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Latifoglou E, Çınar E, Tanıgör G, On AY. Coexistence of fibromyalgia and post-polio syndrome in persons with prior poliomyelitis in Turkey: the relations with symptoms, polio-related impairments, and quality of life. Disabil Rehabil 2023; 45:3511-3518. [PMID: 36169616 DOI: 10.1080/09638288.2022.2127931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate the prevalence of fibromyalgia(FM) and to show its relations with symptoms, polio-related impairments (PRI), and quality of life (QoL) in persons with prior paralytic poliomyelitis (PsPP) with and without post-polio syndrome (PPS). MATERIALS AND METHODS The study included 74 PsPP under 60 years of age, 60 of whom met the criteria for PPS. Presence and severity of FM were assessed by the American College of Rheumatology (ACR) 1990, 2010, and 2016 criteria, and Fibromyalgia Severity Score. PPS symptoms, PRI, and QoL were evaluated using the Self-Reported Impairments in Persons with Late Effects of Polio Rating Scale, Fatigue Severity Scale, and Nottingham Health Profile. Frequency, comparison, and correlation analyses were performed. RESULTS While 15% of PsPP with PPS met the criteria of ACR 1990, 32% of ACR 2010, and 35% of ACR 2016, none of those without PPS met any of the criteria for FM. Severity of PPS symptoms and PRI were significantly higher, and QoL was significantly lower in those with co-existing FM. FM severity was found to be significantly associated with severity of PPS symptoms, PRI and reduced QoL. CONCLUSIONS FM frequently coexists in PsPP with PPS and may increase the burden of PPS.Implications for RehabilitationFibromyalgia (FM) is commonly seen in patients with post-polio syndrome (PPS).Co-existing FM may increase the burden of PPS, as it is associated with more severe symptoms, more polio-related impairments, and worse quality of life.Recognition, appropriate referral, and successful management of co-existing FM may allow for reduced symptoms or symptom severity and improved quality of life in persons with PPS.
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Affiliation(s)
- Emre Latifoglou
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
| | - Ece Çınar
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
| | - Göksel Tanıgör
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
| | - Arzu Yağız On
- Department of Physical Medicine and Rehabilitation, Ege University Medical Faculty, İzmir, Turkey
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102
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Beyaztas H, Aktas S, Guler EM, Ata E. Oxidative stress may be a contributing factor in fibromyalgia patients' pain mechanisms. Reumatismo 2023; 75. [PMID: 37721351 DOI: 10.4081/reumatismo.2023.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/29/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE The pathophysiology of fibromyalgia (FM), a continuously painful syndrome with no known origin, has been related to mitochondrial dysfunction, oxidative stress, and inflammation. Recent studies have shown that FM may be associated with an oxidative balance disorder. The objective of this study was to measure the levels of oxidative stress in FM patients and try to understand the association between FM and free radicals. METHODS This study was performed on 100 volunteers admitted to the University of Health Sciences, Sultan 2, Abdulhamid Han Health Application and Research Center Physical Therapy and Rehabilitation Clinic, including 50 healthy controls and 50 patients with FM. To analyze oxidative stress biomarkers, total oxidant status (TOS) and total antioxidant status (TAS) levels were measured. Total thiol (TT) and native thiol (NT) concentrations were measured to determine the relationship between thiol groups. Disulfide (DIS) and oxidative stress index (OSI) were calculated with mathematical formulas. RESULTS While TOS and OSI levels were statistically higher in FM patients, TAS levels were significantly lower compared to the healthy control group (p<0.001). In comparison to the healthy control group, FM patients had considerably decreased TT and NT levels. DIS levels were significantly higher in FM patients than in controls (p<0.001). CONCLUSIONS Reactive oxygen species have several negative impacts on the human body. As a result of the measurements we analyzed, the relationship between FM and oxidative stress should be studied in terms of disease progression and may help improve the treatment process.
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Affiliation(s)
- H Beyaztas
- Department of Medical Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul.
| | - S Aktas
- Department of Biostatistics and Medical Informatics, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul; Department of Biostatistics, Istanbul Cerrahpasa University .
| | - E M Guler
- Department of Medical Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul; Haydarpasa Numune Health Application and Research Center, University of Health Sciences, Istanbul .
| | - E Ata
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
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103
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Ikeda N, Kawasaki M, Baba K, Nishimura H, Fujitani T, Suzuki H, Matsuura T, Ohnishi H, Shimizu M, Sanada K, Nishimura K, Yoshimura M, Maruyama T, Conway-Campbell BL, Onaka T, Teranishi H, Hanada R, Ueta Y, Sakai A. Chemogenetic Activation of Oxytocin Neurons Improves Pain in a Reserpine-induced Fibromyalgia Rat Model. Neuroscience 2023; 528:37-53. [PMID: 37532013 DOI: 10.1016/j.neuroscience.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
Fibromyalgia (FM) is a syndrome characterized by chronic pain with depression as a frequent comorbidity. However, efficient management of the pain and depressive symptoms of FM is lacking. Given that endogenous oxytocin (OXT) contributes to the regulation of pain and depressive disorders, herein, we investigated the role of OXT in an experimental reserpine-induced FM model. In FM model, OXT-monomeric red fluorescent protein 1 (OXT-mRFP1) transgenic rats exhibited increased depressive behavior and sensitivity in a mechanical nociceptive test, suggesting reduced pain tolerance. Additionally, the development of the FM-like phenotype in OXT-mRFP1 FM model rats was accompanied by a significant reduction in OXT mRNA expression in the magnocellular neurons of the paraventricular nucleus. OXT-mRFP1 FM model rats also had significantly fewer tryptophan hydroxylase (TPH)- and tyrosine hydroxylase (TH)-immunoreactive (ir) neurons as well as reduced serotonin and norepinephrine levels in the dorsal raphe and locus coeruleus. To investigate the effects of stimulating the endogenous OXT pathway, rats expressing OXT-human muscarinic acetylcholine receptor (hM3Dq)-mCherry designer receptors exclusively activated by designer drugs (DREADDs) were also assessed in the FM model. Treatment of these rats with clozapine-N-oxide (CNO), an hM3Dq-activating drug, significantly improved characteristic FM model-induced pathophysiological pain, but did not alter depressive-like behavior. The chemogenetically induced effects were reversed by pre-treatment with an OXT receptor antagonist, confirming the specificity of action via the OXT pathway. These results indicate that endogenous OXT may have analgesic effects in FM, and could be a potential target for effective pain management strategies for this disorder.
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Affiliation(s)
- Naofumi Ikeda
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Makoto Kawasaki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Kazuhiko Baba
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Haruki Nishimura
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Teruaki Fujitani
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hitoshi Suzuki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takanori Matsuura
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hideo Ohnishi
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Makiko Shimizu
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kenya Sanada
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuaki Nishimura
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mitsuhiro Yoshimura
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takashi Maruyama
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Tatsushi Onaka
- Division of Brain and Neurophysiology, Department of Physiology, Jichi Medical University, Shimotsuke, Japan
| | - Hitoshi Teranishi
- Department of Neurophysiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Reiko Hanada
- Department of Neurophysiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yoichi Ueta
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akinori Sakai
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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104
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Yao M, Wang S, Han Y, Zhao H, Yin Y, Zhang Y, Zeng X. Micro-inflammation related gene signatures are associated with clinical features and immune status of fibromyalgia. J Transl Med 2023; 21:594. [PMID: 37670381 PMCID: PMC10478377 DOI: 10.1186/s12967-023-04477-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/26/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a multifaceted disease. Along with the genetic, environmental and neuro-hormonal factors, inflammation has been assumed to have role in the pathogenesis of FM. The aim of the present study was to explore the differences in clinical features and pathophysiology of FM patients under different inflammatory status. METHODS The peripheral blood gene expression profile of FM patients in the Gene Expression Omnibus database was downloaded. Differentially expressed inflammatory genes were identified, and two molecular subtypes were constructed according to these genes used unsupervised clustering analysis. The clinical characteristics, immune features and pathways activities were compared further between the two subtypes. Then machine learning was used to perform the feature selection and construct a classification model. RESULTS The patients with FM were divided into micro-inflammation and non-inflammation subtypes according to 54 differentially expressed inflammatory genes. The micro-inflammation group was characterized by more major depression (p = 0.049), higher BMI (p = 0.021), more active dendritic cells (p = 0.010) and neutrophils. Functional enrichment analysis showed that innate immune response and antibacterial response were significantly enriched in micro-inflammation subtype (p < 0.050). Then 5 hub genes (MMP8, ENPP3, MAP2K3, HGF, YES1) were screened thought three feature selection algorithms, an accurate classifier based on the 5 hub DEIGs and 2 clinical parameters were constructed using support vector machine model. Model scoring indicators such as AUC (0.945), accuracy (0.936), F1 score (0.941), Brier score (0.079) and Hosmer-Lemeshow goodness-of-fit test (χ2 = 4.274, p = 0.832) proved that this SVM-based classifier was highly reliable. CONCLUSION Micro-inflammation status in FM was significantly associated with the occurrence of depression and activated innate immune response. Our study calls attention to the pathogenesis of different subtypes of FM.
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Affiliation(s)
- Menghui Yao
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Shuolin Wang
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Yingdong Han
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - He Zhao
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Yue Yin
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China
| | - Yun Zhang
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China.
| | - Xuejun Zeng
- Division of General Internal Medicine, Department of Family Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, 100730, China.
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105
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Puşuroğlu M, Topaloğlu MS, Hocaoğlu Ç, Yıldırım M. Expressing emotions, rejection sensitivity, and attachment in patients with fibromyalgia. Turk J Phys Med Rehabil 2023; 69:303-308. [PMID: 37674789 PMCID: PMC10478538 DOI: 10.5606/tftrd.2023.11440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/14/2022] [Indexed: 09/08/2023] Open
Abstract
Objectives This study aimed to examine emotional awareness, control of emotions, and the childhood attachment process in fibromyalgia patients. Patients and methods The observational study was conducted with 117 participants (14 males, 103 females; mean age: 43.9±9.0 years; range, 22 to 64 years) between February 20, 2022, and May 20, 2022. Sixty-one patients and 56 healthy control subjects filled out a form including sociodemographic data, such as age, sex, occupation, and educational status. In addition, the participants answered the Expressing Emotions Scale, Rejection Sensitivity Scale, and Experiences in Close Relationships Scale. Results In our study, Expressing Emotions Scale scores are significantly higher in the healthy control group than in the patient group (p<0.05). Rejection Sensitivity Scale scores are significantly higher in the patient group than in the healthy control group (p<0.05). In the Experiences in Close Relationships Scale, a significant difference was determined between the patient and control groups in the avoidant attachment subdimension (p<0.05). Similarly, a significant difference was observed between both groups in terms of the anxiety attachment subdimension (p<0.05). Conclusion The ability to express emotions is lower and avoidant and anxious attachment rates are higher in fibromyalgia patients.
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Affiliation(s)
- Meltem Puşuroğlu
- Department of Spirit Health and Patients, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Mehmet Serhat Topaloğlu
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Çiçek Hocaoğlu
- Department of Spirit Health and Patients, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Murat Yıldırım
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Recep Tayyip Erdoğan University, Rize, Türkiye
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Thomas C, Schneider BT, Verza CS, Fassina G, Weber LR, Moreira M, Fusinato PT, Forcelini CM. Prevalence of fibromyalgia in a Brazilian series of patients with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:803-808. [PMID: 37793402 PMCID: PMC10550347 DOI: 10.1055/s-0043-1772673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/05/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The prevalence of pain in patients with multiple sclerosis is remarkable. Fibromyalgia has been considered as one of the forms of chronic pain encompassed in multiple sclerosis, but data are restricted to studies from Europe and North America. OBJECTIVE To assess the prevalence of fibromyalgia in a series of Brazilian patients with multiple sclerosis and the characteristics of this comorbidity. METHODS The present cross-sectional study included 60 consecutive adult patients with multiple sclerosis. Upon consent, participants underwent a thorough evaluation for disability, fatigue, quality of life, presence of fibromyalgia, depression, and anxiety. RESULTS The prevalence of fibromyalgia was 11.7%, a figure similar to that observed in previous studies. Patients with the comorbidity exhibited worse scores on fatigue (median and interquartile range [IQR]: 68 [48-70] versus 39 [16.5-49]; p < 0.001), quality of life (mean ± standard deviation [SD]: 96.5 ± 35.9 versus 124.8 ± 28.8; p = 0.021), anxiety (mean ± SD: 22.7 ± 15.1 versus 13.8 ± 8.4; p = 0.021), and depression (median and IQR: 23 [6-28] versus 6 [3-12.5]; p = 0.034) indices than patients without fibromyalgia. There was a strong positive correlation between depression and anxiety scores with fatigue (r = 0.773 and r = 0.773, respectively; p < 0.001). Conversely, a moderate negative correlation appeared between the Expanded Disability Status Scale (EDSS), fatigue, and depression scores with quality of life (r= -0.587, r= -0.551, r= -0.502, respectively; p < 0.001). CONCLUSION Fibromyalgia is a comorbidity of multiple sclerosis that can enhance fatigue and decrease quality of life, although depression, anxiety, and disability are factors that can potentiate the impact of the comorbidity.
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Affiliation(s)
| | | | | | - Gabriel Fassina
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
| | - Laís Restel Weber
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
| | - Marlinton Moreira
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
| | | | - Cassiano Mateus Forcelini
- Hospital São Vicente de Paulo, Passo Fundo RS, Brazil.
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo RS, Brazil.
