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Ma KSK, Chan SY, Van Dyke TE, Wang SI, Wei JCC, Ashina S. Tooth Loss and Chronic Pain: A Population-based Analysis of the National Health and Nutrition Examination Survey. THE JOURNAL OF PAIN 2024; 25:104529. [PMID: 38588761 DOI: 10.1016/j.jpain.2024.104529] [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: 08/21/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
Poor oral health conditions in adults are associated with chronic pain. A nationwide cross-sectional study was conducted to investigate the link between tooth loss and chronic pain. The study involved 8,662 participants from the National Health and Nutrition Examination Survey. Tooth count was categorized into 4 groups, and chronic pain was defined as persistent pain lasting over 3 months despite treatment. Location of the chronic pain, demographics, comorbidities, lifestyle determinants, and dietary intake were retrieved. Univariate and multivariate logistic regression were used to explore cross-sectional associations between tooth count and chronic pain. Compared to participants with more than 20 teeth, those with severe tooth loss presented greater odds of chronic pain (adjusted odds ratio [aOR] = 2.111, 95% confidence intervals (CI) = 1.213-3.676 for patients with 1-8 teeth). Edentulous participants presented with significantly higher odds of chronic pain in the lower extremities (78.4%) and buttocks (49.5%). In the multivariate model, apart from rheumatic arthritis (aOR = 4.004, 95% CI = 2.766-5.798), variables of higher chronic pain included smoking (aOR = 1.518, 95% CI = 1.228-1.878), and hypertension (aOR = 1.463, 95% CI = 1.013-2.112). On the contrary, being Mexican American (aOR = .603, 95% CI = .414-.880) was associated with lower odds of chronic pain. The findings suggested a significant link between chronic pain and tooth loss, independent of ethnicity, lifestyle determinants, and immune-mediated inflammatory diseases including rheumatoid arthritis. PERSPECTIVE: A U.S. nationwide study examined tooth loss and chronic pain. Those with severe tooth loss had increased odds of chronic pain. Edentulous individuals presented higher odds of pain in lower extremities and buttocks. This study highlighted the link between tooth loss and chronic pain, independent of comorbidities and lifestyle factors.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Shu-Yen Chan
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Shiow-Ing Wang
- Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Sait Ashina
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Beth Israel Deaconess Medical Center Comprehensive Headache Center, Harvard Medical School, Boston, Massachusetts; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Loçasso FA, Filho HA, Alvarenga RMP, Schimidt SL, Fiorelli FK, Ramos PDS, Leidersnaider SCL, Blum K, Lewandrowski KU, Cunha-Junior EF, Fiorelli RKA. Assessing the Impact of IL-6 and Serotonin on Pain and Symptomatology in Fibromyalgia: An Exploratory Clinical Study. J Pers Med 2024; 14:886. [PMID: 39202077 PMCID: PMC11355107 DOI: 10.3390/jpm14080886] [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: 07/10/2024] [Revised: 08/08/2024] [Accepted: 08/19/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Fibromyalgia (FM) is a chronic musculoskeletal pain syndrome characterized by widespread pain and a variety of other symptoms, including fatigue, cognitive dysfunction, and sleep disturbances. Recent research has highlighted the potential role of pro-inflammatory cytokines and neurotransmitters in the pathophysiology of FM. This study aimed to investigate the relationship between serum levels of interleukin-6 (IL-6) and serotonin with the clinical parameters observed in patients with fibromyalgia. Additionally, it sought to analyze the similarities and differences among the different groups classified by symptom severity. MATERIALS AND METHODS This cross-sectional study included 26 female patients aged 20-70 diagnosed with FM according to the American College of Rheumatology (ACR) 2016 criteria and 14 healthy controls (HCs). Serum levels of IL-6 and serotonin were measured using electrochemiluminescence and high-performance liquid chromatography (HPLC), respectively. RESULTS FM patients exhibited significantly higher pain scores (VAS), anxiety, and depression levels compared to HCs. FIQ-R scores were significantly elevated in FM patients, with stratification showing 3.8% mild, 65.4% moderate, 23.1% severe, and 7.7% very severe cases. While no significant difference in IL-6 levels was observed between the FM patients and HCs, a trend towards increased IL-6 levels in patients with higher FIQ-R scores was noted. Serum serotonin levels were significantly lower in the FM patients than in the HCs, with moderate patients having lower levels than those classified as severe and very severe. CONCLUSIONS The study underscores the potential role of IL-6 and serotonin in the pathophysiology of FM, suggesting that these biomarkers could be relevant in assessing the severity and impact of FM. Further research is needed to elucidate these relationships and their implications for developing personalized treatment strategies.
