframing) (p = .018), and social support (from family) (p = .033). The fibromyalgia group had the greatest fatigue interference and the lowest score for physical activity, followed by the inflammatory bowel disease group and healthy controls (p < .05). Given the interplay between depressive symptoms, fatigue, and benefits/barriers to exercise, there is a need for more psychological interventions to be developed and tested in order to reduce fatigue and increase physical activity to better manage disease-related outcomes.
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111
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Richard JY, Hurley RA, Taber KH. Fibromyalgia: Centralized Pain Processing and Neuroimaging. J Neuropsychiatry Clin Neurosci 2020; 31:A6-187. [PMID: 31322995 DOI: 10.1176/appi.neuropsych.19050107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Julianne Y Richard
- The Mental Health Service Line, Salisbury VA Healthcare System, Salisbury, N.C. (Richard); the Veterans Affairs Mid Atlantic Mental Illness Research, Education, and Clinical Center, and Research and Academic Affairs Service Line, Salisbury VA Healthcare System, Salisbury, N.C. (Hurley, Taber); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Robin A Hurley
- The Mental Health Service Line, Salisbury VA Healthcare System, Salisbury, N.C. (Richard); the Veterans Affairs Mid Atlantic Mental Illness Research, Education, and Clinical Center, and Research and Academic Affairs Service Line, Salisbury VA Healthcare System, Salisbury, N.C. (Hurley, Taber); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Katherine H Taber
- The Mental Health Service Line, Salisbury VA Healthcare System, Salisbury, N.C. (Richard); the Veterans Affairs Mid Atlantic Mental Illness Research, Education, and Clinical Center, and Research and Academic Affairs Service Line, Salisbury VA Healthcare System, Salisbury, N.C. (Hurley, Taber); the Departments of Psychiatry and Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
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113
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A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Pain 2020; 161:1169-1176. [DOI: 10.1097/j.pain.0000000000001819] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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114
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Pagliusi M, Bonet I, Brandão A, Magalhães S, Tambeli C, Parada C, Sartori C. Therapeutic and Preventive Effect of Voluntary Running Wheel Exercise on Social Defeat Stress (SDS)-induced Depressive-like Behavior and Chronic Pain in Mice. Neuroscience 2020; 428:165-177. [DOI: 10.1016/j.neuroscience.2019.12.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/29/2019] [Accepted: 12/23/2019] [Indexed: 01/21/2023]
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115
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Araya-Quintanilla F, Gutiérrez-Espinoza H, Muñoz-Yánez MJ, Cavero-Redondo I, Álvarez-Bueno C, Martinez-Vizcaíno V. Effectiveness of a multicomponent treatment versus conventional treatment in patients with fibromyalgia: Study protocol. Medicine (Baltimore) 2020; 99:e18833. [PMID: 31977878 PMCID: PMC7004771 DOI: 10.1097/md.0000000000018833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain and multiple symptoms. It is a common clinical condition whose etiology is unclear. Currently, there is no gold standard treatment for FM. Management of this condition is therefore aimed at reducing symptoms and maintaining the individual's ability to function optimally. Based on the principal symptoms and characteristics of individuals with FM, we hypothesized that the implementation of a multicomponent treatment (with physical exercise, cognitive behavioral therapy adding to a graded motor imagery program, and therapeutic neuroscience education) would be more effective than conventional treatment in women with FM. This paper describes the rationale and methods of study intended to test the effectiveness of multicomponent treatment versus conventional treatment in patients with FM. METHOD/DESIGN Fifty-six female individuals between 18 and 65 years of age, who were referred to the physical therapy department of the Rehabilitar Center in Chile, will be randomized into two treatment arms. The intervention group will receive a multicomponent treatment program for duration of 12 weeks. The control group will receive a conventional treatment for this condition for 12 weeks. The primary outcome measure will be the pain intensity score, measured by the numeric pain rating scale (NPRS), and the secondary outcomes will be the FM Impact Questionnaire (FIQ), and affective components of pain, such as catastrophizing using the Pain Catastrophizing Scale (PCS), fear of movement using the Tampa Scale Kinesiophobia (TSK), and sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). DISCUSSION This paper reports the design of a randomized clinical trial aimed at assessing the effectiveness of the multicomponent treatment versus conventional treatment in women with FM. TRIAL REGISTRATION Brazilian registry of clinical trials UTN number U1111-1232-0862. Registered 22 April 2019.
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Affiliation(s)
- Felipe Araya-Quintanilla
- Rehabilitation and Health Research Center. CIRES, Universidad de las Américas
- Faculty of Health Sciences, Universidad SEK
| | - Héctor Gutiérrez-Espinoza
- Rehabilitation and Health Research Center. CIRES, Universidad de las Américas
- Physical Therapy Department, Clinical Hospital San Borja Arriaran, Santiago, Chile
| | | | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Vicente Martinez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Yao X, Li L, Kandhare AD, Mukherjee-Kandhare AA, Bodhankar SL. Attenuation of reserpine-induced fibromyalgia via ROS and serotonergic pathway modulation by fisetin, a plant flavonoid polyphenol. Exp Ther Med 2019; 19:1343-1355. [PMID: 32010308 PMCID: PMC6966137 DOI: 10.3892/etm.2019.8328] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 11/06/2019] [Indexed: 12/25/2022] Open
Abstract
Fibromyalgia (FM) is a chronic complex musculoskeletal disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep disturbance, memory defects and mood changes. Fisetin, a plant flavonoid polyphenol, has been reported to possess potent antioxidant, antinociceptive and neuroprotective activities. The present study aimed to evaluate the efficacy of fisetin against reserpine-induced FM (RIF) in rats. RIF was induced in male Wistar rats (180–220 gm) using reserpine (1 mg/kg; subcutaneous; once daily for 3 consecutive days) and the rats were treated with fisetin (5, 10 and 25 mg/kg) for 21 days. Various behavioral, biochemical and molecular parameters were evaluated. Administration of reserpine induced allodynia, hyperalgesia and depression, which were significantly ameliorated (P<0.05) by fisetin (10 and 25 mg/kg), as reflected by an increase in paw and tail withdrawal latency, increased paw withdrawal threshold, and decreased immobility time. Reserpine led to decreased biogenic amine levels [5-hydroxytryptamine (5-HT), noradrenaline (NA) and dopamine (DA)] and increased the ratio to their metabolite 3,4-dihydroxyphenylacetic acid. 5-hydroxyindoleacetic acid in the spinal cord, thalamus and prefrontal cortex was significantly decreased (P<0.05) by fisetin. Immunohistological analysis of brain tissue revealed that fisetin significantly inhibited (P<0.05) reserpine-induced depletion of 5-HT. It also significantly inhibited (P<0.05) elevated oxido-nitrosative stress and reactive oxygen species (ROS) levels, as analyzed by flow cytometry in RIF rats. Fisetin exerts its antinociceptive and anti-depressive potential via modulation of decreased levels of biogenic amines (5-HT, NA and DA), elevated oxido-nitrosative stress and ROS to ameliorate allodynia, hyperalgesia, and depression in experimental RIF.