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107
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Cracchiolo AN, Palma DM, Genco F, Palmeri M, Teresi A, Zummo L, Gigliuto C, Saporito EFG, Ferruzza A, Piccoli T. Fibromyalgia: Could hyperbaric oxygen therapy make the difference? Our experience. Clin Case Rep 2023; 11:e7812. [PMID: 37636871 PMCID: PMC10448139 DOI: 10.1002/ccr3.7812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/03/2023] [Accepted: 07/09/2023] [Indexed: 08/29/2023] Open
Abstract
Fibromyalgia is a rare disease, difficult to diagnose and to treat. We think that hyperbaric oxygen therapy could improve its signs and symptoms although more evidences have to be accumulated.
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Affiliation(s)
| | | | - Fabio Genco
- ARNAS Civico Di Cristina BenfratelliPalermoItaly
| | | | | | - Leila Zummo
- ARNAS Civico Di Cristina Benfratelli, Neurologia con Stroke UnitPalermoItaly
| | - Carmelo Gigliuto
- Umberto I di Siracusa Hospital, UOC Anestesia e Rianimazione Camera IperbaricaSiracusaItaly
| | | | | | - Tommaso Piccoli
- Neurology Unit, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of PalermoPalermoItaly
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108
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Yetkin D, Yılmaz İA, Ayaz F. Anti-inflammatory activity of bupropion through immunomodulation of the macrophages. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:2087-2093. [PMID: 36928557 DOI: 10.1007/s00210-023-02462-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
Depression might manifest itself with a chronic inflammation in different tissues and organs independent of the central nervous system. Psoriasis, Crohn's disease, and fibromyalgia are among these disorders accompanying the depression. The treatment options for these conditions are a combination of the anti-depressants and anti-inflammatory agents. Bupropion has been widely utilized as an anti-depressant. It has been preferred among the patients with Crohn's disease and psoriasis due to its anti-inflammatory role, as well. In this study, we aimed to decipher its target in the immune system. Macrophages were activated in the presence of LPS and increasing concentrations of the bupropion. TNF-α, IL-6, GM-CSF, and IL-12p40 cytokines' production levels were measured by ELISA to compare it to the control groups. These cytokines have been associated with the aggressive inflammation in different tissues. Moreover, p38 and PI3K proteins' phosphorylated levels were measured to examine whether bupropion acts through these pathways or not. Our results suggest that bupropion had anti-inflammatory action on the activated macrophages and its mechanism of action was partially dependent on p38 but independent of PI3K pathways.
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Affiliation(s)
- Derya Yetkin
- Advanced Technology, Research and Application Center, Mersin University, TR-33343, Mersin, Turkey
| | - İbrahim Arda Yılmaz
- Department of Neurology, Faculty of Medicine, Mersin University, TR-33343, Mersin, Turkey
- Mersin University Biotechnology Research and Application Center, Mersin University, TR-33343, Mersin, Turkey
| | - Furkan Ayaz
- Mersin University Biotechnology Research and Application Center, Mersin University, TR-33343, Mersin, Turkey.
- Department of Biotechnology, Faculty of Arts and Science, Mersin University, TR-33343, Mersin, Turkey.
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Philippe S, Delay M, Macian N, Morel V, Pickering ME. Common miRNAs of Osteoporosis and Fibromyalgia: A Review. Int J Mol Sci 2023; 24:13513. [PMID: 37686318 PMCID: PMC10488272 DOI: 10.3390/ijms241713513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
A significant clinical association between osteoporosis (OP) and fibromyalgia (FM) has been shown in the literature. Given the need for specific biomarkers to improve OP and FM management, common miRNAs might provide promising tracks for future prevention and treatment. The aim of this review is to identify miRNAs described in OP and FM, and dysregulated in the same direction in both pathologies. The PubMed database was searched until June 2023, with a clear mention of OP, FM, and miRNA expression. Clinical trials, case-control, and cross-sectional studies were included. Gray literature was not searched. Out of the 184 miRNAs found in our research, 23 are shared by OP and FM: 7 common miRNAs are dysregulated in the same direction for both pathologies (3 up-, 4 downregulated). The majority of these common miRNAs are involved in the Wnt pathway and the cholinergic system and a possible link has been highlighted. Further studies are needed to explore this relationship. Moreover, the harmonization of technical methods is necessary to confirm miRNAs shared between OP and FM.
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Affiliation(s)
- Soline Philippe
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
| | - Marine Delay
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
- Inserm 1107, Neuro-Dol, University Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Nicolas Macian
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
| | - Véronique Morel
- Platform of Clinical Investigation Department, Inserm CIC 1405, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (S.P.); (M.D.); (N.M.); (V.M.)
| | - Marie-Eva Pickering
- Rheumatology Department, University Hospital Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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Hong-Baik I, Úbeda-D’Ocasar E, Cimadevilla-Fernández-Pola E, Jiménez-Díaz-Benito V, Hervás-Pérez JP. The Effects of Non-Pharmacological Interventions in Fibromyalgia: A Systematic Review and Metanalysis of Predominants Outcomes. Biomedicines 2023; 11:2367. [PMID: 37760809 PMCID: PMC10525643 DOI: 10.3390/biomedicines11092367] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Fibromyalgia (FM) is a chronic musculoskeletal condition with multiple symptoms primarily affecting women. An imbalance in cytokine levels has been observed, suggesting a chronic low-grade inflammation. The main aim of the meta-analysis was to examine the effect of multimodal rehabilitation on cytokine levels and other predominant variables in patients with FM. Furthermore, to examine which non-pharmacological tools have been used to investigate the effects that these can have on cytokines in FM patients. (2) Methods: Searches were conducted in PubMed, Scopus, Web of Science, Cochrane, and ScienceDirect databases. This systematic review and metanalysis followed the PRISMA statement protocol. The methodological quality of the studies was assessed using the PEDro scale, the risk of bias followed the Cochrane Manual 5.0.1, and the GRADE system was used for rating the certainty of evidence. (3) Results: Of 318 studies found, eight were finally selected, with a sample size of 320 women with a mean age of 57 ± 20. The proinflammatory cytokines IL-1β, IL-6, IL-8 and TNF-α were the most studied. Resistance exercise, aquatic exercise, dynamic contractions, cycling, treadmill, and infrared therapy were the main non-pharmacological tools used. (4) Conclusions: The systematic review with meta-analysis found evidence of elevated cytokine levels in patients with FM, suggesting low chronic inflammation and a possible contribution to central sensitization and chronic pain. However, the effects of physiotherapeutic interventions on cytokine levels are variable, highlighting the importance of considering different factors and the need for further research.
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Affiliation(s)
- Isabel Hong-Baik
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
| | - Edurne Úbeda-D’Ocasar
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
| | - Eduardo Cimadevilla-Fernández-Pola
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
| | - Victor Jiménez-Díaz-Benito
- Department of Sport Sciences, Faculty of Physical Activity and Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Madrid, Spain;
| | - Juan Pablo Hervás-Pérez
- Department of Physiotherapy, Faculty of Health, Camilo José Cela University, 28692 Villanueva de la Cañada, Madrid, Spain; (I.H.-B.); (E.Ú.-D.); (E.C.-F.-P.)
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Ćwirlej-Sozańska A, Sozański B, Łyko A, Łagowska A, Leszczyńska N, Kuduk B, Wilmowska-Pietruszyńska A. Psychometric properties and validation of the polish version of the Fibromyalgia Impact Questionnaire (FIQ-Pol). BMC Public Health 2023; 23:1477. [PMID: 37537582 PMCID: PMC10398978 DOI: 10.1186/s12889-023-16411-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, intestinal disorders, mood swings, and sleep disturbances. To the best of our knowledge, the questionnaire used for assessing problems and difficulties in the functioning of people with FM has not been translated and adapted in Poland so far. The aim of the study was to assess the psychometric properties of the Polish version of the Fibromyalgia Impact Questionnaire (FIQ-Pol). MATERIAL AND METHOD The study covered 150 people with FM living in Poland. The measurement reliability, internal structure, repeatability, and validity of the Polish version of the FIQ were examined. RESULTS The scale score reliability of the entire tool for the research group was very good. The alpha Cronbach's test result for the whole scale was 0.84. The repeatability of the scale measured by the test-retest method using the interclass correlation coefficients (ICC) was very good and amounted to 0.96. Internal structure suggested by FIQ-Pol authors was confirmed (Confirmatory factor analysis). After introducing modification indices for the entire scale, satisfactory parameter values were obtained, i.e.: RMSEA (0.06), CFI (0.97) and TLI (0.96). Theoretical validity was assessed by correlating the results of the Polish version of the FIQ with the results of the Beck's Depression Inventory (BDI). Both the FIQ-Pol total score and its domains showed strong positive correlations with BDI. CONCLUSION The Polish FIQ is a reliable and valid tool to measure the functional disability and health status of Polish people with FM.
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Affiliation(s)
- Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland.
| | - Bernard Sozański
- Institute of Medical Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Aleksandra Łyko
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Anna Łagowska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Natalia Leszczyńska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
| | - Barbara Kuduk
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana 16C, 35-959, Rzeszow, Poland
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Sarı İF, İlhanlı İ, Mızrak T, Kulaklı F, Kasap Z. The Effect of Transcutaneous Posterior Tibial Nerve Stimulation on Pain and Quality of Life in Patients with Fibromyalgia: A Single-Blind, Randomized Controlled Trial. J Clin Med 2023; 12:4989. [PMID: 37568391 PMCID: PMC10420003 DOI: 10.3390/jcm12154989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to investigate the effectiveness of posterior tibial nerve stimulation (PTNS) in reducing pain, improving quality of life, and decreasing disease severity in patients with fibromyalgia. This prospective, single-blind, randomized controlled trial included female patients newly diagnosed with fibromyalgia who had started duloxetine treatment (30 mg/day). The patients in the study group received six sessions of posterior tibial nerve stimulation, twice weekly, 3-4 days apart, in addition to duloxetine; the controls received duloxetine only. The patients were evaluated three times (at baseline, 1st month, and 3rd month). Pain was evaluated using a numeric rating scale, the short-form McGill Pain Questionnaire, and quality of life with a 36-item short-form health survey (SF-36). Patient functional status and disease severity were evaluated using the fibromyalgia impact questionnaire (FIQ). A total of 64 patients met the inclusion criteria: 22 were ultimately included in the study group and 30 in the control group. Statistical improvements in pain and FIQ scores were observed after treatment in both groups. The SF-36 scores indicated improved vitality only in the 1st month in both groups, with no significant changes in the other quality-of-life subscales in either group. There was no statistical difference between the two groups in terms of changes in pain, FIQ, and SF-36 scores compared with baseline at the 1st month and 3rd month. The addition of PTNS to pharmacological treatment did not contribute to the reduction in pain or improvement in quality of life in fibromyalgia either in the 1st or 3rd month. NIH Clinical Trial Registration Number NCT05937711.
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Affiliation(s)
- İlker Fatih Sarı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Gazipaşa Yerleşkesi Debboy Mevki Giresun/Türkiye, Giresun 28200, Turkey; (F.K.); (Z.K.)
| | - İlker İlhanlı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ondokuz Mayıs University, Samsun 55139, Turkey;
| | - Tuba Mızrak
- Havza Physical Therapy and Rehabilitation Center, Ondokuz Mayıs University, Samsun 55700, Turkey;
| | - Fazıl Kulaklı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Gazipaşa Yerleşkesi Debboy Mevki Giresun/Türkiye, Giresun 28200, Turkey; (F.K.); (Z.K.)
| | - Zerrin Kasap
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Gazipaşa Yerleşkesi Debboy Mevki Giresun/Türkiye, Giresun 28200, Turkey; (F.K.); (Z.K.)
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113
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Zhu M, Huang H. The Underlying Mechanisms of Sleep Deprivation Exacerbating Neuropathic Pain. Nat Sci Sleep 2023; 15:579-591. [PMID: 37533626 PMCID: PMC10392808 DOI: 10.2147/nss.s414174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Abstract
Pain disrupts sleep, and sleep deprivation or interference can alter pain perception in animals and humans, for example by increasing sensitivity to pain. However, the mechanism by which sleep affects neuropathic pain remains unclear. In this review, we discuss the available evidence from the epidemiologic, clinical, and human, as well as laboratory studies. In previous studies, we have found that sleep deprivation affects various injurious systems, including opioids, dopaminergic, immune, orexins, hypothalamic-pituitary-adrenal axis, and adenosine. At the same time, these systems play a crucial role in neuropathic pain regulation. In the complex interactions between these neurobiological systems, there may be potential regulatory pathways through which sleep deprivation amplifies neuropathic pain. Because of the impact sleep problems and neuropathic pain can have on the patients' quality of life, studying the link between sleep and neuropathic pain is important for neuropathic pain prevention and public health.
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Affiliation(s)
- Manmin Zhu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Guizhou, People’s Republic of China
| | - Hao Huang
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Guizhou, People’s Republic of China
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114
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Chmielewski G, Majewski MS, Kuna J, Mikiewicz M, Krajewska-Włodarczyk M. Fatigue in Inflammatory Joint Diseases. Int J Mol Sci 2023; 24:12040. [PMID: 37569413 PMCID: PMC10418999 DOI: 10.3390/ijms241512040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Fatigue is a prevalent symptom in various rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It is characterised as a subjective, enduring feeling of generalised tiredness or exhaustion, impacting the patient's life quality and exacerbating disability. The fatigue nature is multifaceted, encompassing physiological, psychological, and social factors, and although the exact cause of inflammatory joint diseases is not fully understood, several factors are believed to contribute to its development. Despite high prevalence and importance, the symptom is often underestimated in clinical practice. Chronic inflammation, commonly associated with rheumatic diseases, has been proposed as a potential contributor to fatigue development. While current treatments effectively target inflammation and reduce disease activity, fatigue remains a persistent problem. Clinical evaluation of rheumatic diseases primarily relies on objective criteria, whereas fatigue, being a subjective symptom, is solely experienced and reported by the patient. Managing fatigue in inflammatory joint diseases involves a multifaceted approach. Identifying and comprehensively assessing the subjective components of fatigue in individual patients is crucial for effectively managing this symptom in everyday clinical practice.