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Affiliation(s)
- Felipe Altino Loçasso
- Programa de Pós-Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil; (H.A.F.); (R.M.P.A.); (S.L.S.); (R.K.A.F.)
- Faculdade de Ciências Médicas de Três Rios (SUPREMA), Rio de Janeiro 25804-250, Brazil; (F.K.F.); (P.d.S.R.); (S.C.L.L.)
| | - Hélcio Alvarenga Filho
- Programa de Pós-Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil; (H.A.F.); (R.M.P.A.); (S.L.S.); (R.K.A.F.)
| | - Regina Maria Papais Alvarenga
- Programa de Pós-Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil; (H.A.F.); (R.M.P.A.); (S.L.S.); (R.K.A.F.)
| | - Sérgio Luís Schimidt
- Programa de Pós-Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil; (H.A.F.); (R.M.P.A.); (S.L.S.); (R.K.A.F.)
| | - Filipe Kleinman Fiorelli
- Faculdade de Ciências Médicas de Três Rios (SUPREMA), Rio de Janeiro 25804-250, Brazil; (F.K.F.); (P.d.S.R.); (S.C.L.L.)
| | - Plínio dos Santos Ramos
- Faculdade de Ciências Médicas de Três Rios (SUPREMA), Rio de Janeiro 25804-250, Brazil; (F.K.F.); (P.d.S.R.); (S.C.L.L.)
| | | | - Kenneth Blum
- Division of Addiction Research & Education, Center for Sports, Exercise & Mental Health, Western University, Health Sciences, Pomona, CA 91766, USA;
| | - Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona, The Surgical Institute of Tucson, 4787 E Camp Lowell Dr., Tucson, AZ 85712, USA;
| | - Edezio Ferreira Cunha-Junior
- Instituto de Ciências Farmacêuticas, Centro Multidisciplinar UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Rio de Janeiro 27930-560, Brazil;
| | - Rossano Kepler Alvim Fiorelli
- Programa de Pós-Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil; (H.A.F.); (R.M.P.A.); (S.L.S.); (R.K.A.F.)
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D’Amuri A, Greco S, Pagani M, Presciuttini B, Ciaffi J, Ursini F. Common Non-Rheumatic Medical Conditions Mimicking Fibromyalgia: A Simple Framework for Differential Diagnosis. Diagnostics (Basel) 2024; 14:1758. [PMID: 39202246 PMCID: PMC11354086 DOI: 10.3390/diagnostics14161758] [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: 05/20/2024] [Revised: 08/06/2024] [Accepted: 08/10/2024] [Indexed: 09/03/2024] Open
Abstract
Fibromyalgia (FM) is a chronic non-inflammatory disorder mainly characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and a constellation of other symptoms. For this reason, delineating a clear distinction between pure FM and FM-like picture attributable to other common diseases can be extremely challenging. Physicians must identify the most significant confounders in individual patients and implement an appropriate diagnostic workflow, carefully choosing a minimal (but sufficient) set of tests to be used for identifying the most plausible diseases in the specific case. This article discusses prevalent non-rheumatological conditions commonly observed in the general population that can manifest with clinical features similar to primary FM. Given their frequent inclusion in the differential diagnosis of FM patients, the focus will be on elucidating the distinctive clinical characteristics of each condition. Additionally, the most cost-effective and efficient diagnostic methodologies for accurately discerning these conditions will be examined.