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Affiliation(s)
- Xianli Yao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Li Li
- Encephalopathy Department, The Traditional Chinese Medicine Hospital of Zhangqiu District, Jinan, Shandong 250200, P.R. China
| | - Amit D Kandhare
- Department of Pharmacology, Poona College of Pharmacy, Bharati Vidyapeeth Deemed University, Pune-411038, Maharashtra, India
| | - Anwesha A Mukherjee-Kandhare
- Department of Pharmacology, Poona College of Pharmacy, Bharati Vidyapeeth Deemed University, Pune-411038, Maharashtra, India
| | - Subhash L Bodhankar
- Department of Pharmacology, Poona College of Pharmacy, Bharati Vidyapeeth Deemed University, Pune-411038, Maharashtra, India
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117
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Pando-Naude V, Barrios FA, Alcauter S, Pasaye EH, Vase L, Brattico E, Vuust P, Garza-Villarreal EA. Functional connectivity of music-induced analgesia in fibromyalgia. Sci Rep 2019; 9:15486. [PMID: 31664132 PMCID: PMC6820536 DOI: 10.1038/s41598-019-51990-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 10/07/2019] [Indexed: 11/09/2022] Open
Abstract
Listening to self-chosen, pleasant and relaxing music reduces pain in fibromyalgia (FM), a chronic centralized pain condition. However, the neural correlates of this effect are fairly unknown. In our study, we wished to investigate the neural correlates of music-induced analgesia (MIA) in FM patients. To do this, we studied 20 FM patients and 20 matched healthy controls (HC) acquiring rs-fMRI with a 3T MRI scanner, and pain data before and after two 5-min auditory conditions: music and noise. We performed resting state functional connectivity (rs-FC) seed-based correlation analyses (SCA) using pain and analgesia-related ROIs to determine the effects before and after the music intervention in FM and HC, and its correlation with pain reports. We found significant differences in baseline rs-FC between FM and HC. Both groups showed changes in rs-FC after the music condition. FM patients reported MIA that was significantly correlated with rs-FC decrease between the angular gyrus, posterior cingulate cortex and precuneus, and rs-FC increase between amygdala and middle frontal gyrus. These areas are related to autobiographical and limbic processes, and auditory attention, suggesting MIA may arise as a consequence of top-down modulation, probably originated by distraction, relaxation, positive emotion, or a combination of these mechanisms.
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Affiliation(s)
- Victor Pando-Naude
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", México City, México
- Institute of Neurobiology, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, México
- Center for Music in the Brain, University of Aarhus, Aarhus, Denmark
| | - Fernando A Barrios
- Department of Behavioral and Cognitive Neurobiology, Brain Mapping Lab, Institute of Neurobiology, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, México
| | - Sarael Alcauter
- Department of Behavioral and Cognitive Neurobiology, Brain Mapping Lab, Institute of Neurobiology, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, México
| | - Erick H Pasaye
- Magnetic Resonance Unit, Institute of Neurobiology, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, México
| | - Lene Vase
- Department of Psychology and Behavioral Sciences, University of Aarhus, Aarhus, Denmark
- Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark
| | - Elvira Brattico
- Center for Music in the Brain, University of Aarhus, Aarhus, Denmark
| | - Peter Vuust
- Center for Music in the Brain, University of Aarhus, Aarhus, Denmark
- Royal Academy of Music, Aarhus, Denmark
| | - Eduardo A Garza-Villarreal
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", México City, México.
- Center for Music in the Brain, University of Aarhus, Aarhus, Denmark.
- Laboratorio Nacional de Imagenología por Resonancia Magnética (LANIREM), Institute of Neurobiology, Universidad Nacional Autonoma de Mexico (UNAM) campus Juriquilla, Queretaro, Mexico.
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118
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Pehlevan S. Fibromiyaljide güncel ilaç tedavisi. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.649156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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119
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Koca TT, Tugan CB, Koçyiğit BF, Nacitarhan V. Fibromyalgia awareness in women aged between 18 and 75 years: a current view to fibromyalgia. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0970-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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120
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Ghavidel-Parsa B, Bidari A, Hajiabbasi A, Shenavar I, Ghalehbaghi B, Sanaei O. Fibromyalgia diagnostic model derived from combination of American College of Rheumatology 1990 and 2011 criteria. Korean J Pain 2019; 32:120-128. [PMID: 31091511 PMCID: PMC6549593 DOI: 10.3344/kjp.2019.32.2.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 12/03/2022] Open
Abstract
Background We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria’s items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM’s key features. Methods The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.
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Affiliation(s)
- Banafsheh Ghavidel-Parsa
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Bidari
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Asghar Hajiabbasi
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Irandokht Shenavar
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Babak Ghalehbaghi
- ENT and Head and Neck Research Center and Department, Iran University of Medical Sciences, Tehran, Iran
| | - Omid Sanaei
- Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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121
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Accuracy, completeness and accessibility of online information on fibromyalgia. Rheumatol Int 2019; 39:735-742. [DOI: 10.1007/s00296-019-04265-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 02/25/2019] [Indexed: 12/29/2022]
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122
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Harth M, Nielson WR. Pain and affective distress in arthritis: relationship to immunity and inflammation. Expert Rev Clin Immunol 2019; 15:541-552. [PMID: 30669892 DOI: 10.1080/1744666x.2019.1573675] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Most arthritides are associated with pain and psychological distress (clinically significant depression and anxiety). Pain and depression are mutually exacerbating; both may continue even when joint involvement appears well controlled. Area covered: There is strong evidence that arthritis-related stress impacts the central nervous system and, together with peripheral inflammatory changes, can cause central sensitization that can lead to chronic pain and worsening of affective distress. Cytokines and chemokines participate both in joint inflammation and in central sensitization. We review evidence of these relationships in five arthritides, namely rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout, and in osteoarthritis of the hips and knees. Central sensitization in these conditions results in long-lasting pain and psychological distress. Expert commentary: Chronic pain and depression are important but often neglected in the clinical assessment and treatment of arthritis. The potential role of biologic cytokines and Janus kinase inhibitors in dealing with these symptoms needs further study.