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Affiliation(s)
- Grzegorz Chmielewski
- Department of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-900 Olsztyn, Poland; (G.C.); (J.K.)
| | - Michał S. Majewski
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland;
| | - Jakub Kuna
- Department of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-900 Olsztyn, Poland; (G.C.); (J.K.)
| | - Mateusz Mikiewicz
- Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Magdalena Krajewska-Włodarczyk
- Department of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-900 Olsztyn, Poland; (G.C.); (J.K.)
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115
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Manojlović D, Kopše EI. The effectiveness of aerobic exercise for pain management in patients with fibromyalgia. Eur J Transl Myol 2023; 33:11423. [PMID: 37449965 PMCID: PMC10583145 DOI: 10.4081/ejtm.2023.11423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Abstract
The effectiveness of exercise therapy is being increasingly studied in patients with fibromyalgia. The aim of our systematic review was to determine the effectiveness of different types of aerobic exercise programs for pain management in patients with fibromyalgia. The literature search was performed by two independent researchers in the PubMed, CINAHL and PEDro databases using various combinations of the following keywords: fibromyalgia, pain and aerobic exercise. Studies were eligible if they included adults diagnosed with fibromyalgia and examined the effectiveness of at least one aerobic exercise program on pain management. A total of 14 randomized controlled trials were screened in full-text, nine of which were included in the systematic review. Overall, our results indicate that aerobic exercise is effective for pain management in patients with fibromyalgia. The results of the aerobic exercise programs were more effective for pain management than stretching exercises, but did not differ significantly from those of pilates, muscle strengthening exercises, relaxation techniques and stress management treatment. Additional high-quality studies are warranted to determine accurate clinical guidelines in terms of aerobic exercise programs for pain management in patients with fibromyalgia.
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116
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Ramírez-Tejero JA, Durán-González E, Martínez-Lara A, Lucena Del Amo L, Sepúlveda I, Huancas-Díaz A, Carvajal M, Cotán D. Microbiota and Mitochondrial Sex-Dependent Imbalance in Fibromyalgia: A Pilot Descriptive Study. Neurol Int 2023; 15:868-880. [PMID: 37489361 PMCID: PMC10366818 DOI: 10.3390/neurolint15030055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/26/2023] Open
Abstract
Fibromyalgia is a widespread chronic condition characterized by pain and fatigue. Among the long list of physiological disturbances linked to this syndrome, mitochondrial imbalance and oxidative stress stand out. Recently, the crosstalk between mitochondria and intestinal microbiota has caught the attention of biomedical researchers, who have found connections between this axis and several inflammatory and pain-related conditions. Hence, this pilot descriptive study focused on characterizing the mitochondrial mass/mitophagy ratio and total antioxidant capacity in PBMCs, as well as some microbiota components in feces, from a Peruvian cohort of 19 females and 7 males with FM. Through Western blotting, electrochemical oxidation, ELISA, and real-time qPCR, we determined VDAC1 and MALPLC3B protein levels; total antioxidant capacity; secretory immunoglobulin A (sIgA) levels; and Firmicutes/Bacteroidetes, Bacteroides/Prevotella, and Roseburia/Eubacterium ratios; as well as Ruminococcus spp., Pseudomonas spp., and Akkermansia muciniphila levels, respectively. We found statistically significant differences in Ruminococcus spp. and Pseudomonas spp. levels between females and males, as well as a marked polarization in mitochondrial mass in both groups. Taken together, our results point to a mitochondrial imbalance in FM patients, as well as a sex-dependent difference in intestinal microbiota composition.
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Affiliation(s)
| | | | | | | | | | | | - Marco Carvajal
- Instituto de Medicina Funcional e Integral de Perú, Lima 15073, Peru
| | - David Cotán
- Pronacera Therapeutics S.L., 41015 Sevilla, Spain
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117
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Mueller C, Jordan I, Jones C, Lawson P, Younger JW. Abnormal immune system response in the brain of women with Fibromyalgia after experimental endotoxin challenge. Brain Behav Immun Health 2023; 30:100624. [PMID: 37114015 PMCID: PMC10126845 DOI: 10.1016/j.bbih.2023.100624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/13/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Background The pathophysiology of fibromyalgia (FM) is thought to include an overactive immune system, leading to central nervous system sensitization, allodynia, and hyperalgesia. We aimed to test this theory using an experimental immune system activation procedure and neuroimaging with magnetic resonance spectroscopic imaging (MRSI). Methods Twelve women with FM and 13 healthy women (healthy controls; HC) received 0.3 or 0.4 ng/kg endotoxin and underwent MRSI before and after the infusion. Changes in brain levels of choline (CHO), myo-inositol (MI), N-Acetylaspartate (NAA), and MRSI-derived brain temperature were compared between groups and dosage levels using mixed analyses of variance. Results Significant group-by-time interactions in brain temperature were found in the right thalamus. Post-hoc testing revealed that brain temperature increased by 0.55 °C in the right thalamus in FM (t(10) = -3.483, p = 0.006), but not in HCs (p > 0.05). Dose-by-time interactions revealed brain temperature increases in the right insula after 0.4 ng/kg (t(12) = -4.074, p = 0.002), but not after 0.3 ng/kg (p > 0.05). Dose-by-time interactions revealed decreased CHO in the right Rolandic operculum after 0.4 ng/kg endotoxin (t(13) = 3.242, p = 0.006) but not 0.3 ng/kg. In the left paracentral lobule, CHO decreased after 0.3 ng/kg (t(9) = 2.574, p = 0.030) but not 0.4 ng/kg. Dose-by-time interactions affected MI in several brain regions. MI increased after 0.3 ng/kg in the right Rolandic operculum (t(10) = -2.374, p = 0.039), left supplementary motor area (t(9) = -2.303, p = 0.047), and left occipital lobe (t(10) = -3.757, p = 0.004), with no changes after 0.4 ng/kg (p > 0.05). Group-by time interactions revealed decreased NAA in the left Rolandic operculum in FM (t(13) = 2.664, p = 0.019), but not in HCs (p > 0.05). A dose-by-time interaction showed decreased NAA in the left paracentral lobule after 0.3 ng/kg (t(9) = 3.071, p = 0.013) but not after 0.4 ng/kg (p > 0.05). In the combined sample, there was a main effect of time whereby NAA decreased in the left anterior cingulate (F[1,21] = 4.458, p = 0.047) and right parietal lobe (F[1,21] = 5.457, p = 0.029). Conclusion We found temperature increases and NAA decreases in FM that were not seen in HCs, suggesting that FM patients may have abnormal immune responses in the brain. The 0.3 and 0.4 ng/kg had differential effects on brain temperature and metabolites, with neither dose effecting a stronger response overall. There is insufficient evidence provided by the study to determine whether FM involves abnormal central responses to low-level immune challenges.
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Affiliation(s)
- Christina Mueller
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Indonesia Jordan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Chloe Jones
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Prentiss Lawson
- Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jarred W. Younger
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Akel A, Almanasyeh B, Abo Kobaa A, Aljabali A, Al-Abadleh A, Alkhalaileh A, Alwardat AR, Sarhan MY, Abu-Jeyyab M. A Cross-Sectional Study of Fibromyalgia and Post-acute COVID-19 Syndrome (PACS): Could There Be a Relationship? Cureus 2023; 15:e42663. [PMID: 37644924 PMCID: PMC10462402 DOI: 10.7759/cureus.42663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2023] [Indexed: 08/31/2023] Open
Abstract
Background Post-acute COVID-19 syndrome (PACS) is a syndrome characterized by a wide spectrum of symptoms emerging after clearance of coronavirus 2019 (COVID-19) infection. These symptoms include fatigue, myalgia, arthralgia, cognitive dysfunction, and many other psychiatric symptoms. Given that fibromyalgia patients have similar symptoms, we conducted a web-based cross-sectional study to investigate the prevalence and predictors of fibromyalgia patients who recovered from COVID-19. Methods Data were collected between the 9th and 19th of March 2022 using a web-based survey. The questionnaire consisted of 25 questions gathering sociodemographic information, comorbid diseases and features of acute COVID-19 infection. Lastly, the American College of Rheumatology (ACR) survey criteria completed the questionnaire. Results A final sample of 404 individuals (75% women) filled out the form. Of these, 80 (19.8%) satisfied the ACR survey criteria for fibromyalgia (93.8% women). A multivariate logistic regression model including demographic and clinical factors showed that female gender (OR: 6.557, 95% CI: 2.376 - 18.093, p = 0.001) and dyspnea (OR: 1.980, 95% CI: 1.146 - 3.420, p = 0.014) were the strongest predictors of being classified as having post-COVID-19 fibromyalgia. Bivariate correlation revealed that age (r = 0.200, p = 0.001) and duration of COVID-19 infection (r = 0.121, p = 0.015) were directly correlated with fibromyalgia symptom (FS) score. Conclusion Our data suggest that clinical features of fibromyalgia are common in patients who recovered from COVID-19 and that dyspnea and female gender increase the risk of developing post-COVID-19 fibromyalgia.
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Affiliation(s)
- Alaa Akel
- Orthopaedic Surgery, School of Medicine, Mutah University, Al-Karak, JOR
| | - Bilal Almanasyeh
- General Practice, School of Medicine, Mutah University, Al-Karak, JOR
| | | | - Ahmed Aljabali
- School of Medicine, Jordan University of Science and Technology, Irbid, JOR
| | - Ahmed Al-Abadleh
- General Practice, School of Medicine, Mutah University, Al-Karak, JOR
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Favretti M, Iannuccelli C, Di Franco M. Pain Biomarkers in Fibromyalgia Syndrome: Current Understanding and Future Directions. Int J Mol Sci 2023; 24:10443. [PMID: 37445618 DOI: 10.3390/ijms241310443] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 07/15/2023] Open
Abstract
Fibromyalgia is a complex and heterogeneous clinical syndrome, mainly characterized by the presence of widespread pain, possibly associated with a variety of other symptoms. Fibromyalgia can have an extremely negative impact on the psychological, physical and social lives of people affected, sometimes causing patients to experience dramatically impaired quality of life. Nowadays, the diagnosis of fibromyalgia is still clinical, thus favoring diagnostic uncertainties and making its clear identification challenging to establish, especially in primary care centers. These difficulties lead patients to undergo innumerable clinical visits, investigations and specialist consultations, thus increasing their stress, frustration and even dissatisfaction. Unfortunately, research over the last 25 years regarding a specific biomarker for the diagnosis of fibromyalgia has been fruitless. The discovery of a reliable biomarker for fibromyalgia syndrome would be a critical step towards the early identification of this condition, not only reducing patient healthcare utilization and diagnostic test execution but also providing early intervention with guideline-based treatments. This narrative article reviews different metabolite alterations proposed as possible biomarkers for fibromyalgia, focusing on their associations with clinical evidence of pain, and highlights some new, promising areas of research in this context. Nevertheless, none of the analyzed metabolites emerge as sufficiently reliable to be validated as a diagnostic biomarker. Given the complexity of this syndrome, in the future, a panel of biomarkers, including subtype-specific biomarkers, could be considered as an interesting alternative research area.
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Affiliation(s)
- Martina Favretti
- Rheumatology Unit, Department of Internal Clinical, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Cristina Iannuccelli
- Rheumatology Unit, Department of Internal Clinical, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Manuela Di Franco
- Rheumatology Unit, Department of Internal Clinical, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
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120
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Widerström-Noga E. Neuropathic Pain and Spinal Cord Injury: Management, Phenotypes, and Biomarkers. Drugs 2023:10.1007/s40265-023-01903-7. [PMID: 37326804 DOI: 10.1007/s40265-023-01903-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
Chronic neuropathic pain after a spinal cord injury (SCI) continues to be a complex condition that is difficult to manage due to multiple underlying pathophysiological mechanisms and the association with psychosocial factors. Determining the individual contribution of each of these factors is currently not a realistic goal; however, focusing on the primary mechanisms may be more feasible. One approach used to uncover underlying mechanisms includes phenotyping using pain symptoms and somatosensory function. However, this approach does not consider cognitive and psychosocial mechanisms that may also significantly contribute to the pain experience and impact treatment outcomes. Indeed, clinical experience supports that a combination of self-management, non-pharmacological, and pharmacological approaches is needed to optimally manage pain in this population. This article will provide a broad updated summary integrating the clinical aspects of SCI-related neuropathic pain, potential pain mechanisms, evidence-based treatment recommendations, neuropathic pain phenotypes and brain biomarkers, psychosocial factors, and progress regarding how defining neuropathic pain phenotypes and other surrogate measures in the neuropathic pain field may lead to targeted treatments for neuropathic pain after SCI.
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Affiliation(s)
- Eva Widerström-Noga
- The Miami Project to Cure Paralysis, University of Miami, 1611 NW 12th Avenue, Miami, FL, 33136, USA.
- Department of Neurological Surgery, University of Miami, 1095 NW 14th Terrace, Miami, FL, 33136, USA.