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Affiliation(s)
- Andrea D’Amuri
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy; (A.D.); (M.P.); (B.P.)
| | - Salvatore Greco
- Internal Medicine Unit, Medical Department, Ospedale del Delta, Via Valle Oppio 2, Lagosanto, 44023 Ferrara, Italy;
| | - Mauro Pagani
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy; (A.D.); (M.P.); (B.P.)
| | - Barbara Presciuttini
- General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy; (A.D.); (M.P.); (B.P.)
| | - Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy
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Jenssen MDK, Salvi E, Fors EA, Nilsen OA, Ngo PD, Tejedor M, Bellika JG, Godtliebsen F. Exploring Pain Reduction through Physical Activity: A Case Study of Seven Fibromyalgia Patients. Bioengineering (Basel) 2024; 11:765. [PMID: 39199723 PMCID: PMC11351168 DOI: 10.3390/bioengineering11080765] [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: 05/29/2024] [Revised: 07/16/2024] [Accepted: 07/20/2024] [Indexed: 09/01/2024] Open
Abstract
Fibromyalgia is a chronic disease that affects a considerable fraction of the global population, primarily women. Physical activity is often recommended as a tool to manage the symptoms. In this study, we tried to replicate a positive result of pain reduction through physical activity. After collecting pain and physical activity data from seven women with fibromyalgia, one patient experienced a considerable reduction in pain intensity. According to the patient, the improvement was related to physical activity. Our study was conducted to investigate the replicability of this result through personalized activity recommendations. Out of the other six patients, three experienced a reduction in pain. The remaining three patients did not experience any pain relief. Our results show that two of these were not able to follow the activity recommendations. These results indicate that physical activity may have a positive effect on chronic pain patients. To estimate how effective physical activity can be for this patient group, an intervention with longer follow-ups and larger sample sizes needs to be performed in the future.
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Affiliation(s)
- Marit Dagny Kristine Jenssen
- Department of Mathematics and Statistics, University of Tromsø—The Arctic University of Norway, NO-9019 Tromsø, Norway; (M.T.); (F.G.)
| | - Elisa Salvi
- Norwegian Centre for E-Health Research, P.O. Box 35, NO-9038 Tromsø, Norway; (E.S.); (P.D.N.); (J.G.B.)
| | - Egil Andreas Fors
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), NO-7491 Trondheim, Norway;
| | - Ole Andreas Nilsen
- Department of Health and Care Sciences, University of Tromsø—The Arctic University of Norway, NO-9019 Tromsø, Norway;
| | - Phuong Dinh Ngo
- Norwegian Centre for E-Health Research, P.O. Box 35, NO-9038 Tromsø, Norway; (E.S.); (P.D.N.); (J.G.B.)
- Department of Physics and Technology, University of Tromsø—The Arctic University of Norway, NO-9019 Tromsø, Norway
| | - Miguel Tejedor
- Department of Mathematics and Statistics, University of Tromsø—The Arctic University of Norway, NO-9019 Tromsø, Norway; (M.T.); (F.G.)
- Norwegian Centre for E-Health Research, P.O. Box 35, NO-9038 Tromsø, Norway; (E.S.); (P.D.N.); (J.G.B.)
| | - Johan Gustav Bellika
- Norwegian Centre for E-Health Research, P.O. Box 35, NO-9038 Tromsø, Norway; (E.S.); (P.D.N.); (J.G.B.)
- Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, NO-9019 Tromsø, Norway
| | - Fred Godtliebsen
- Department of Mathematics and Statistics, University of Tromsø—The Arctic University of Norway, NO-9019 Tromsø, Norway; (M.T.); (F.G.)
- Norwegian Centre for E-Health Research, P.O. Box 35, NO-9038 Tromsø, Norway; (E.S.); (P.D.N.); (J.G.B.)