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Affiliation(s)
- Manfred Harth
- a Medicine , Western University , London , Ontario , Canada
| | - Warren R Nielson
- b Lawson Health Research Institute , London , Ontario , Canada.,c Department of Psychology , Western University , London , Ontario , Canada
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123
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The role of HHV-6 and HHV-7 infections in the development of fibromyalgia. J Neurovirol 2019; 25:194-207. [PMID: 30617851 PMCID: PMC6505518 DOI: 10.1007/s13365-018-0703-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/31/2018] [Accepted: 11/13/2018] [Indexed: 12/19/2022]
Abstract
Human herpes virus-6 (HHV-6) and human herpes virus-7 (HHV-7) are immunomodulating viruses potentially affecting the nervous system. We evaluated the influence of HHV-6 and HHV-7 infections on fibromyalgia (FM) clinical course. Forty-three FM patients and 50 control group participants were enrolled. 39.50% (n = 17) FM patients had light A delta and C nerve fiber damage, 27.91% (n = 12) had severe A delta and C nerve fiber damage. 67.44% (n = 29) FM patients had loss of warm sensation in feet, loss of heat pain sensation, and increased cold pain sensation (34.90%, n = 15 in both findings). HHV-6 and HHV-7 genomic sequences in peripheral blood DNA in 23/43 (51.00%) and 34/43 (75.50%) of samples from FM patients and in 3/50 (6.00%) and 26/50 (52.00%) of samples from the control group individuals were detected. Active HHV-6 (plasma viremia) or HHV-7 infection was revealed only in FM patients (4/23, 17.40% and 4/34, 11.80%, respectively). A statistically significant moderate positive correlation was found between A delta and C nerve fiber damage severity and HHV-6 infection (p < 0.01, r = 0.410). 23/43 patients from the FM group and control group participants HHV-6 and 34/45 HHV-7 did have infection markers. A statistically significant moderate positive correlation was found between A delta and C nerve fiber damage severity and HHV-6 infection (p < 0.01, r = 0.410). No difference was found between detection frequency of persistent HHV-6 and HHV-7 infection between FM patients and the control group. Statistically significant correlation was observed between quantitation of changes in QST thermal modalities and HHV-6 infection. There was no correlation between A delta and C nerve fiber damage and HHV-7 infection.
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124
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Applbaum E, Lichtbroun A. Novel Sjögren's autoantibodies found in fibromyalgia patients with sicca and/or xerostomia. Autoimmun Rev 2018; 18:199-202. [PMID: 30572137 DOI: 10.1016/j.autrev.2018.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION A significant proportion of patients with fibromyalgia (FM) complain of dry eyes and mouth. Many Sjögren's syndrome (SS) patients also complain of FM symptoms, and there is literature that suggests that there is interplay between these two disorders. Recently, the presence of novel tissue specific autoantibodies (TSAs), SP-1, CA6, and PSP, has been observed in the early stages of SS. These early markers present themselves before the classic autoantibodies, such as SS-A/Ro, SS-B/La, ANA, and RF. OBJECTIVE This study aims to examine the relationship between SS and FM by testing patients with FM who also complain of xerostomia and sicca symptoms, for SS- related biomarkers. METHODS A cohort of 185 patients who met both the 1990 and 2010 preliminary diagnostic criteria for FM and who admitted to symptoms of sicca and/or xerostomia were selected for this study. Serum from 151 study patients was sent to a tertiary lab, Immco Diagnostics, for testing of the classic autoantibodies (SS-A/Ro, SS-B/La, ANA and RF) and TSAs (SP-1, CA6, PSP), while the rest (34 patients) were tested for TSAs only. RESULTS Of the 151 patients who were evaluated for both the early and classic SS markers, 49 (32%) tested positive for SS autoantibodies. Of those, 4 (3%) tested positive for the classic SS markers only, 40 (26%) of the patients tested positive for the early SS markers only, and 5 (3%) tested positive for both the early and classic SS markers. Of the 34 patients who were tested for early SS markers only, 10 (29%) tested positive and 24 (71%) tested negative. Further analysis of all the patients that tested positive for the TSAs (n = 55), found 83.6% (46) were positive for SP-1, 12.7% (7) were positive for CA6 and 20.0% (11) were positive for PSP. 85.5% (47) of these patients were positive for only one of the TSAs and 14.5% (8) were positive for more than one TSA. CONCLUSION Approximately 1/3 of FM patients that were tested for both the TSAs and classic Sjögren's markers tested positive for a SS biomarker, and the majority of those patients tested positive for one or more of the TSAs. This suggests that autoimmunity, specifically early- stage Sjögren's syndrome, may be involved in the pathophysiology of fibromyalgia.
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Affiliation(s)
- Eliana Applbaum
- Rutgers- Robert Wood Johnson Medical School, Piscataway, NJ, USA.
| | - Alan Lichtbroun
- Department of Medicine, Rutgers-Robert Wood Johnson University Hospital, New Brunswick, NJ, USA
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125
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Gerber MR, Bogdan KM, Haskell SG, Scioli ER. Experience of Childhood Abuse and Military Sexual Trauma Among Women Veterans with Fibromyalgia. J Gen Intern Med 2018; 33:2030-2031. [PMID: 30076571 PMCID: PMC6258609 DOI: 10.1007/s11606-018-4594-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Megan R Gerber
- Women's Health Program , VA Boston Healthcare System, 150 South Huntington Avenue, PC 11/WHC, Boston, MA, 02130, USA.
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Kristina M Bogdan
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Sally G Haskell
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Erica R Scioli
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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126
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Abstract
STUDY DESIGN A cross-sectional study. OBJECTIVES The main goal of the study was to analyze posture of Fibromyalgia syndrome (FMS) in women compared with healthy subjects to establish if posture assessment could be useful to characterize the syndrome. Secondarily, we explored the impact of sedentary behavior on trunk posture. SUMMARY OF BACKGROUND DATA Pain has been associated with poor static postures, however there is little information on the effect of FMS, which is characterized by widespread pain, on trunk posture. METHODS One hundred eighteen women with FMS and 110 healthy counterparts participated in this study, in which trunk posture was assessed. The thoracic kyphosis, forward head position, and shoulder position (basal and maximum protraction) were measured. Further, maximum shoulder protraction and the ability to maintain the cervical and thoracic angle were assessed. To compare the differences in posture depending on the grouping, an independent Student t test was conducted. To analyze the differences between groups in the ability to maintain the position over a period of time and the differences in posture depending on more or less active lifestyles, two multivariate analysis of variance were performed. RESULTS The results showed a significantly larger thoracic kyphosis, baseline shoulder protraction and lower craniovertebral angle and maximum protraction in FMG compared with CG (P < 0.05). FMG subjects exhibited an impaired ability to maintain the cervical and thoracic angles, as this varied throughout the test, unlike those of their counterparts. A sedentary lifestyle did not affect trunk posture in the FMS participants. CONCLUSION FMS female population present an altered trunk posture and an inability to maintain trunk position. Since this does not appear to be influenced by a more or less active lifestyle, specific treatment programs are needed to manage this clinical condition. LEVEL OF EVIDENCE 2.