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Garofalo C, Cristiani CM, Ilari S, Passacatini LC, Malafoglia V, Viglietto G, Maiuolo J, Oppedisano F, Palma E, Tomino C, Raffaeli W, Mollace V, Muscoli C. Fibromyalgia and Irritable Bowel Syndrome Interaction: A Possible Role for Gut Microbiota and Gut-Brain Axis. Biomedicines 2023; 11:1701. [PMID: 37371796 DOI: 10.3390/biomedicines11061701] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Fibromyalgia (FM) is a serious chronic pain syndrome, characterised by muscle and joint stiffness, insomnia, fatigue, mood disorders, cognitive dysfunction, anxiety, depression and intestinal irritability. Irritable Bowel Syndrome (IBS) shares many of these symptoms, and FM and IBS frequently co-exist, which suggests a common aetiology for the two diseases. The exact physiopathological mechanisms underlying both FM and IBS onset are unknown. Researchers have investigated many possible causes, including alterations in gut microbiota, which contain billions of microorganisms in the human digestive tract. The gut-brain axis has been proven to be the link between the gut microbiota and the central nervous system, which can then control the gut microbiota composition. In this review, we will discuss the similarities between FM and IBS. Particularly, we will focus our attention on symptomatology overlap between FM and IBS as well as the similarities in microbiota composition between FM and IBS patients. We will also briefly discuss the potential therapeutic approaches based on microbiota manipulations that are successfully used in IBS and could be employed also in FM patients to relieve pain, ameliorate the rehabilitation outcome, psychological distress and intestinal symptoms.
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Affiliation(s)
- Cinzia Garofalo
- Department of Experimental and Clinical Medicine, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Costanza Maria Cristiani
- Department of Medical and Surgical Sciences, Neuroscience Research Center, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Sara Ilari
- Physiology and Pharmacology of Pain, IRCCS San Raffaele Roma, 00166 Rome, Italy
| | - Lucia Carmela Passacatini
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | | | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Jessica Maiuolo
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Oppedisano
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Ernesto Palma
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Carlo Tomino
- Scientific Direction, IRCCS San Raffaele Roma, 00166 Rome, Italy
| | - William Raffaeli
- Institute for Research on Pain, ISAL Foundation, Torre Pedrera, 47922 Rimini, Italy
| | - Vincenzo Mollace
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Carolina Muscoli
- Department of Health Science, Institute of Research for Food Safety & Health (IRC-FSH), "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
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Gau SY, Hung TH, Chuang MF, Wei JCC. Depressive Symptoms in Patients with Fibromyalgia: Current Evidence and Preventive Approaches. J Clin Med 2023; 12:3987. [PMID: 37373680 DOI: 10.3390/jcm12123987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 06/29/2023] Open
Abstract
Fibromyalgia is a chronic inflammatory disease characterized by multifocal pain, fatigue, and cognitive impairment [...].
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Affiliation(s)
- Shuo-Yan Gau
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Tsung-Hsuan Hung
- School of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Min-Fei Chuang
- Department of Neurology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - James Cheng-Chung Wei
- Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 402, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
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Quijas MM, Queme LF, Weyler AA, Butterfield A, Joshi DP, Mitxelena-Balerdi I, Jankowski MP. Sex specific role of RNA-binding protein, AUF1, on prolonged hypersensitivity after repetitive ischemia with reperfusion injury. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.08.544080. [PMID: 37333316 PMCID: PMC10274888 DOI: 10.1101/2023.06.08.544080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Repetitive ischemia with reperfusion (I/R) injury is a common cause of myalgia. I/R injuries occur in many conditions that differentially affect males and females including complex regional pain syndrome and fibromyalgia. Our preclinical studies have indicated that primary afferent sensitization and behavioral hypersensitivity due to I/R may be due to sex specific gene expression in the DRGs and distinct upregulation of growth factors and cytokines in the affected muscles. In order to determine how these unique gene expression programs may be established in a sex dependent manner in a model that more closely mimics clinical scenarios, we utilized a newly developed prolonged ischemic myalgia model in mice whereby animals experience repeated I/R injuries to the forelimb and compared behavioral results to unbiased and targeted screening strategies in male and female DRGs. Several distinct proteins were found to be differentially expressed in male and female DRGs, including AU-rich element RNA binding protein (AUF1), which is known to regulate gene expression. Nerve specific siRNA-mediated knockdown of AUF1 inhibited prolonged hypersensitivity in females only, while overexpression of AUF1 in male DRG neurons increased some pain-like responses. Further, AUF1 knockdown was able to specifically inhibit repeated I/R induced gene expression in females but not males. Data suggests that RNA binding proteins like AUF1 may underlie the sex specific effects on DRG gene expression that modulate behavioral hypersensitivity after repeated I/R injury. This study may aid in finding distinct receptor differences related to the evolution of acute to chronic ischemic muscle pain development between sexes.
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Affiliation(s)
- Meranda M. Quijas
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Luis F. Queme
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Alex A. Weyler
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Ally Butterfield
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Diya P. Joshi
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Irati Mitxelena-Balerdi
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Michael P. Jankowski
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Pediatric Pain Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
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Cai L, Chen Z, Liang J, Song Y, Yu H, Zhu J, Wu Q, Zhou X, Du Q. Effectiveness of non-pharmacological traditional Chinese medicine combined with conventional therapy in treating fibromyalgia: a systematic review and meta-analysis. Front Neurosci 2023; 17:1097475. [PMID: 37325034 PMCID: PMC10267337 DOI: 10.3389/fnins.2023.1097475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Objective Fibromyalgia is a chronic musculoskeletal disorder characterized by generalized pain, which is also known as "muscular rheumatism" in Chinese medicine. We undertook this systematic review to evaluate the effectiveness of non-pharmacological traditional Chinese medicine (TCM) combined with conventional therapy on pain, health status, depression, and the quality of life of fibromyalgia patients. Methods Studies were retrieved from five electronic databases (PubMed, the Cumulative Index to Nursing and Allied Health, Cochrane Library, Embase, and Web of Science) with publication date up to August 2022. We included randomized controlled trials examining the effects of a combination of non-pharmacological TCM and conventional therapy on pain intensity, health status, depression, and quality of life. Results Four randomized controlled trials with 384 fibromyalgia patients met the inclusion criteria. Results of the meta-analysis showed that non-pharmacological TCM combined with conventional therapy exerted significant positive effects on alleviating pain at the post-intervention time point than conventional therapy only (visual analog scale WMD1 = -1.410, P < 0.01; pressure pain threshold WMD2 = 0.830, P < 0.001, respectively). Significant differences in pain assessment were also observed between the two groups after a long-term follow-up (12 months) (WMD1 = -1.040 and WMD2= 0.380, all P < 0.05). The combination therapy group also showed a greater reduction in fibromyalgia impact questionnaire than the control group after a long-term follow-up (WMD = -6.690, P < 0.05). Depression and pain-related quality of life showed no difference between groups (all P > 0.05). Conclusion Non-pharmacological TCM combined with conventional therapy may be more effective in alleviating pain and improving health status than conventional therapy only. However, it remains some concerns over the safety and clinic application. Systematic review registration Identifier: CRD42022352991.
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Affiliation(s)
- Lili Cai
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengquan Chen
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Juping Liang
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuanyuan Song
- Chongming Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Hong Yu
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jiaye Zhu
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qikai Wu
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xuan Zhou
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qing Du
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Chongming Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Silva A, Barcessat AR, Gonçalves R, Landre C, Brandão L, Nunes L, Feitosa H, Costa L, Silva R, de Lima E, Monteiro ES, Rinaldi A, Fontani V, Rinaldi S. REAC Neurobiological Modulation as a Precision Medicine Treatment for Fibromyalgia. J Pers Med 2023; 13:902. [PMID: 37373891 DOI: 10.3390/jpm13060902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Fibromyalgia syndrome (FS) is a disorder characterized by widespread musculoskeletal pain and psychopathological symptoms, often associated with central pain modulation failure and dysfunctional adaptive responses to environmental stress. The Radio Electric Asymmetric Conveyer (REAC) technology is a neuromodulation technology. The aim of this study was to evaluate the effects of some REAC treatments on psychomotor responses and quality of life in 37 patients with FS. Tests were conducted before and after a single session of Neuro Postural Optimization and after a cycle of 18 sessions of Neuro Psycho Physical Optimization (NPPO), using evaluation of the functional dysmetria (FD) phenomenon, Sitting and Standing (SS), Time Up and Go (TUG) tests for motor evaluation, Fibromyalgia Impact Questionnaire (FIQ) for quality of life. The data were statistically analyzed, and the results showed a statistically significant improvement in motor response and quality of life parameters, including pain, as well as reduced FD measures in all participants. The study concludes that the neurobiological balance established by the REAC therapeutic protocols NPO and NPPO improved the dysfunctional adaptive state caused by environmental and exposomal stress in FS patients, leading to an improvement in psychomotor responses and quality of life. The findings suggest that REAC treatments could be an effective approach for FS patients, reducing the excessive use of analgesic drugs and improving daily activities.
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Affiliation(s)
- Analízia Silva
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Ana Rita Barcessat
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Rebeca Gonçalves
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Cleuton Landre
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Lethícia Brandão
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Lucas Nunes
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Hyan Feitosa
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Leonardo Costa
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Raquel Silva
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Emanuel de Lima
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Ester Suane Monteiro
- Department of Biological and Health Sciences, Federal University of Amapá-UNIFAP, Macapá 68903-419, Brazil
| | - Arianna Rinaldi
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, 50144 Florence, Italy
- Department of Regenerative Medicine, Rinaldi Fontani Institute, 50144 Florence, Italy
| | - Vania Fontani
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, 50144 Florence, Italy
- Department of Regenerative Medicine, Rinaldi Fontani Institute, 50144 Florence, Italy
- Research Department, Rinaldi Fontani Foundation, 50144 Florence, Italy
| | - Salvatore Rinaldi
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, 50144 Florence, Italy
- Department of Regenerative Medicine, Rinaldi Fontani Institute, 50144 Florence, Italy
- Research Department, Rinaldi Fontani Foundation, 50144 Florence, Italy
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Pacheco-Barrios K, Pimenta DC, Pessotto AV, Fregni F. Motor Cortex Inhibition and Facilitation Correlates with Fibromyalgia Compensatory Mechanisms and Pain: A Cross-Sectional Study. Biomedicines 2023; 11:1543. [PMID: 37371638 DOI: 10.3390/biomedicines11061543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The role of transcranial magnetic stimulation (TMS) measures as biomarkers of fibromyalgia syndrome (FMS) phenotypes is still unclear. We aimed to determine the clinical correlates of TMS measures in FMS patients. We conducted a cross-sectional analysis that included 58 patients. We performed standardized TMS assessments, including resting motor threshold (MT), motor-evoked potential (MEP), short intracortical inhibition (SICI), and intracortical facilitation (ICF). Sociodemographic, clinical questionnaires, and quantitative sensory testing were collected from all of the patients. Univariate and multivariate linear regression models were built to explore TMS-associated factors. We found that SICI did not significantly correlate with pain levels but was associated with sleepiness, comorbidities, disease duration, and anxiety. On the other hand, ICF showed a positive correlation with pain levels and a negative correlation with body mass index (BMI). BMI was a negative effect modifier of the ICF and pain association. The clinical correlates of MT and MEP were scarce. Our results suggest that SICI and ICF metrics are potential phenotyping biomarkers in FMS related to disease compensation and levels of pain perception, respectively. The clinical translation of TMS paired-pulse protocols represents an opportunity for a mechanistic understanding of FMS and the future development of precision treatments.
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Affiliation(s)
- Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
- Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
| | - Danielle Carolina Pimenta
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Anne Victorio Pessotto
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
- Laboratório de Imunohematologia e Hematologia Forense (LIM40), Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC da FMUSP), São Paulo 05403-010, Brazil
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
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Atta AA, Ibrahim WW, Mohamed AF, Abdelkader NF. Targeting α7-nAChR by galantamine mitigates reserpine-induced fibromyalgia-like symptoms in rats: Involvement of cAMP/PKA, PI3K/AKT, and M1/M2 microglia polarization. Eur J Pharmacol 2023; 952:175810. [PMID: 37245858 DOI: 10.1016/j.ejphar.2023.175810] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 05/30/2023]
Abstract
Fibromyalgia (FM) is a pain disorder marked by generalized musculoskeletal pain accompanied by depression, fatigue, and sleep disturbances. Galantamine (Gal) is a positive allosteric modulator of neuronal nicotinic acetylcholine receptors (nAChRs) and a reversible inhibitor of cholinesterase. The current study aimed to explore the therapeutic potential of Gal against reserpine (Res)-induced FM-like condition along with investigating the α7-nAChR's role in Gal-mediated effects. Rats were injected with Res (1 mg/kg/day; sc) for 3 successive days then Gal (5 mg/kg/day; ip) was given alone and with the α7-nAChR blocker methyllycaconitine (3 mg/kg/day; ip), for the subsequent 5 days. Galantamine alleviated Res-induced histopathological changes and monoamines depletion in rats' spinal cord. It also exerted analgesic effect along with ameliorating Res-induced depression and motor-incoordination as confirmed by behavioral tests. Moreover, Gal produced anti-inflammatory effect through modulating AKT1/AKT2 and shifting M1/M2 macrophage polarization. The neuroprotective effects of Gal were mediated through activating cAMP/PKA and PI3K/AKT pathways in α7-nAChR-dependent manner. Thus, Gal can ameliorate Res-induced FM-like symptoms and mitigate the associated monoamines depletion, neuroinflammation, oxidative stress, apoptosis, and neurodegeneration through α7-nAChR stimulation, with the involvement of cAMP/PKA, PI3K/AKT, and M1/M2 macrophage polarization.
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Affiliation(s)
- Ahd A Atta
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., 11562, Cairo, Egypt.
| | - Weam W Ibrahim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., 11562, Cairo, Egypt
| | - Ahmed F Mohamed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., 11562, Cairo, Egypt
| | - Noha F Abdelkader
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., 11562, Cairo, Egypt
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Martínez-Navarro O, Climent-Sanz C, Lletjà-Guijarro A, Adel El Arab R, Verdejo-Amengual FJ, Valenzuela-Pascual F. Effectiveness of eHealth therapeutic education interventions in the management of fibromyalgia: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e070012. [PMID: 37164470 PMCID: PMC10173998 DOI: 10.1136/bmjopen-2022-070012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/13/2023] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION Non-pharmacological approaches have shown promising results in improving symptoms and quality of life of patients with fibromyalgia. However, these approaches may not be easily accessible or feasible for everyone. eHealth interventions may offer a more convenient and cost-effective approach to reach a wider range of patients with fibromyalgia and improve their outcomes. As eHealth tools become more prevalent in clinical practice, it is crucial to understand their effectiveness, limitations and how they can be integrated into standard care to optimise clinical outcomes. This systematic review aims to evaluate the effectiveness of eHealth therapeutic education interventions in managing fibromyalgia. METHODS AND ANALYSIS Randomised controlled trials including eHealth therapeutic education interventions for individuals ≥18 years old with fibromyalgia, published in English or Spanish, will be retrieved by searching the databases PubMed, CINAHL Plus, EMBASE, Scopus, ISI Web of Science, PsycINFO and the Cochrane Central Register of Controlled Trials. Covidence software will be used for the selection of studies and data extraction. The risk of bias and the certainty of evidence will be assessed using the Cochrane Risk of Bias Assessment tool. We plan to perform a meta-analysis contingent on the number of studies retrieved and the interstudy heterogeneity, which will be explored with I2 statistics. ETHICS AND DISSEMINATION This protocol and the subsequent systematic review will not collect individual-level data and do not require approval by an ethical committee. We intend to disseminate the study results via peer-reviewed scientific journals and relevant (inter)national conferences. PROSPERO REGISTRATION NUMBER CRD42022343373.
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Affiliation(s)
- Oriol Martínez-Navarro
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research group of health care (GRECS), Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré, Lleida, Spain
| | - Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research group of health care (GRECS), Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré, Lleida, Spain
- Consolidated research group: Society, Health, Education and Culture (GESEC), University of Lleida, Lleida, Spain
| | - Ariadna Lletjà-Guijarro
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Alcarras Primary Care Centre, Catalan Health Institute (ICS), 25180 Lleida, Spain
| | - Rabie Adel El Arab
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research group of health care (GRECS), Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré, Lleida, Spain
| | - Francisco José Verdejo-Amengual
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research group of health care (GRECS), Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré, Lleida, Spain
| | - Fran Valenzuela-Pascual
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research group of health care (GRECS), Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré, Lleida, Spain
- Consolidated research group: Society, Health, Education and Culture (GESEC), University of Lleida, Lleida, Spain
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Xin M, Qu Y, Peng X, Zhu D, Cheng S. A systematic review and meta-analysis of voxel-based morphometric studies of fibromyalgia. Front Neurosci 2023; 17:1164145. [PMID: 37229427 PMCID: PMC10203234 DOI: 10.3389/fnins.2023.1164145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Objective Although neuroimaging investigations have revealed significant changes in brain structure in fibromyalgia (FM) patients, these findings are inconsistent. The current study conducted a systematic review and meta-analysis of voxel-based morphometric studies in order to comprehend those alterations in brain structure in FM patients. Methods Voxel-based morphometric (VBM) studies published up to January 17, 2023 were searched in the Web of Science, PubMed, EMBASE, Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Chongqing VIP, Wanfang Database. Two independent researchers carried out study screening, quality assessment, clinical data and neuroimaging data extraction. The whole-brain voxel-based gray matter (GM) data of FM patients were collected from eligible studies, and meta-analyzed using anisotropic effect size-signed differential mapping (AES-SDM). Results Twelve researches were included in this study, including 289 FM patients (mean age: 47.36 years) and 272 HS (mean age: 47.34 years). According to the meta-analysis, FM patients had increased GM in the right postcentral gyrus and left angular gyrus, and decreased GM in the right cingulate gyrus, right paracingulate gyrus, left cerebellum, and left gyrus rectus. Conclusion Our study suggests that fibromyalgia patients have altered gray matter in several brain regions that are involved in affective, cognitive functions, and in motor adaptations to pain processing.
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Affiliation(s)
- Ming Xin
- Geriatric Diseases Institute of Chengdu, Department of Rehabilitation, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Yuzhu Qu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingfu Peng
- Geriatric Diseases Institute of Chengdu, Department of Rehabilitation, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Deliang Zhu
- Geriatric Diseases Institute of Chengdu, Department of Rehabilitation, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Shirui Cheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Abd Elmaaboud MA, Awad MM, El-Shaer RAA, Kabel AM. The immunomodulatory effects of ethosuximide and sodium butyrate on experimentally induced fibromyalgia: The interaction between IL-4, synaptophysin, and TGF-β1/NF-κB signaling. Int Immunopharmacol 2023; 118:110061. [PMID: 36989891 DOI: 10.1016/j.intimp.2023.110061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/01/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND AND AIMS Fibromyalgia is a widespread chronic pain syndrome associated with several comorbid conditions that affect the quality of patients' life. Its pathogenesis is complex, and the treatment strategies are limited by partial efficacy and potential adverse effects. So, our aim was to investigate the possible ameliorative effects of ethosuximide and sodium butyrate on fibromyalgia and compare their effects to pregabalin. MATERIALS AND METHODS In a mouse model of reserpine induced fibromyalgia, the effect of ethosuximide, sodium butyrate, and pregabalin was investigated. Evaluation of mechanical allodynia, cold hypersensitivity, anxiety, cognitive impairment, and depression was performed. Also, the brain and spinal cord tissue serotonin, dopamine and glutamate in addition to the serum levels of interleukin (IL)-4 and transforming growth factor beta 1 (TGF-β1) were assayed. Moreover, the expression of nuclear factor kappa B (NF-κB) synaptophysin was immunoassayed in the hippocampal tissues. KEY FINDINGS Ethosuximide and sodium butyrate restored the behavioral tests to the normal values except for the antidepressant effect which was evident only with ethosuximide. Both drugs elevated the levels of the anti-inflammatory cytokines IL-4 and TGF-β1, reduced the hippocampal NF-κB, and increased synaptophysin expression with superiority of sodium butyrate. Ethosuximide reduced only spinal cord and brain glutamate while improved brain dopamine while sodium butyrate elevated spinal cord dopamine and serotonin with no effect on glutamate. Also, sodium butyrate elevated brain serotonin and reduced glutamate with no effect on brain dopamine. SIGNIFICANCE Each of sodium butyrate and ethosuximide would serve as a promising therapeutic modality for management of fibromyalgia and its comorbid conditions.
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Affiliation(s)
| | - Marwa M Awad
- Department of physiology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rehab A A El-Shaer
- Department of physiology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed M Kabel
- Department of pharmacology, Faculty of Medicine, Tanta University, Tanta, Egypt.
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Mitchell ME, Cook LC, Shiers S, Tavares-Ferreira D, Akopian AN, Dussor G, Price TJ. Characterization of Fragile X Mental Retardation Protein expression in human nociceptors and their axonal projections to the spinal dorsal horn. J Comp Neurol 2023; 531:814-835. [PMID: 36808110 PMCID: PMC10038933 DOI: 10.1002/cne.25463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/20/2022] [Accepted: 01/27/2023] [Indexed: 02/23/2023]
Abstract
Fragile X Mental Retardation Protein (FMRP) regulates activity-dependent RNA localization and local translation to modulate synaptic plasticity throughout the central nervous system. Mutations in the FMR1 gene that hinder or ablate FMRP function cause Fragile X Syndrome (FXS), a disorder associated with sensory processing dysfunction. FXS premutations are associated with increased FMRP expression and neurological impairments including sex dimorphic presentations of chronic pain. In mice, FMRP ablation causes dysregulated dorsal root ganglion (DRG) neuron excitability and synaptic vesicle exocytosis, spinal circuit activity, and decreased translation-dependent nociceptive sensitization. Activity-dependent, local translation is a key mechanism for enhancing primary nociceptor excitability that promotes pain in animals and humans. These works indicate that FMRP likely regulates nociception and pain at the level of the primary nociceptor or spinal cord. Therefore, we sought to better understand FMRP expression in the human DRG and spinal cord using immunostaining in organ donor tissues. We find that FMRP is highly expressed in DRG and spinal neuron subsets with substantia gelatinosa exhibiting the most abundant immunoreactivity in spinal synaptic fields. Here, it is expressed in nociceptor axons. FMRP puncta colocalized with Nav1.7 and TRPV1 receptor signals suggesting a pool of axoplasmic FMRP localizes to plasma membrane-associated loci in these branches. Interestingly, FMRP puncta exhibited notable colocalization with calcitonin gene-related peptide (CGRP) immunoreactivity selectively in female spinal cord. Our results support a regulatory role for FMRP in human nociceptor axons of the dorsal horn and implicate it in the sex dimorphic actions of CGRP signaling in nociceptive sensitization and chronic pain.
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Affiliation(s)
- Molly E Mitchell
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Lauren C Cook
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Stephanie Shiers
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Diana Tavares-Ferreira
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Armen N Akopian
- Department of Endodontics, UT Health San Antonio, San Antonio, Texas, USA
| | - Gregory Dussor
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Theodore J Price
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
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132
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Ovrom EA, Mostert KA, Khakhkhar S, McKee DP, Yang P, Her YF. A Comprehensive Review of the Genetic and Epigenetic Contributions to the Development of Fibromyalgia. Biomedicines 2023; 11:1119. [PMID: 37189737 PMCID: PMC10135661 DOI: 10.3390/biomedicines11041119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023] Open
Abstract
This narrative review summarizes the current knowledge of the genetic and epigenetic contributions to the development of fibromyalgia (FM). Although there is no single gene that results in the development of FM, this study reveals that certain polymorphisms in genes involved in the catecholaminergic pathway, the serotonergic pathway, pain processing, oxidative stress, and inflammation may influence susceptibility to FM and the severity of its symptoms. Furthermore, epigenetic changes at the DNA level may lead to the development of FM. Likewise, microRNAs may impact the expression of certain proteins that lead to the worsening of FM-associated symptoms.
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Affiliation(s)
- Erik A. Ovrom
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA;
| | - Karson A. Mostert
- Department of Physical Medicine and Rehabilitation, Mayo Clinic Hospital, Rochester, MN 55905, USA
| | - Shivani Khakhkhar
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Daniel P. McKee
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Padao Yang
- Department of Psychiatry and Psychology, Mayo Clinic Hospital, Rochester, MN 55905, USA
| | - Yeng F. Her
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN 55905, USA
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133
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Yang CC, Tsai ST, Ting B, Cheng YC, Wang CK, Chang JPC, Su KP. Psychological Outcomes and Quality of Life of Fibromyalgia Patients with Vitamin D Supplementation-A Meta-Analysis. J Clin Med 2023; 12:jcm12072750. [PMID: 37048833 PMCID: PMC10095322 DOI: 10.3390/jcm12072750] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
The efficacy of current pharmaceutical treatments for fibromyalgia are limited. Vitamin D has shown promise in relieving pain. However, there is a lack of comprehensive analysis of psychological outcomes with vitamin D supplementation in fibromyalgia. This study aimed to investigate the impact of vitamin D supplementation on psychological outcomes and quality of life in fibromyalgia patients, given the unmet clinical need for effective treatment options. A meta-analysis of randomized controlled trials comparing vitamin D to placebo and prospective studies examining changes before and after vitamin D supplementation for patients with fibromyalgia was conducted to evaluate the effects of vitamin D on psychological outcomes, quality of life, and pain scores in patients with fibromyalgia. Databases were searched for relevant articles published from earliest available date to October 31, 2022. (PROSPERO number, CRD42022369889). We included 8 trials with a total of 694 participants and found that vitamin D supplementation had significant positive effects on physical function (standard mean differences (SMD) = 0.44, 95% CI = [0.10, 0.77 ]), role limitations due to emotional health (SMD = 0.57, 95% CI = [0.32, 0.82]), social function (SMD = 0.50, 95% CI = [0.08, 0.93]), and general health (SMD = 0.36, 95% CI = [0.11, 0.61]). Improvement of the Fibromyalgia Impact Questionnaire (FIQ) scores was noted (SMD = -0.414, 95% CI = [-0.808, -0.021]), but not on the Visual Analog Scale (VAS) (SMD = -0.15, 95% CI = [-0.771, 0.471]) and the Beck's Depression Inventory (BDI) scores (SMD = -0.456, 95% CI = [-1.27, 0.30]). In conclusion, vitamin D supplementation might be an alternative option for improvement of psychological outcomes and quality of life in patients with fibromyalgia.