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127
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Andrade A, de Azevedo Klumb Steffens R, Sieczkowska SM, Peyré Tartaruga LA, Torres Vilarino G. A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations. Adv Rheumatol 2018; 58:36. [PMID: 30657077 DOI: 10.1186/s42358-018-0033-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/28/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) is characterized by chronic and generalized musculoskeletal pain. There is currently no cure for FM, but palliative treatments are available. One type of treatment is strength training (ST). However, there is a need for more information on optimal training protocols, intensity, and volume needed to improve symptoms. The aim of this study was to analyze the effects of ST in the treatment of FM through a systematic review of experimental research. METHODS Medical Subject Headings search terms and electronic databases including Scientific Electronic Library Online, PubMed, Science Direct, Web of Science, and Physiotherapy Evidence Database were used to identify studies. RESULTS The inclusion criteria were met by 22 eligible studies. Most of the studies were conducted in the United States (36%), Finland (23%), Brazil (18%), and Sweden (18%). The studies showed that ST reduces the number of tender points, fatigue, depression, and anxiety, and improves sleep quality and quality of life in patients with FM. The intervention period ranged from 3 to 21 weeks, with sessions performed 2 times a week in 81.81% of the studies, at initial intensities of 40% of 1-repetition maximum. The repetitions ranged from 4 to 20, with no specific protocol defined for ST in FM. CONCLUSION The main results included reduction in pain, fatigue, number of tender points, depression, and anxiety, with increased functional capacity and quality of life. Current evidence demonstrates that ST is beneficial and can be used to treat FM. TRIAL REGISTRATION CRD42016048480.
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Affiliation(s)
- Alexandro Andrade
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil. .,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil.
| | - Ricardo de Azevedo Klumb Steffens
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil.,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil.,Regional University of Blumenau - FURB, Blumenau, SC, Brazil
| | - Sofia Mendes Sieczkowska
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil.,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil
| | - Leonardo Alexandre Peyré Tartaruga
- Human Movement Sciences and Pneumological Sciences, UFRGS- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Research Laboratory of Exercise - LAPEX, Porto Alegre, RS, Brazil
| | - Guilherme Torres Vilarino
- Health and Sports Science Center, CEFID / Santa Catarina State University - UDESC, Florianópolis, SC, Brazil.,Laboratory of Sports and Exercise Psychology - LAPE, Florianópolis, SC, Brazil
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128
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Abstract
Fibromyalgia is a common disorder and has substantial impact on quality of life. The cause remains unknown, but current evidence points to multifactorial involvement of pain processing. Clinical diagnosis is aided by evidence-based diagnostic criteria with subscores for widespread pain and symptom severity. Nonpharmacologic treatments, including cognitive behavioral therapy, sleep hygiene, and regular aerobic exercise, form the cornerstone of management. Pharmacologic intervention is an important adjunct, but benefit is variable. There is no cure for fibromyalgia at this time, but persistence and patience in management may lead to a satisfactory lifestyle.
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Affiliation(s)
- Jay B Higgs
- Brooke Army Medical Center, MCHE-ZDM-MDR, Brooke Army Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234-4504, USA.
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129
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Lawson K. Kv7 channels a potential therapeutic target in fibromyalgia: A hypothesis. World J Pharmacol 2018; 7:1-9. [DOI: 10.5497/wjp.v7.i1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/05/2018] [Accepted: 10/13/2018] [Indexed: 02/06/2023] Open
Abstract
Fibromyalgia is characterized by the primary symptoms of persistent diffuse pain, fatigue, sleep disturbance and cognitive dysfunction. Persistent pain conditions, such as fibromyalgia, are often refractory to current available therapies. An involvement of K+ channels in the pathophysiology of fibromyalgia is emerging and supported by drug treatments for this condition exhibiting action at these molecular processes. K+ channels constitute potential novel target candidates for pain therapy offering peripheral and/or central actions. The Kv7 channel activators, flupirtine and retigabine, have exhibited pharmacological profiles compatible to the requirements needed for use as a therapeutic approach to fibromyalgia. Clinical trials to address the multidimensional challenges of fibromyalgia with flupirtine and retigabine will provide important insight to the role of K+ channels in this condition.
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Affiliation(s)
- Kim Lawson
- Department of Biosciences and Chemistry, Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, United Kingdom
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130
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Duffield SJ, Miller N, Zhao S, Goodson NJ. Concomitant fibromyalgia complicating chronic inflammatory arthritis: a systematic review and meta-analysis. Rheumatology (Oxford) 2018; 57:1453-1460. [PMID: 29788461 PMCID: PMC6055651 DOI: 10.1093/rheumatology/key112] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Indexed: 02/06/2023] Open
Abstract
Objectives This systematic review and meta-analysis will describe the prevalence of concomitant FM in adults with inflammatory arthritis and quantify the impact of FM on DAS. Methods Cochrane library, MEDLINE, Psychinfo, PubMed, Scopus and Web of Science were searched using key terms and predefined exclusion criteria. As appropriate, proportional and pairwise meta-analysis methods were used to pool results. Results Forty articles were identified. In RA the prevalence of FM ranged from 4.9 to 52.4% (21% pooled). In axSpA the range was 4.11–25.2% (13% pooled in AS only). In PsA the range was 9.6–27.2% (18% pooled). The presence of concomitant FM was related to higher DAS in patients with RA and AS (DAS28 mean difference 1.24, 95% CI: 1.10, 1.37 in RA; BASDAI mean difference 2.22, 95% CI: 1.86, 2.58 in AS). Concomitant FM was also associated with higher DAS in existing PsA studies. Self-reported, rather than objective, components of DAS appear to be raised in the presence of FM (e.g. tender joint count and Visual Analogue Scale (VAS) pain scores). Conclusion FM is common in RA, AxSpA and PsA. Comorbid FM appears to amplify DAS and could therefore influence management of these rheumatic conditions.