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Grants
- 109-2320-B-038-057-MY3 Ministry of Science and Technology, Taiwan
- 110-2321-B-006-004 Ministry of Science and Technology, Taiwan
- 110-2811-B-039-507 Ministry of Science and Technology, Taiwan
- 110-2320-B-039-048-MY2 Ministry of Science and Technology, Taiwan
- 110-2320-B-039-047-MY3 Ministry of Science and Technology, Taiwan
- 110-2813-C-039-327-B Ministry of Science and Technology, Taiwan
- 110-2314-B-039-029-MY3 Ministry of Science and Technology, Taiwan
- 111-2321-B-006-008 Ministry of Science and Technology, Taiwan
- 109-31 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 109-40 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-13 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-26 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-44 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 110-45 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-27 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-28 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-47 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-48 An-Nan Hospital, China Medical University, Tainan, Taiwan
- 111-52 An-Nan Hospital, China Medical University, Tainan, Taiwan
- CMRC-CMA-2 Higher Education Sprout Project by the Ministry of Education (MOE), Taiwan
- 110-AWARD-02 China Medical University, Taichung, Taiwan
- 110-N-17 China Medical University, Taichung, Taiwan
- 1110-SR-73 China Medical University, Taichung, Taiwan
- DMR-106-101 China Medical University Hospital, Taichung, Taiwan
- DMR-106-227 China Medical University Hospital, Taichung, Taiwan
- DMR-109-102 China Medical University Hospital, Taichung, Taiwan
- DMR-109-244 China Medical University Hospital, Taichung, Taiwan
- DMR-110-124 China Medical University Hospital, Taichung, Taiwan
- DMR-111-245 China Medical University Hospital, Taichung, Taiwan
- DMR-112-097 China Medical University Hospital, Taichung, Taiwan
- DMR-112-086 China Medical University Hospital, Taichung, Taiwan
- DMR-112-109 China Medical University Hospital, Taichung, Taiwan
- DMR-112-232 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-109-11 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-109-12 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-110-10 China Medical University Hospital, Taichung, Taiwan
- DMR-HHC-111-8 China Medical University Hospital, Taichung, Taiwan
- CMUH-C1110812016-11 China Medical University Hospital, Taichung, Taiwan
- NSTC 111-2314-B-039-041-MY3 National Science and Technology Council, Taiwan
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Affiliation(s)
- Chia-Chun Yang
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan 330, Taiwan
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
| | - Sheng-Ta Tsai
- School of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan
- Neuroscience and Brain Disease Center, China Medical University, Taichung 404, Taiwan
| | - Berne Ting
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu 302, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
| | - Chin-Kun Wang
- Department of Nutrition, Chung Shan Medical University, Taichung 402, Taiwan
| | - Jane Pei-Chen Chang
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
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134
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Wang F, Cheung CW, Wong SSC. Use of pain-related gene features to predict depression by support vector machine model in patients with fibromyalgia. Front Genet 2023; 14:1026672. [PMID: 37065490 PMCID: PMC10090498 DOI: 10.3389/fgene.2023.1026672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
The prevalence rate of depression is higher in patients with fibromyalgia syndrome, but this is often unrecognized in patients with chronic pain. Given that depression is a common major barrier in the management of patients with fibromyalgia syndrome, an objective tool that reliably predicts depression in patients with fibromyalgia syndrome could significantly enhance the diagnostic accuracy. Since pain and depression can cause each other and worsen each other, we wonder if pain-related genes can be used to differentiate between those with major depression from those without. This study developed a support vector machine model combined with principal component analysis to differentiate major depression in fibromyalgia syndrome patients using a microarray dataset, including 25 fibromyalgia syndrome patients with major depression, and 36 patients without major depression. Gene co-expression analysis was used to select gene features to construct support vector machine model. The principal component analysis can help reduce the number of data dimensions without much loss of information, and identify patterns in data easily. The 61 samples available in the database were not enough for learning based methods and cannot represent every possible variation of each patient. To address this issue, we adopted Gaussian noise to generate a large amount of simulated data for training and testing of the model. The ability of support vector machine model to differentiate major depression using microarray data was measured as accuracy. Different structural co-expression patterns were identified for 114 genes involved in pain signaling pathway by two-sample KS test (p < 0.001 for the maximum deviation D = 0.11 > Dcritical = 0.05), indicating the aberrant co-expression patterns in fibromyalgia syndrome patients. Twenty hub gene features were further selected based on co-expression analysis to construct the model. The principal component analysis reduced the dimension of the training samples from 20 to 16, since 16 components were needed to retain more than 90% of the original variance. The support vector machine model was able to differentiate between those with major depression from those without in fibromyalgia syndrome patients with an average accuracy of 93.22% based on the expression levels of the selected hub gene features. These findings would contribute key information that can be used to develop a clinical decision-making tool for the data-driven, personalized optimization of diagnosing depression in patients with fibromyalgia syndrome.
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135
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Chan SY, Lu LY, Lin SY, Ma KSK. Pain neuroscience education for fibromyalgia. Int J Rheum Dis 2023. [PMID: 36889746 DOI: 10.1111/1756-185x.14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Shu-Yen Chan
- School of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Internal Medicine, University of Pittsburgh Medical Center, Pennsylvania, Pittsburgh, USA
| | - Li-Yu Lu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Sheng-Yi Lin
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Massachusetts, Boston, USA.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kevin Sheng-Kai Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Massachusetts, Boston, USA.,Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, Philadelphia, USA.,Department of Dermatology, Massachusetts General Hospital, Massachusetts, Boston, USA.,Department of Orthodontics and Dentofacial Orthopedics, Henry M. Goldman School of Dental Medicine, Boston University, Massachusetts, Boston, USA
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136
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Coexistence of fibromyalgia syndrome and inflammatory rheumatic diseases, and autonomic cardiovascular system involvement in fibromyalgia syndrome. Clin Rheumatol 2023; 42:645-652. [PMID: 36151442 DOI: 10.1007/s10067-022-06385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/03/2022]
Abstract
The spectrum of symptoms represented by fibromyalgia syndrome (FMS) has a profound effect on daily activities and impairs the quality of life. A considerable proportion of patients with inflammatory rheumatic diseases (IRDs) fulfill the FMS criteria, which can complicate the diagnosis, treatment, and follow-ups of IRD. In addition, the coexistence of FMS may cause unnecessary laboratory and radiological assessments. Several mechanisms have been proposed that may have a role in the etiopathogenesis of FMS, one of which is autonomic dysregulation. In studies evaluating cardiac autonomic dysfunction based on heart rate variability (HRV), there has been found to be a decrease in HRV and dominance of the sympathetic nervous system. Autonomic reactivity reflects modulations of several functions to overcome the existing state and conditions. Blunted autonomic reactivity has been found in some FMS patients, which makes it difficult for these patients to respond appropriately to unexpected stress sources that occur during daily living activities. Baroreceptor signals have an inhibitory influence on the central nervous system, and these impulses cause pain suppression. From this perspective, there are studies that have suggested the involvement of diminished baroreflex sensitivity in the etiology of FMS. The risk of endothelial dysfunction and increased arterial stiffness have been shown to occur in FMS patients due to autonomic dysfunction, sympathetic nervous system dominance, chronic stress, and pain. There is also evidence linking FMS with the risk of atrial and ventricular arrhythmias. Considering all these cardiovascular autonomic dysfunctions, tests that can confirm abnormalities should be performed when suspicion arises. There is a need for specific pharmacological and non-pharmacological treatment alternatives to be identified for subgroups of patients with cardiovascular system abnormalities. Key points • The frequency of FMS accompanying inflammatory rheumatic diseases is considerable and this coexistence leads to troubles in evaluating treatment response and determining appropriate medical treatment options in inflammatory rheumatic diseases. • Various cardiovascular autonomic abnormalities have been described in FMS patients. Among these, the most emphasized are autonomic dysfunction, the disruption of the balance between the sympathetic-parasympathetic nervous systems, blunted autonomic reactivity to acute stress, changes in baroreflex sensitivity, increased arterial stiffness, and electrophysiological alterations. • Autonomic cardiovascular dysfunction may be involved in the complex etiopathogenesis of the fibromyalgia syndrome and may trigger at least some symptoms.
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137
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Bordoni B, Escher AR, Cannadoro G, Tobbi F. The Cognitive and Emotional Aspect in Fibromyalgia: The Importance of the Orofacial Sphere. Cureus 2023; 15:e36380. [PMID: 36945233 PMCID: PMC10025772 DOI: 10.7759/cureus.36380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/22/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a systemic and multifactorial disease of unknown etiology. There are many co-morbidities that the patient presents, making the clinical picture not immediate. Cognitive decline and emotional alteration (anxiety and depression) are found in fibromyalgic patients, as well as temporomandibular joint arthrokinematic disorders, dental malocclusion, and periodontitis. There seems to be a biunivocal relationship between oral and psychiatric dysfunctions in fibromyalgia. The article reviews the information regarding oral health alterations with respect to the patient's cognitive and emotional response, as the most recent information we have raises new hypotheses about the diagnosis of FMS.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
| | - Allan R Escher
- Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | | | - Filippo Tobbi
- Osteopathy, Poliambulatorio Medico e Odontoiatrico, Varese, ITA
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138
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Sambataro G, Orlandi M, Fagone E, Fruciano M, Gili E, Libra A, Palmucci S, Vancheri C, Malatino L, Colaci M, Sambataro D. Myositis-Specific and Myositis-Associated Antibodies in Fibromyalgia Patients: A Prospective Study. Biomedicines 2023; 11:biomedicines11030658. [PMID: 36979638 PMCID: PMC10045737 DOI: 10.3390/biomedicines11030658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/08/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Fibromyalgia (FM) is a common rheumatologic disorder characterised by widespread muscular pain. Myalgia is also a common clinical feature in Connective Tissue Disease (CTD), and FM should be studied for the concomitant presence of a CTD. The aim of this study is to evaluate the prevalence of Myositis-Specific and Myositis-Associated Antibodies (MSA/MAA) in a cohort of FM patients. We enrolled 233 consecutive FM patients (defined according to the 2016 criteria) that did not report clinical signs of autoimmune disorders and followed them for at least one year. The patients were tested for MSA/MAA with immunoblotting. FM patients were seropositive for Antinuclear Antibodies (ANA) in 24% of cases, for MSA in 9%, and for MAA in 6%. A specific diagnosis of CTD was made in 12 patients (5.2%), namely, 5 cases of primary Sjögren’s Syndrome and 7 of Idiopathic Inflammatory Myopathy. Seropositive patients showed clinical features similar to those who were seronegative at baseline. A CTD diagnosis was associated with ANA positivity (p = 0.03, X2 4.9), the presence of a speckled pattern (p = 0.02, X2 5.3), positivity for MAA (p = 0.004, X2 8.1), and MSA (p = 0.003, X2 9.2). In conclusion, a non-negligible proportion of FM patients may be seropositive for MSA/MAA, and that seropositivity might suggest a diagnosis of CTD.
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Affiliation(s)
- Gianluca Sambataro
- Artroreuma s.r.l., Rheumatology Outpatient Clinic, 95030 Mascalucia, CT, Italy
- Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, Policlinico “G. Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
- Correspondence:
| | - Martina Orlandi
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC Careggi, University of Florence, 50134 Florence, Italy
| | - Evelina Fagone
- Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, Policlinico “G. Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
| | - Mary Fruciano
- Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, Policlinico “G. Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
| | - Elisa Gili
- Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, Policlinico “G. Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
| | - Alessandro Libra
- Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, Policlinico “G. Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
| | - Stefano Palmucci
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University Hospital Policlinico “G. Rodolico-San Marco”, 95123 Catania, Italy
| | - Carlo Vancheri
- Department of Clinical and Experimental Medicine, Regional Referral Centre for Rare Lung Disease, Policlinico “G. Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
| | - Lorenzo Malatino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, Division of Rheumatology, Cannizzaro Hospital, University of Catania, 95123 Catania, Italy
| | - Michele Colaci
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, Division of Rheumatology, Cannizzaro Hospital, University of Catania, 95123 Catania, Italy
| | - Domenico Sambataro
- Artroreuma s.r.l., Rheumatology Outpatient Clinic, 95030 Mascalucia, CT, Italy
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139
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Peripheral Beta-2 Adrenergic Receptors Mediate the Sympathetic Efferent Activation from Central Nervous System to Splenocytes in a Mouse Model of Fibromyalgia. Int J Mol Sci 2023; 24:ijms24043465. [PMID: 36834875 PMCID: PMC9967679 DOI: 10.3390/ijms24043465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Abnormalities in the peripheral immune system are involved in the pathophysiology of fibromyalgia, although their contribution to the painful symptoms remains unknown. Our previous study reported the ability of splenocytes to develop pain-like behavior and an association between the central nervous system (CNS) and splenocytes. Since the spleen is directly innervated by sympathetic nerves, this study aimed to examine whether adrenergic receptors are necessary for pain development or maintenance using an acid saline-induced generalized pain (AcGP) model (an experimental model of fibromyalgia) and whether the activation of these receptors is also essential for pain reproduction by the adoptive transfer of AcGP splenocytes. The administration of selective β2-blockers, including one with only peripheral action, prevented the development but did not reverse the maintenance of pain-like behavior in acid saline-treated C57BL/6J mice. Neither a selective α1-blocker nor an anticholinergic drug affects the development of pain-like behavior. Furthermore, β2-blockade in donor AcGP mice eliminated pain reproduction in recipient mice injected with AcGP splenocytes. These results suggest that peripheral β2-adrenergic receptors play an important role in the efferent pathway from the CNS to splenocytes in pain development.
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140
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Lopez-Ruiz M, Doreste Soler A, Pujol J, Losilla JM, Ojeda F, Blanco-Hinojo L, Martínez-Vilavella G, Gutiérrez-Rosado T, Monfort J, Deus J. Central Sensitization and Chronic Pain Personality Profile: Is There New Evidence? A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2935. [PMID: 36833631 PMCID: PMC9957222 DOI: 10.3390/ijerph20042935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Personality traits are relevant for pain perception in persistent pain disorders, although they have not been studied in depth in sensitized and nonsensitized patients with knee osteoarthritis (OA). OBJECTIVE To explain and compare the personality profile of patients with OA, with and without central sensitization (CS), and fibromyalgia (FM). SETTING Participants were selected at the Rheumatology Department in two major hospitals in Spain. PARTICIPANTS Case-control study where the sample consists of 15 patients with OA and CS (OA-CS), 31 OA without CS (OA-noCS), 47 FM, and 22 controls. We used a rigorous and systematic process that ensured the sample strictly fulfilled all the inclusion/exclusion criteria, so the sample is very well delimited. PRIMARY OUTCOME MEASURES Personality was assessed by the Temperament and Character Inventory of Cloninger. RESULTS The percentile in harm-avoidance dimension for the FM group is higher compared to OA groups and controls. The most frequent temperamental profiles in patients are cautious, methodical, and explosive. Patients with FM are more likely to report larger scores in harm-avoidance, with an increase in logistic regression adjusted odds ratio (ORadj) between 4.2% and 70.2%. CONCLUSIONS Harm-avoidance seems to be the most important dimension in personality patients with chronic pain, as previously found. We found no differences between OA groups and between sensitized groups, but there are differences between FM and OA-noCS, so harm-avoidance might be the key to describe personality in patients with CS rather than the presence of prolonged pain, as found in the literature before.
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Affiliation(s)
| | - Andrea Doreste Soler
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain
| | - Josep-Maria Losilla
- Department of Methodology, Faculty of Psychology, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
| | - Fabiola Ojeda
- Rheumatology Service, Hospital del Mar, 08003 Barcelona, Spain
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain
| | | | - Teresa Gutiérrez-Rosado
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Jordi Monfort
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain
| | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
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141
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Nepotchatykh E, Caraus I, Elremaly W, Leveau C, Elbakry M, Godbout C, Rostami-Afshari B, Petre D, Khatami N, Franco A, Moreau A. Circulating microRNA expression signatures accurately discriminate myalgic encephalomyelitis from fibromyalgia and comorbid conditions. Sci Rep 2023; 13:1896. [PMID: 36732593 PMCID: PMC9894933 DOI: 10.1038/s41598-023-28955-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia (FM) are two chronic complex diseases with overlapping symptoms affecting multiple systems and organs over time. Due to the absence of validated biomarkers and similarity in symptoms, both disorders are misdiagnosed, and the comorbidity of the two is often unrecognized. Our study aimed to investigate the expression profiles of 11 circulating miRNAs previously associated with ME/CFS pathogenesis in FM patients and individuals with a comorbid diagnosis of FM associated with ME/CFS (ME/CFS + FM), and matched sedentary healthy controls. Whether these 11 circulating miRNAs expression can differentiate between the two disorders was also examined. Our results highlight differential circulating miRNAs expression signatures between ME/CFS, FM and ME/CFS + FM, which also correlate to symptom severity between ME/CFS and ME/CFS + FM groups. We provided a prediction model, by using a machine-learning approach based on 11 circulating miRNAs levels, which can be used to discriminate between patients suffering from ME/CFS, FM and ME/CFS + FM. These 11 miRNAs are proposed as potential biomarkers for discriminating ME/CFS from FM. The results of this study demonstrate that ME/CFS and FM are two distinct illnesses, and we highlight the comorbidity between the two conditions. Proper diagnosis of patients suffering from ME/CFS, FM or ME/CFS + FM is crucial to elucidate the pathophysiology of both diseases, determine preventive measures, and establish more effective treatments.
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Affiliation(s)
- Evguenia Nepotchatykh
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Molecular Biology PhD Program, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Iurie Caraus
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Wesam Elremaly
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Corinne Leveau
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Mohamed Elbakry
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Biochemistry Division, Chemistry Department, Faculty of Science, Tanta University, Tanta, Egypt
| | - Christian Godbout
- Patient-Partner, ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Bita Rostami-Afshari
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Diana Petre
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Nasrin Khatami
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada
| | - Anita Franco
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada.,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada.,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada
| | - Alain Moreau
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Office 2.17.027, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada. .,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada. .,Open Medicine Foundation ME/CFS Collaborative Center at CHU Sainte-Justine/Université de Montréal, Montreal, Canada. .,ICanCME Research Network, Sainte-Justine University Hospital Research Center, 3175 Cote-Ste-Catherine Road, Montreal, QC, H3T 1C5, Canada. .,Department of Stomatology, Faculty of Dentistry, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.
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142
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Navarro-Ledesma S, Carroll J, Burton P, Ana GM. Short-Term Effects of Whole-Body Photobiomodulation on Pain, Quality of Life and Psychological Factors in a Population Suffering from Fibromyalgia: A Triple-Blinded Randomised Clinical Trial. Pain Ther 2023; 12:225-239. [PMID: 36369323 PMCID: PMC9845459 DOI: 10.1007/s40122-022-00450-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a multifunctional chronic musculoskeletal pain condition characterised by sensory hypersensitivity. Photobiomodulation (PBM) has shown a positive impact on relieving pain; however, no studies to our knowledge have analysed a whole-body PBM intervention in subjects with FM. The aims of the study were to compare the effects of whole-body PBM with placebo PBM on pain, functionality and psychological symptoms in patients suffering from FM. METHODS Forty-two subjects were recruited from a private care practice. The design of the study is a randomised, triple-blinded, placebo-controlled clinical trial. Participants received 12 treatment sessions. Pain, quality of life, level of physical activity and psychological factors were assessed at baseline (T0), after session 6 (T1), after treatment (T2) and at 2-week (T3) follow-up. RESULTS There were statistically significant differences in pain at 4 weeks (p ≤ 0.001) (T2) and the 2-week follow-up (T3) (p ≤ 0.001). In relation to the quality of life, there were statistically significant improvements after session 6 (p ≤ 0.001) (T1), immediately after treatment (p ≤ 0.001) (T2) and at the 2-week (T3) follow-up (p ≤ 0.001). Kinesiophobia presented significant differences between groups immediately after treatment (p ≤ 0.001) (T2) and at the 2-week (T3) follow-up (p ≤ 0.001), with self-efficacy only showing significant differences between groups 2 weeks after the treatment (p = 0.01) (T2). There were no differences between groups when comparing pain catastrophising at any time. CONCLUSION Whole-body PBM resulted in a significant reduction in pain and an improvement in quality of life in those participants suffering from FM after receiving 4 weeks of treatment. Furthermore, psychological factors such as kinesiophobia and self-efficacy were also improved. Thus, a whole-body PBM treatment is presented as a possible new multifactorial treatment with potential benefits for those with FM and more studies are needed to corroborate our findings. TRIAL REGISTRATION ClinicalTrials.gov (NCT0424897).
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Affiliation(s)
- Santiago Navarro-Ledesma
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Querol Street, 5, 52004, Melilla, Spain.
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143
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Maddox EK, Massoni SC, Hoffart CM, Takata Y. Dietary Effects on Pain Symptoms in Patients with Fibromyalgia Syndrome: Systematic Review and Future Directions. Nutrients 2023; 15:nu15030716. [PMID: 36771421 PMCID: PMC9921865 DOI: 10.3390/nu15030716] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is recognized for its difficulty to diagnose and its subjective symptomatology. There is neither a known cure nor a recommended therapeutic diet to aid in the multidisciplinary treatment. We conducted a systematic review to investigate if diets can improve pain symptoms of fibromyalgia. Through the PubMed search in March 2022, 126 abstracts were identified. We included both intervention and observational studies of diets and pain symptoms among patients with FMS. After screening titles, abstracts, and full-texts, 12 studies, including 11 intervention and one observational study, were selected. These studies included 546 participants and investigated plant-based diets (n = 3), anti-inflammatory diets (n = 1), gluten-free diets (n = 2), and elimination/restrictive diets (n = 6). These studies assessed pain symptoms through visual analogue scale for pain, fibromyalgia impact questionnaire/revised fibromyalgia impact questionnaire, tender point count, pain pressure threshold, and/or total myalgic score. Nine studies, including all three plant-based diet studies, reported statistically significant beneficial effects of their respective diets on pain symptom measurements. Given the small sample size and short intervention duration of the included studies, limited evidence currently exists to recommend any specific diet to patients with FMS. Further research is warranted to clarify specific diets to recommend and explore their potential mechanisms.
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Affiliation(s)
- Emma K. Maddox
- BioHealth Science Program, College of Science, Oregon State University, Corvallis, OR 97331, USA
| | - Shawn C. Massoni
- Department of Microbiology, College of Science, Oregon State University, Corvallis, OR 97331, USA
| | - Cara M. Hoffart
- Department of Pediatrics, Division of Rheumatology, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Yumie Takata
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
- Correspondence: ; Tel.: +1-541-737-1606
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144
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Chen X, You J, Ma H, Zhou M, Huang C. Efficacy and safety of hyperbaric oxygen therapy for fibromyalgia: a systematic review and meta-analysis. BMJ Open 2023; 13:e062322. [PMID: 36690401 PMCID: PMC9872467 DOI: 10.1136/bmjopen-2022-062322] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To investigate the efficacy and safety of hyperbaric oxygen therapy (HBOT) for fibromyalgia (FM). DESIGN A systematic review and meta-analysis. DATA SOURCES PubMed, EMBASE, Cochrane Library, Web of Science, VIP (China Science and Technology Journal Database), CNKI (China National Knowledge Infrastructure) and WanFang database were searched from from inception to 22 October 2022. ELIGIBILITY CRITERIA We included clinical trials (randomised controlled and non-randomised controlled trials) of HBOT for FM. DATA EXTRACTION AND SYNTHESIS Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The Cochrane Collaboration checklists and the Methodological Index for Non-randomised Studies were used to assess the risk of bias. Meta-analysis was performed by RevMan V.5.4.1 software. Random effect models were used for meta-analysis. RESULTS Nine studies were included in this review, with a total of 288 patients. For pain assessment, we combined the results of the Visual Analogue Scale and Widespread Pain Index. The results showed that HBOT could relieve the pain of FM patients compared with the control intervention (standardised mean difference=-1.56, 95% CI (-2.18 to -0.93), p<0.001, I 2=51%). Most included studies reported that HBOT ameliorated tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM. Adverse events occurred in 44 of 185 patients (23.8%). Twelve patients (6.5%) withdrew because of adverse reactions. No serious adverse events or complications were observed. CONCLUSIONS HBOT might have a positive effect in improving pain, tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM, with reversible side effects. Low pressure (less than 2.0 atmospheric absolute) may be beneficial to reduce adverse events in FM. Further studies should be carried out to evaluate the optimal protocol of HBOT in FM. PROSPERO REGISTRATION NUMBER CRD42021282920.
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Affiliation(s)
- Xinxin Chen
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jiuhong You
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Hui Ma
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Mei Zhou
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Cheng Huang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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145
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Ghafouri B, Matikhan D, Christidis N, Ernberg M, Kosek E, Mannerkorpi K, Gerdle B, Wåhlén K. The Vastus Lateralis Muscle Interstitium Proteome Changes after an Acute Nociception in Patients with Fibromyalgia Compared to Healthy Subjects-A Microdialysis Study. Biomedicines 2023; 11:biomedicines11010206. [PMID: 36672714 PMCID: PMC9856129 DOI: 10.3390/biomedicines11010206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Fibromyalgia (FM) is a complex disorder and a clinical challenge to diagnose and treat. Microdialysis is a valuable tool that has been used to investigate the interstitial proteins and metabolites of muscle in patients with fibromyalgia. The implantation of the catheter in the muscle causes acute tissue trauma and nociception. The aim of this study was to investigate acute proteome changes in the vastus lateralis muscle in women fibromyalgia patients (FM) and healthy subjects (CON). A further aim was to study if a 15-week resistance exercise program in FM had any influence on how chronic painful muscle responds to acute nociception. Twenty-six women patients with FM and twenty-eight CON were included in this study. A microdialysis catheter (100 kilo Dalton cut off, membrane 30 mm) was inserted in the vastus lateralis muscle, and samples were collected every 20 min. Subjects rated pain before catheter insertion, directly after, and every 20 min of sample collection. Dialysate samples from time points 0-120 were pooled and considered trauma samples due to the catheter insertion. The samples were analyzed with nano-liquid chromatography-tandem mass spectrometry (nLC-MS/MS). Advanced multivariate data analysis was used to investigate protein profile changes between the groups. Multivariate data analysis showed significant (CV-ANOVA p = 0.036) discrimination between FM and CON based on changes in 26 proteins. After the 15-week exercise intervention, the expression levels of the 15 proteins involved in muscle contraction, response to stimulus, stress, and immune system were increased to the same expression levels as in CON. In conclusion, this study shows that microdialysis, in combination with proteomics, can provide new insights into the interstitial proteome in the muscle of FM. In response to acute nociception, exercise may alter the innate reactivity in FM. Exercise may also modulate peripheral muscle proteins related to muscle contraction, stress, and immune response in patients with FM.