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Affiliation(s)
- Stephen J Duffield
- Department of Musculoskeletal Biology 1, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK
| | - Natasha Miller
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Sizheng Zhao
- Department of Musculoskeletal Biology 1, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK
| | - Nicola J Goodson
- Department of Musculoskeletal Biology 1, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK
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131
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Yavne Y, Amital D, Watad A, Tiosano S, Amital H. A systematic review of precipitating physical and psychological traumatic events in the development of fibromyalgia. Semin Arthritis Rheum 2018; 48:121-133. [DOI: 10.1016/j.semarthrit.2017.12.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 11/11/2017] [Accepted: 12/09/2017] [Indexed: 01/09/2023]
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132
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Furness PJ, Vogt K, Ashe S, Taylor S, Haywood-Small S, Lawson K. What causes fibromyalgia? An online survey of patient perspectives. Health Psychol Open 2018; 5:2055102918802683. [PMID: 30275965 PMCID: PMC6158621 DOI: 10.1177/2055102918802683] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Fibromyalgia is a severe chronic pain condition that affects every aspect of life. Causes of the condition remain unclear, and quantitative research cannot account for patients' personal illness narratives and perceptions. This online survey gathered qualitative accounts of the perceived causes of their condition from 596 people with fibromyalgia, which were analyzed thematically. Themes were "Bodily assault, ill-health, and change"; "Emotional trauma and distress"; "Stress and vulnerability"; and "Explaining and authenticating fibromyalgia." Discussion focuses on the complexity of causation, the importance of understanding and having symptoms validated, and the potential for benefiting from patient expertise in building better practitioner-client relationships.
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Abstract
PURPOSE OF REVIEW Fibromyalgia syndrome (FMS) is defined as chronic, widespread musculoskeletal pain and tenderness with concomitant mood and cognitive dysfunction. Several comorbidities have been reported to be associated with FMS. We reviewed the literature concerning the most noteworthy chronic conditions associated with FMS. RECENT FINDINGS There is mounting evidence displaying the concurrence of fibromyalgia and coexisting medical and psychiatric conditions. Such comorbidities may blur the classical clinical presentations and erroneously lead to misinterpretation of disease activity. The recognition of this fact should be underlined, as misrecognition may lead to excessive therapy and avoidable side-effects of medications on the one hand and to a better handling of FMS on the other hand, leading to improved clinical outcomes. SUMMARY A greater proportion of psychiatric and rheumatologic disorders are associated with FMS patients than the population. Consequently, physicians treating patients with either condition should keep in mind that these patients may have such comorbidities and should be treated accordingly.
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Almeida SC, George SZ, Leite RDV, Oliveira AS, Chaves TC. Cluster subgroups based on overall pressure pain sensitivity and psychosocial factors in chronic musculoskeletal pain: Differences in clinical outcomes. Physiother Theory Pract 2018; 35:1218-1232. [PMID: 29771165 DOI: 10.1080/09593985.2018.1474512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: We aimed to empirically derive psychosocial and pain sensitivity subgroups using cluster analysis within a sample of individuals with chronic musculoskeletal pain (CMP) and to investigate derived subgroups for differences in pain and disability outcomes. Methods: Eighty female participants with CMP answered psychosocial and disability scales and were assessed for pressure pain sensitivity. A cluster analysis was used to derive subgroups, and analysis of variance (ANOVA) was used to investigate differences between subgroups. Results: Psychosocial factors (kinesiophobia, pain catastrophizing, anxiety, and depression) and overall pressure pain threshold (PPT) were entered into the cluster analysis. Three subgroups were empirically derived: cluster 1 (high pain sensitivity and high psychosocial distress; n = 12) characterized by low overall PPT and high psychosocial scores; cluster 2 (high pain sensitivity and intermediate psychosocial distress; n = 39) characterized by low overall PPT and intermediate psychosocial scores; and cluster 3 (low pain sensitivity and low psychosocial distress; n = 29) characterized by high overall PPT and low psychosocial scores compared to the other subgroups. Cluster 1 showed higher values for mean pain intensity (F(2,77) = 10.58, p < 0.001) compared with cluster 3, and cluster 1 showed higher values for disability (F(2,77) = 3.81, p = 0.03) compared with both clusters 2 and 3. Conclusions: Only cluster 1 was distinct from cluster 3 according to both pain and disability outcomes. Pain catastrophizing, depression, and anxiety were the psychosocial variables that best differentiated the subgroups. Overall, these results call attention to the importance of considering pain sensitivity and psychosocial variables to obtain a more comprehensive characterization of CMP patients' subtypes.
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Affiliation(s)
- Suzana C Almeida
- Physical Therapy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Steven Z George
- Duke Clinical Research Institute, Duke University, Durham NC, USA.,Department of Orthopaedic Surgery, Duke University, Durham NC, USA
| | - Raquel D V Leite
- Post Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Anamaria S Oliveira
- Post Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.,Department of Biomechanics, Medicine and Rehabilitation of the Musculoskeletal System, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Thais C Chaves
- Post Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.,Department of Neurosciences and Behavioral Sciences Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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135
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Forestier E, Gonnet F, Revil-Signorat A, Zipper AC. [Pathway to diagnosis and real-life experience of patients believing they are affected by "chronic Lyme disease"]. Rev Med Interne 2018; 39:912-917. [PMID: 29706237 DOI: 10.1016/j.revmed.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/29/2018] [Accepted: 04/03/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Chronic Lyme disease is a subject of scientific and social controversy in both Europe and the United States. The aim of our study was to analyze the pathway to diagnosis of patients believing they were affected by the disease, and to describe their real-life experience. METHOD A qualitative study was performed with 13 patients declaring themselves to be affected by chronic Lyme disease. Interviews were analyzed by 2 general medical practice interns, supervised by a general practitioner with a diploma in socio-anthropology and an infectious diseases specialist. RESULTS Internet and other media played a major role in informing the patients or their doctor about the existence and the characteristics of chronic Lyme disease. The diagnosis was confirmed by features considered objective (chronic infection by Borrelia, tick bite, positive serology, beneficial or worsening effects of antibiotics). The long medical diagnosis and treatment process of those interviewed was marked by a conflicted relationship with the medical profession, caused by a feeling of non-recognition and abandonment. They reported their experience as being very painful, both because of the physical pain and also the psychological consequences of their condition. CONCLUSION Improving the diagnosis and therapeutic management of patients believing themselves to be affected by chronic Lyme disease appears highly necessary both to limit their search for diagnosis and their experience of pain. It could be based on existing guidelines concerning medically unexplained symptoms to which the chronic Lyme disease issue appears quite similar on several points.
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Affiliation(s)
- E Forestier
- Service de maladies infectieuses, centre hospitalier métropole Savoie, BP 31125, 73011 Chambéry cedex, France.