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Affiliation(s)
- Bijar Ghafouri
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Correspondence: ; Tel.: +46-13-282-664
| | - Daria Matikhan
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Nikolaos Christidis
- Department of Dental Medicine, Karolinska Institutet, the Scandinavian Center for Orofacial Neurosciences (SCON), SE-141 04 Huddinge, Sweden
| | - Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, the Scandinavian Center for Orofacial Neurosciences (SCON), SE-141 04 Huddinge, Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Kaisa Mannerkorpi
- Department of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
- Centre for Person Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Karin Wåhlén
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
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146
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Denche-Zamorano Á, Barrios-Fernandez S, Mendoza-Muñoz M, Carlos-Vivas J, Vega-Muñoz A, Collado-Mateo D, Olivares PR, Adsuar JC. Fibromyalgia, Pain, and Physical Activity: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1335. [PMID: 36674090 PMCID: PMC9859565 DOI: 10.3390/ijerph20021335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Fibromyalgia (FM) is a rheumatic disease characterized by pain, fatigue, low-quality sleep, depression, anxiety, stiffness, fall risk, mood disturbance, cognitive impairment, poor physical condition, and other symptoms leading to a worse quality of life. Physical activity (PA) and exercise are effective methods to reduce FM symptoms, including pain. This study presents the first bibliometric study on FM, pain, and PA. An advanced search of the Web of Science (WoS) Core Collection database performed on this topic using was carried out traditional bibliometric laws. A total of 737 documents were found. Annual publications presented an exponentially growing trend (R2 = 85.3%). Rheumatology International, Kaisa Mannerkorpi, and the USA were the journal, co-author, and country most productive, respectively. The exponential growth of annual publications on FM, PA, and pain shows the high interest of researchers and publishers in this topic. The document "Fibromyalgia A Clinical Review" was the most cited. Moreover, Kaisa Mannerkorpi was the most prolific co-author, Rheumatology International was the most prolific journal, "Fibromyalgia: a clinical review" was the most highly cited document, and Daniel Clauw was the most cited co-author.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Jorge Carlos-Vivas
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Alejandro Vega-Muñoz
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
| | - Daniel Collado-Mateo
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain
| | - Pedro R. Olivares
- Faculty of Education, Psychology and Sport Sciences, Universidad de Huelva, 21007 Huelva, Spain
- Facultad de Educación, Universidad Autonoma de Chile, Talca 3480094, Chile
| | - José Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
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147
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Alexandropoulou I, Grammatikopoulou MG, Gkouskou KK, Pritsa AA, Vassilakou T, Rigopoulou E, Lindqvist HM, Bogdanos DP. Ceramides in Autoimmune Rheumatic Diseases: Existing Evidence and Therapeutic Considerations for Diet as an Anticeramide Treatment. Nutrients 2023; 15:nu15010229. [PMID: 36615886 PMCID: PMC9824311 DOI: 10.3390/nu15010229] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
Autoimmune rheumatic diseases (AIRDs) constitute a set of connective tissue disorders and dysfunctions with akin clinical manifestations and autoantibody responses. AIRD treatment is based on a comprehensive approach, with the primary aim being achieving and attaining disease remission, through the control of inflammation. AIRD therapies have a low target specificity, and this usually propels metabolic disturbances, dyslipidemias and increased cardiovascular risk. Ceramides are implicated in inflammation through several different pathways, many of which sometimes intersect. They serve as signaling molecules for apoptosis, altering immune response and driving endothelial dysfunction and as regulators in the production of other molecules, including sphingosine 1-phosphate (S1P) and ceramide 1-phosphate (C1P). With lipid metabolism being severely altered in AIRD pathology, several studies show that the concentration and variety of ceramides in human tissues is altered in patients with rheumatic diseases compared to controls. As a result, many in vitro and some in vivo (animal) studies research the potential use of ceramides as therapeutic targets in rheumatoid arthritis (RA), ankylosing spondylitis, systemic lupus erythematosus, fibromyalgia syndrome, primary Sjögren's syndrome, systemic sclerosis, myositis, systemic vasculitis and psoriatic arthritis. Furthermore, the majority of ceramide synthesis is diet-centric and, as a result, dietary interventions may alter ceramide concentrations in the blood and affect health. Subsequently, more recently several clinical trials evaluated the possibility of distinct dietary patterns and nutrients to act as anti-ceramide regimes in humans. With nutrition being an important component of AIRD-related complications, the present review details the evidence regarding ceramide levels in patients with AIRDs, the results of anti-ceramide treatments and discusses the possibility of using medical nutritional therapy as a complementary anti-ceramide treatment in rheumatic disease.
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Affiliation(s)
- Ioanna Alexandropoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57400 Thessaloniki, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - Kalliopi K. Gkouskou
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece
| | - Agathi A. Pritsa
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57400 Thessaloniki, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, GR-11521 Athens, Greece
| | - Eirini Rigopoulou
- Department of Medicine and Research Laboratory of Internal Medicine, University Hospital of Larissa, Biopolis, GR-41222 Larissa, Greece
| | - Helen M. Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P.O. Box 115, 40530 Gothenburg, Sweden
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
- Correspondence:
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148
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Dong Z, Liu K, Liu H, Jia Z, Gui W, Dong M, Cheng Y, Lv Y, Qu K, Zhao H, Chen J, Zhang D, Fan Z, Yang X, Hu D, Zhang Y, Xie H, Li M, Wen B, Chen S, Xu P, Rong Q, He Q, Ren Z, Yan F, Zhao H, Chen M, Yu T, Qu H, An X, Guo H, Zhang X, Pan X, Wang X, Qiu S, Zhang L, Zhao H, Pan X, Wan Q, Yan L, Liu J, Yu Z, Zhang M, Ran Y, Han X, Yu S. The prevalence and clinical features of fibromyalgia in Chinese hospital patients with primary headache: The survey of fibromyalgia comorbid with headache. Headache 2023; 63:62-70. [PMID: 36651491 DOI: 10.1111/head.14443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aims were to explore the prevalence and clinical features of fibromyalgia in Chinese hospital patients with primary headache. BACKGROUND Studies done in non-Chinese populations suggest that around one-third of patients with primary headache have fibromyalgia, but data from mainland China are limited. Investigations into the prevalence and clinical features of fibromyalgia in Chinese patients with primary headache would improve our understanding of these two complex disease areas and help guide future clinical practice. METHODS This cross-sectional study included adults with primary headache treated at 23 Chinese hospitals from September 2020 to May 2021. Fibromyalgia was diagnosed using the modified 2010 American College of Rheumatology criteria. Mood and insomnia were evaluated employing the Hospital Anxiety and Depression Scale and the Insomnia Severity Index. RESULTS A total of 2782 participants were analyzed. The fibromyalgia prevalence was 6.0% (166/2782; 95% confidence interval: 5.1%, 6.8%). Compared to primary headache patients without combined fibromyalgia, patients with primary headache combined with fibromyalgia were more likely to be older (47.8 vs. 41.7 years), women (83.7% [139/166] vs. 72.8% [1904/2616]), less educated (65.1% [108/166] vs. 45.2% [1183/2616]), and with longer-duration headache (10.0 vs. 8.0 years). Such patients were more likely to exhibit comorbid depression (34.3% [57/166] vs. 9.9% [260/2616]), anxiety (16.3% [27/166] vs. 2.7% [70/2612]), and insomnia (58.4% [97/166] vs. 17.1% [447/2616]). Fibromyalgia was more prevalent in those with chronic (rather than episodic) migraine (11.1% [46/414] vs. 4.4% [72/1653], p < 0.001) and chronic (rather than episodic) tension-type headache (11.5% [27/235] vs. 4.6% [19/409], p = 0.001). Most fibromyalgia pain was in the shoulders, neck, and upper back. CONCLUSIONS The prevalence of fibromyalgia in mainland Chinese patients with primary headache was 6.0%. Fibromyalgia was more common in those with chronic rather than episodic headache. The most common sites of fibromyalgia pain were the neck, shoulders, and back.
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Affiliation(s)
- Zhao Dong
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Kaiming Liu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Huanxian Liu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Zhihua Jia
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Gui
- Department of Neurology, The First Affiliated Hospital of USTC, Anhui, China
| | - Ming Dong
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, China
| | - Yingying Cheng
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, China
| | - Yudan Lv
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, China
| | - Kang Qu
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin, China
| | - Hongru Zhao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Jianjun Chen
- Department of Neurology, Lishui Municipal Central Hospital, Zhejiang, China
| | - Dan Zhang
- Department of Neurology, Sir Run Shaw Hospital, Zhejiang, China
| | - Zhiliang Fan
- Department of Neurology, Xingtai People's Hospital, Hebei, China
| | - Xiaosu Yang
- Department of Neurology, Xiangya Hospital, Central South University, Hunan, China
| | - Dongmei Hu
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, China
| | - Yanbo Zhang
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, China
| | - Hongyan Xie
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, China
| | - Mingxin Li
- Department of Neurology, Qilu Hospital, Shandong, China
| | - Bing Wen
- Department of Neurology, Qilu Hospital, Shandong, China
| | - Sufen Chen
- Department of Neurology, Changsha Central Hospital Affiliated to University of South China, Changsha, China
| | - Peng Xu
- Department of Neurology, Affiliated Hospital of Jining Medical University, Shandong, China
| | - Qingqing Rong
- Department of Neurology, Affiliated Hospital of Jining Medical University, Shandong, China
| | - Qiu He
- Department of Neurology, The People's Hospital of Liaoning Province, Liaoning, China
| | - Zhanxiu Ren
- Department of Neurology, The People's Hospital of Liaoning Province, Liaoning, China
| | - Fanhong Yan
- Department of Neurology, Linyi Jinluo Hospital, Shandong, China
| | - Heling Zhao
- Department of Neurology, Linyi Jinluo Hospital, Shandong, China
| | - Min Chen
- Department of Neurology, Zhengzhou University First Affiliated Hospital, Henan, China
| | - Tingmin Yu
- Department of Neurology, The Second Hospital of Jilin University, Jilin, China
| | - Hongli Qu
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Fujian, China
| | - Xingkai An
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Fujian, China
| | - Huailian Guo
- Department of Neurology, People's Hospital, Peking University, Beijing, China
| | - Xinhua Zhang
- Department of Neurology, People's Hospital, Peking University, Beijing, China
| | - Xiaoping Pan
- Department of Neurology, Guangzhou First People's Hospital, Guangdong, China
| | - Xiaojuan Wang
- Department of Neurology, Guangzhou First People's Hospital, Guangdong, China
| | - Shi Qiu
- Department of Neurology, Aerospace Center Hospital, Beijing, China
| | - Lvming Zhang
- Department of Neurology, Aerospace Center Hospital, Beijing, China
| | - Hongling Zhao
- Department of Neurology, Dalian Municipal Central Hospital, Liaoning, China
| | - Xin Pan
- Department of Neurology, Dalian Municipal Central Hospital, Liaoning, China
| | - Qi Wan
- Department of Neurology, Jiangsu Province Hospital, Jiangsu, China
| | - Lanyun Yan
- Department of Neurology, Jiangsu Province Hospital, Jiangsu, China
| | - Jing Liu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Zhe Yu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Mingjie Zhang
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Ye Ran
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Xun Han
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing, China.,International Headache Center, Chinese PLA General Hospital, Beijing, China
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149
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Kulshreshtha P, Deepak KK. Personality construct as a biomarker in fibromyalgia: A narrative review from an autonomic rehabilitation perspective. J Back Musculoskelet Rehabil 2023; 36:1251-1260. [PMID: 37482976 DOI: 10.3233/bmr-220353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND The heterogeneity of symptoms and ineffective treatment raise questions about the current diagnostic criteria of fibromyalgia (FM). Misdiagnosis of FM often leads to less than efficacious treatment and poor quality of life. OBJECTIVE This article reviews relevant evidence-based literature on personality traits in FM patients with an autonomic dysfunction perspective based on a hierarchical model to explain the utility of considering the personality trait in FM diagnosis. METHODS A narrative review of articles concerning chronic pain, FM, and personality traits with respect to autonomic dysfunction in FM was conducted after extensive relevant literature searches. RESULTS Reports discussing the predisposing factors, including coping styles, anger, suicide risk, a lack of physical activity and social support, in maintaining persistent pain in FM exist. Relationships between pain duration and severity and personality traits like neuroticism and extraversion have been reported. Coexisting clinical manifestations of FM like sleep disorders, anxiety, and intestinal irritability indicate autonomic dysfunction. CONCLUSIONS This article lays out a constructive framework for individualized and personalized medicine for the effective rehabilitation of FM patients. The quest to find a definitive diagnosis of FM should include personality biomarkers that might translate into personalized medicine. An individualistic approach may bank upon artificial intelligence algorithms for both diagnostic as well as prognostic purposes in FM.
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150
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Yang J, Shin KM, Do A, Bierle DM, Abu Dabrh AM, Yin Z, Bauer BA, Mohabbat AB. The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review. J Pain Res 2023; 16:1017-1023. [PMID: 36974308 PMCID: PMC10039621 DOI: 10.2147/jpr.s395457] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN) has been increasingly used as an off-label treatment option in FM. However, current evidence on the safety and efficacy of LDN in patients with FM is not well known. To systematically assess the current evidence on the safety and efficacy of LDN use in the treatment of FM. A comprehensive bibliographic search was conducted on EBM Reviews - Cochrane Central Register of Controlled Trials, EBM Reviews - Cochrane Database of Systematic, Embase, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions and Scopus databases in September 2022. Inclusion criteria were articles that were published in English, focusing on clinical trials involving LDN for the treatment of FM. Two reviewers independently screened and extracted the data. A qualitative analysis was used due to the high methodological heterogeneity between studies. The electronic search produced 805 articles. After applying the inclusion criteria, 9 articles (one RCT, two case reports, two case series, and four pilot trials) were selected for evaluation. LDN intervention protocols, study designs, and follow-up periods were different among the included studies. Overall, LDN was found to be effective in the symptomatic management of FM, and of the 78% of included studies that evaluated for safety, no severe adverse events were reported. Proving the efficacy and safety of low-dose naltrexone is a future possibility based on current study data, but the level of scientific evidence is limited. Future well-designed trials with large sample sizes are required.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kyung-Min Shin
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, South Korea
| | - Alex Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Dennis M Bierle
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Abd Moain Abu Dabrh
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Ziying Yin
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Arya B Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
- Correspondence: Arya B Mohabbat, Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, RO_GO_17_102GIM, Rochester, MN, 55905, USA, Tel +1-507-284-2511, Email
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