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Andrade A, Vilarino GT, Sieczkowska SM, Coimbra DR, Steffens RDAK, Vietta GG. Acute effects of physical exercises on the inflammatory markers of patients with fibromyalgia syndrome: A systematic review. J Neuroimmunol 2018; 316:40-49. [DOI: 10.1016/j.jneuroim.2017.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022]
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de Boer M, Colaris M, van der Hulst RRWJ, Cohen Tervaert JW. Is explantation of silicone breast implants useful in patients with complaints? Immunol Res 2018; 65:25-36. [PMID: 27412295 PMCID: PMC5406477 DOI: 10.1007/s12026-016-8813-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
In this review, we present a critical review of the existing literature reflecting the results of explantation of silicone breast implants in patients with silicone-related complaints and/or autoimmune diseases. A literature search was performed to discuss the following issues: which clinical manifestations and autoimmune diseases improve after explantation, and what is the course of these complaints after explantation. Next, we reviewed studies in which the effect of explantation on laboratory findings observed in patients with silicone breast implants was studied, and lastly, we reviewed studies that described the effect of reconstruction of the breast with a new implant or autologous tissue after explantation. We calculated from the literature that explantation of the silicone breast improved silicone-related complaints in 75 % of the patients (469 of 622). In patients with autoimmune diseases, however, improvement was only infrequently observed without additional therapy with immunosuppressive therapy, i.e., in 16 % of the patients (3 of 18). The effect of explantation did not influence autoantibody testing such as ANA. We discuss several possibilities which could clarify why patients improve after explantation. Firstly, the inflammatory response could be reduced after explantation. Secondly, explantation of the implants may remove a nociceptive stimulus, which may be the causative factor for many complaints. Options for reconstruction of the explanted breast are autologous tissue and/or water-/hydrocellulose-filled breast implant. Unfortunately, in very few studies attention was paid to reconstructive possibilities. Therefore, no adequate conclusion regarding this issue could be drawn. In conclusion, explantation is useful for improvement of silicone-related complaints in 75 % of the patients, whereas in patients who developed autoimmune diseases improvement is only observed when explantation is combined with immunosuppressive therapy. In a patient with silicone-related complaints in which explantation is considered, the patient should be counseled for the different options of reconstruction after explantation.
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Affiliation(s)
- M de Boer
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Reconstructive, Plastic and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M Colaris
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Reconstructive, Plastic and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R R W J van der Hulst
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Reconstructive, Plastic and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - J W Cohen Tervaert
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Clinical and Experimental Immunology, Reinaert Clinic, Maastricht, The Netherlands.
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Blomberg J, Gottfries CG, Elfaitouri A, Rizwan M, Rosén A. Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model. Front Immunol 2018; 9:229. [PMID: 29497420 PMCID: PMC5818468 DOI: 10.3389/fimmu.2018.00229] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/26/2018] [Indexed: 12/13/2022] Open
Abstract
Myalgic encephalomyelitis (ME) often also called chronic fatigue syndrome (ME/CFS) is a common, debilitating, disease of unknown origin. Although a subject of controversy and a considerable scientific literature, we think that a solid understanding of ME/CFS pathogenesis is emerging. In this study, we compiled recent findings and placed them in the context of the clinical picture and natural history of the disease. A pattern emerged, giving rise to an explanatory model. ME/CFS often starts after or during an infection. A logical explanation is that the infection initiates an autoreactive process, which affects several functions, including brain and energy metabolism. According to our model for ME/CFS pathogenesis, patients with a genetic predisposition and dysbiosis experience a gradual development of B cell clones prone to autoreactivity. Under normal circumstances these B cell offsprings would have led to tolerance. Subsequent exogenous microbial exposition (triggering) can lead to comorbidities such as fibromyalgia, thyroid disorder, and orthostatic hypotension. A decisive infectious trigger may then lead to immunization against autoantigens involved in aerobic energy production and/or hormone receptors and ion channel proteins, producing postexertional malaise and ME/CFS, affecting both muscle and brain. In principle, cloning and sequencing of immunoglobulin variable domains could reveal the evolution of pathogenic clones. Although evidence consistent with the model accumulated in recent years, there are several missing links in it. Hopefully, the hypothesis generates testable propositions that can augment the understanding of the pathogenesis of ME/CFS.
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Affiliation(s)
- Jonas Blomberg
- Department of Medical Sciences, Uppsala University, Clinical Microbiology, Academic Hospital, Uppsala, Sweden
| | | | - Amal Elfaitouri
- Department of Infectious Disease and Tropical Medicine, Faculty of Public Health, Benghazi University, Benghazi, Libya
| | - Muhammad Rizwan
- Department of Medical Sciences, Uppsala University, Clinical Microbiology, Academic Hospital, Uppsala, Sweden
| | - Anders Rosén
- Department of Clinical and Experimental Medicine, Division of Cell Biology, Linköping University, Linköping, Sweden
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Abstract
There are possibly millions of mold species on earth. The vast majority of these mold spores live in harmony with humans, rarely causing disease. The rare species that does cause disease does so by triggering allergies or asthma, or may be involved in hypersensitivity diseases such as allergic bronchopulmonary aspergillosis or allergic fungal sinusitis. Other hypersensitivity diseases include those related to occupational or domiciliary exposures to certain mold species, as in the case of Pigeon Breeder's disease, Farmer's lung, or humidifier fever. The final proven category of fungal diseases is through infection, as in the case of onchomycosis or coccidiomycosis. These diseases can be treated using anti-fungal agents. Molds and fungi can also be particularly important in infections that occur in immunocompromised patients. Systemic candidiasis does not occur unless the individual is immunodeficient. Previous reports of "toxic mold syndrome" or "toxic black mold" have been shown to be no more than media hype and mass hysteria, partly stemming from the misinterpreted concept of the "sick building syndrome." There is no scientific evidence that exposure to visible black mold in apartments and buildings can lead to the vague and subjective symptoms of memory loss, inability to focus, fatigue, and headaches that were reported by people who erroneously believed that they were suffering from "mycotoxicosis." Similarly, a causal relationship between cases of infant pulmonary hemorrhage and exposure to "black mold" has never been proven. Finally, there is no evidence of a link between autoimmune disease and mold exposure.
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140
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Andrade A, Vilarino GT, Sieczkowska SM, Coimbra DR, Bevilacqua GG, Steffens RDAK. The relationship between sleep quality and fibromyalgia symptoms. J Health Psychol 2018; 25:1176-1186. [DOI: 10.1177/1359105317751615] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the relationship between sleep quality and fibromyalgia symptoms in 326 patients. The Pittsburgh Sleep Quality Index was used to assess the presence of sleep disorders. Multivariate analysis of variance was performed to determine the influence of fibromyalgia symptoms on sleep quality. The prevalence of sleep disorders was 92.9 percent. Patients reported generalized pain (88.3%), memory failure (78.5%), moodiness (59%), excessive anxiety (77.5%), and concentration difficulties (69.1%). Patients with more symptoms reported poor sleep quality ( p < .05; d = .74), and the total Pittsburgh Sleep Quality Index score correlated with the number of symptoms ( p < .01). Sleep quality has an important association with fibromyalgia symptoms.
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Abstract
OBJECTIVE The study aimed to investigate the effect of an 8-wk structured strength training program on pain and sleep quality in patients with fibromyalgia. DESIGN Fifty-two patients with fibromyalgia were evaluated; 31 submitted to strength training and 21 comprised the control group. The instruments used were the Fibromyalgia Impact Questionnaire and The Pittsburgh Sleep Quality Index. The questionnaires were applied before the first training session, at 12 sessions, and after 24 sessions. Descriptive statistics (mean, SD, and frequency) and inferential tests were used. RESULTS After 8 wks of intervention, significant differences were found between groups in subjective quality of sleep (P = 0.03), sleep disturbance (P = 0.02), daytime dysfunction (P = 0.04), and total sleep score (P < 0.01). The correlation analysis using Spearman's test indicated a positive relationship between the variables of pain intensity and sleep quality (P < 0.01); when pain intensity increased in patients with fibromyalgia, sleep quality worsened. CONCLUSIONS Strength training is safe and effective in treating people with fibromyalgia, and a significant decrease in sleep disturbances occurs after 8 wks of intervention.
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Sancassiani F, Machado S, Ruggiero V, Cacace E, Carmassi C, Gesi C, Dell'Osso L, Carta MG. The management of fibromyalgia from a psychosomatic perspective: an overview. Int Rev Psychiatry 2017; 29:473-488. [PMID: 28681628 DOI: 10.1080/09540261.2017.1320982] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Fibromyalgia (FM) is a central sensitization syndrome characterized by chronic widespread pain. FM is often comorbid with psychiatric disorders, as well as psychological distress that worsens the quality-of-life of people affected. The aim was to collect current evidence about the management of FM from a psychosomatic perspective. The literature was synthesized and summarized in a narrative format. The literature search was carried out in PubMed; review articles, meta-analysis, overview, and guidelines published in the last 10 years written in English were included. Five main topics (Diagnostic criteria of FM; Pathogenesis of chronic widespread pain in FM; Early stress and trauma as predisposing factors for central sensitization; FM and Psychiatric comorbidity; Implications for treatment) were pointed out and discussed. Much evidence underlies the importance of considering and treating the comorbidity of FM with psychiatric disorders and psychological factors that affect pain management. Validation of FM as a central sensitization syndrome by a clinician facilitates therapeutic strategies that involve patients as active participants in the pain management process, likely leading to improved outcomes.
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Affiliation(s)
- Federica Sancassiani
- a Department of Medical Sciences and Public Health , University of Cagliari , Cagliari , Italy
| | - Sergio Machado
- b Laboratory of Panic and Respiration , Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ) , Rio de Janeiro , RJ , Brazil.,c Physical Activity Neuroscience , Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University , Niterói , Brazil
| | - Valeria Ruggiero
- a Department of Medical Sciences and Public Health , University of Cagliari , Cagliari , Italy
| | - Enrico Cacace
- a Department of Medical Sciences and Public Health , University of Cagliari , Cagliari , Italy
| | - Claudia Carmassi
- d Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy
| | - Camilla Gesi
- d Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy
| | - Liliana Dell'Osso
- d Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy
| | - Mauro Giovanni Carta
- a Department of Medical Sciences and Public Health , University of Cagliari , Cagliari , Italy
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143
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Ben-Ami Shor D, Weitzman D, Dahan S, Gendelman O, Bar-On Y, Amital D, Shalev V, Chodick G, Amital H. Adherence and Persistence with Drug Therapy among Fibromyalgia Patients: Data from a Large Health Maintenance Organization. J Rheumatol 2017; 44:1499-1506. [DOI: 10.3899/jrheum.170098] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2017] [Indexed: 02/08/2023]
Abstract
Objective.To assess 1-year persistence and adherence rates with drug therapy among patients with fibromyalgia (FM) and to identify factors associated with therapy discontinuation.Methods.This retrospective, cohort study included members ≥ 21 years old from the Maccabi Healthcare Services, a large health maintenance organization in Israel, who were diagnosed with FM from 2008 through 2011. Medications of interest included the anticonvulsant pregabalin, antidepressants [selective serotonin reuptake inhibitor (SSRI), serotonin/norepinephrine reuptake inhibitor (SNRI)], and tricyclic antidepressants (TCA). Time to treatment discontinuation and proportion of days covered (PDC) with FM-specific therapies during the year from first dispensed were analyzed. PDC < 20% was considered low adherence and PDC ≥ 80% was considered high adherence. Logistic regression models were constructed for multivariable analyses.Results.Overall, 3932 patients with FM were included; 88.7% were female. Pre-diagnosis use of medication of interest was documented in 41% of the study population. Of the remaining 2312 patients, 56.1% were issued a prescription, 45.0% were dispensed at least 1 medication in the year following diagnosis, and only 28.8% had prescriptions filled twice within the first year from diagnosis. Among newly prescribed patients, 1-year discontinuation was highest for TCA (91.0%) and lowest for SSRI/SNRI antidepressants (73.7%). Over half of the patients (60.5%) had fewer than 20% of the days covered by any medication during the year and only 9.3% were very adherent (PDC ≥ 80%).Conclusion.This study clearly shows that in an Israeli “real-life” population of patients with FM, persistence and adherence with FM therapy in the year following diagnosis is remarkably low.
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145
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Araújo-Filho HG, Pereira EWM, Rezende MM, Menezes PP, Araújo AAS, Barreto RSS, Martins AOBPB, Albuquerque TR, Silva BAF, Alcantara IS, Coutinho HDM, Menezes IRA, Quintans-Júnior LJ, Quintans JSS. D-limonene exhibits superior antihyperalgesic effects in a β-cyclodextrin-complexed form in chronic musculoskeletal pain reducing Fos protein expression on spinal cord in mice. Neuroscience 2017; 358:158-169. [PMID: 28673718 DOI: 10.1016/j.neuroscience.2017.06.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/12/2017] [Accepted: 06/21/2017] [Indexed: 10/19/2022]
Abstract
Chronic musculoskeletal pain is one of the main symptoms found in Fibromyalgia with unclear etiology and limited pharmacological treatment. The aim of this study was to complex LIM in β-cyclodextrin (LIM-βCD) and then evaluate its antihyperalgesic effect in an animal model of chronic musculoskeletal pain. Differential scanning calorimetry and scanning electron microscopy was used for the characterization of the inclusion complex. Male Swiss mice were used for experimental procedures where mechanical hyperalgesia, thermal hyperalgesia, muscular strength, Fos immunofluorescence was studied after induction of hyperalgesia. Mechanism of action was also investigated through tail flick test and capsaicin-induced nociception. Endothermic events and morphological changes showed that the slurry complex method was the best method for the complexation. After induction of hyperalgesia, the oral administration of LIM-βCD (50mg/kg) significantly increased the paw withdrawal threshold compared to uncomplexed limonene. Fos immunofluorescence showed that both compounds significantly decreased the number of Fos-positive cells in the dorsal horn. In nociceptive tests, FLU was able to reverse the antinociceptive effect of LIM-βCD. After intraplantar administration of capsaicin, LIM was able to significantly decrease time to lick. LIM-βCD has antihyperalgesic action superior to its uncomplexed form, with possible action in the dorsal horn of the spinal cord. These results suggest the possible applicability of LIM, uncomplexed or complexed with βCD, in conditions such as FM and neuropathic pain, for which there are currently only limited pharmacological options.
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Affiliation(s)
- Heitor G Araújo-Filho
- Laboratory of Neuroscience and Pharmacological Assays (LANEF). Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Erik W M Pereira
- Laboratory of Neuroscience and Pharmacological Assays (LANEF). Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Marília M Rezende
- Laboratory of Neuroscience and Pharmacological Assays (LANEF). Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Paula P Menezes
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Adriano A S Araújo
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Rosana S S Barreto
- Department of Health Education, Federal University of Sergipe, Largato, SE, Brazil
| | | | - Thaís R Albuquerque
- Department of Biological Chemistry, Regional University of Crato, Crato, CE, Brazil
| | - Bruno A F Silva
- Department of Biological Chemistry, Regional University of Crato, Crato, CE, Brazil
| | - Isabel S Alcantara
- Department of Biological Chemistry, Regional University of Crato, Crato, CE, Brazil
| | | | - Irwin R A Menezes
- Department of Biological Chemistry, Regional University of Crato, Crato, CE, Brazil
| | - Lucindo J Quintans-Júnior
- Laboratory of Neuroscience and Pharmacological Assays (LANEF). Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Jullyana S S Quintans
- Laboratory of Neuroscience and Pharmacological Assays (LANEF). Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil.
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Ashe SC, Furness PJ, Taylor SJ, Haywood-Small S, Lawson K. A qualitative exploration of the experiences of living with and being treated for fibromyalgia. Health Psychol Open 2017; 4:2055102917724336. [PMID: 29379616 PMCID: PMC5779932 DOI: 10.1177/2055102917724336] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study explores the life and treatment experience of people in the United Kingdom with fibromyalgia in order to inform the development of treatments which are both effective and acceptable to users. Qualitative interviews were conducted with 14 participants with interpretative phenomenological analysis used as the theoretical framework and analytical method. The themes identified were as follows: Inauthenticity of fibromyalgia, An Unconventional healthcare experience, Re-creating support networks, Challenging the working identity, Threatening the family dynamic and Fighting, accepting or accommodating? The biopsychosocial impacts of fibromyalgia disrupted the identity, lifestyle, roles and relationships of our participants with such challenges further exacerbated by the contested nature of the illness.
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147
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Undifferentiated connective tissue disease, fibromyalgia and the environmental factors. Curr Opin Rheumatol 2017; 29:355-360. [DOI: 10.1097/bor.0000000000000392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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148
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Lawson K. A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia. Biomedicines 2017; 5:biomedicines5020024. [PMID: 28536367 PMCID: PMC5489810 DOI: 10.3390/biomedicines5020024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/10/2017] [Accepted: 05/13/2017] [Indexed: 02/07/2023] Open
Abstract
Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ) score, which is a quality of life assessment. The multimodal profile of the mechanisms of action of amitriptyline include monoamine reuptake inhibition, receptor modulation and ion channel modulation. Several of the actions of amitriptyline on multiple nociceptive and sensory processes at central and peripheral locations have the potential to act cumulatively to suppress the characteristic symptoms of fibromyalgia. Greater understanding of the role of these mechanisms of action of amitriptyline could provide further clues to the pathophysiology of fibromyalgia and to a preferable pharmacological profile for future drug development.
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Affiliation(s)
- Kim Lawson
- Department of Biosciences and Chemistry, Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK.
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149
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What do people search online concerning the “elusive” fibromyalgia? Insights from a qualitative and quantitative analysis of Google Trends. Clin Rheumatol 2017; 36:1873-1878. [DOI: 10.1007/s10067-017-3665-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/03/2017] [Accepted: 04/25/2017] [Indexed: 12/15/2022]
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150
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Collin SM, Bakken IJ, Nazareth I, Crawley E, White PD. Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001-2013: a Clinical Practice Research Datalink study. J R Soc Med 2017; 110:231-244. [PMID: 28358988 PMCID: PMC5499564 DOI: 10.1177/0141076817702530] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective Trends in recorded diagnoses of chronic fatigue syndrome (CFS, also known as ‘myalgic encephalomyelitis’ (ME)) and fibromyalgia (FM) in the UK were last reported more than ten years ago, for the period 1990–2001. Our aim was to analyse trends in incident diagnoses of CFS/ME and FM for the period 2001–2013, and to investigate whether incidence might vary by index of multiple deprivation (IMD) score. Design Electronic health records cohort study. Setting NHS primary care practices in the UK. Participants Participants: Patients registered with general practices linked to the Clinical Practice Research Datalink (CPRD) primary care database from January 2001 to December 2013. Main outcome measure Incidence of CFS/ME, FM, post-viral fatigue syndrome (PVFS), and asthenia/debility. Results The overall annual incidence of recorded cases of CFS/ME was 14.8 (95% CI 14.5, 15.1) per 100,000 people. Overall annual incidence per 100,000 people for FM was 33.3 (32.8–33.8), for PVFS 12.2 (11.9, 12.5), and for asthenia/debility 7.0 (6.8, 7.2). Annual incidence rates for CFS/ME diagnoses decreased from 17.5 (16.1, 18.9) in 2001 to 12.6 (11.5, 13.8) in 2013 (annual percent change −2.8% (−3.6%, −2.0%)). Annual incidence rates for FM diagnoses decreased from 32.3 (30.4, 34.3) to 27.1 (25.5, 28.6) in 2007, then increased to 38.2 (36.3, 40.1) per 100,000 people in 2013. Overall annual incidence of recorded fatigue symptoms was 2246 (2242, 2250) per 100,000 people. Compared with the least deprived IMD quintile, incidence of CFS/ME in the most deprived quintile was 39% lower (incidence rate ratio (IRR) 0.61 (0.50, 0.75)), whereas rates of FM were 40% higher (IRR 1.40 (0.95, 2.06)). Conclusion These analyses suggest a gradual decline in recorded diagnoses of CFS/ME since 2001, and an increase in diagnoses of fibromyalgia, with opposing socioeconomic patterns of lower rates of CFS/ME diagnoses in the poorest areas compared with higher rates of FM diagnoses.
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Affiliation(s)
- Simon M Collin
- 1 School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
| | - Inger J Bakken
- 2 Norwegian Institute of Public Health, 0403 Oslo, Norway
| | - Irwin Nazareth
- 3 UCL Department of Primary Care and Population Health, UCL Royal Free Campus, London NW3 2PF, UK
| | - Esther Crawley
- 1 School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
| | - Peter D White
- 4 Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
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