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Han T, Xi R, Wang J, Yan H, Li L. Adherence to ACSM exercise guidelines and its influence on Fibromyalgia treatment outcomes: a meta-analysis of randomized controlled trials. Front Physiol 2024; 15:1413038. [PMID: 39100274 PMCID: PMC11294170 DOI: 10.3389/fphys.2024.1413038] [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: 04/06/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024] Open
Abstract
Background The Fibromyalgia Syndrome (FMS) is a multifaceted chronic pain disorder that exerts a substantial impact on the overall state of health and quality of life of patients. Purpose Investigate the effects of exercise therapy and adherence to the American College of Sports Medicine (ACSM) guidelines on treatment outcomes in FMS patients. Methods The literature search, which concluded in October 2023, encompassed studies investigating the impact of exercise interventions on patients diagnosed with FMS and providing adequate data for calculating standardized mean difference (SMD). The primary outcome measures encompassed the Fibromyalgia Impact Questionnaire (FIQ) and Health Assessment Questionnaire (HAQ), while secondary outcome measures comprised pain levels, sleep quality, fatigue, and mental health. Results Among 4,008 records, 19 studies (patients = 857) were eligible for qualitative synthesis. The meta-analysis revealed that the SMD for overall state of health impact was -0.94 (95%CI -1.26, -0.63), and the pooled SMD for the subgroup with high adherence to ACSM guidelines was -1.17 (95%CI -1.65, -0.69). The SMD for the subgroup with low or uncertain adherence was -0.73 (95%CI -1.12, -0.34). The overall effects included a -1.21 (95%CI -1.62, -0.79) SMD for pain relief, with high adherence achieving a -1.32 (95%CI -2.00, -0.64) SMD and low adherence a -1.06 (95%CI -1.55, -0.57) SMD. Mental health improvements showed a -0.95 (95%CI -1.32, -0.57) overall SMD, with high and low adherence subgroups at -0.96 (95%CI -1.62, -0.30) and -0.94 (95%CI -1.29, -0.60), respectively. Sleep quality impact was -1.59 (95%CI -2.31, -0.87) overall, with high adherence at -1.71 (95%CI -2.58, -0.83) and low adherence at -1.11 (95%CI -1.88, -0.33). Fatigue impact had a -1.55 (95%CI -2.26, -0.85) overall SMD, with -1.77 (95%CI -3.18, -0.36) for high adherence and -1.35 (95%CI -2.03, -0.66) for low adherence. Conclusion Exercise therapy can improve the overall state of health, pain, sleep, and fatigue of FMS patients, particularly when adhering to ACSM guidelines. However, adherence levels do not affect mental health gains, indicating a need for future research on psychological impact. Systematic Review Registration https://inplasy.com/inplasy-2024-3-0106/, identifier INPLASY202430106.
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Affiliation(s)
- Tianran Han
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
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Demori I, Losacco S, Giordano G, Mucci V, Blanchini F, Burlando B. Fibromyalgia pathogenesis explained by a neuroendocrine multistable model. PLoS One 2024; 19:e0303573. [PMID: 38990866 PMCID: PMC11238986 DOI: 10.1371/journal.pone.0303573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/26/2024] [Indexed: 07/13/2024] Open
Abstract
Fibromyalgia (FM) is a central disorder characterized by chronic pain, fatigue, insomnia, depression, and other minor symptoms. Knowledge about pathogenesis is lacking, diagnosis difficult, clinical approach puzzling, and patient management disappointing. We conducted a theoretical study based on literature data and computational analysis, aimed at developing a comprehensive model of FM pathogenesis and addressing suitable therapeutic targets. We started from the evidence that FM must involve a dysregulation of central pain processing, is female prevalent, suggesting a role for the hypothalamus-pituitary-gonadal (HPG) axis, and is stress-related, suggesting a role for the HP-adrenocortical (HPA) axis. Central pathogenesis was supposed to involve a pain processing loop system including the thalamic ventroposterolateral nucleus (VPL), the primary somatosensory cortex (SSC), and the thalamic reticular nucleus (TRN). For decreasing GABAergic and/or increasing glutamatergic transmission, the loop system crosses a bifurcation point, switching from monostable to bistable, and converging on a high-firing-rate steady state supposed to be the pathogenic condition. Thereafter, we showed that GABAergic transmission is positively correlated with gonadal-hormone-derived neurosteroids, notably allopregnanolone, whereas glutamatergic transmission is positively correlated with stress-induced glucocorticoids, notably cortisol. Finally, we built a dynamic model describing a multistable, double-inhibitory loop between HPG and HPA axes. This system has a high-HPA/low-HPG steady state, allegedly reached in females under combined premenstrual/postpartum brain allopregnanolone withdrawal and stress condition, driving the thalamocortical loop to the high-firing-rate steady state, and explaining the connection between endocrine and neural mechanisms in FM pathogenesis. Our model accounts for FM female prevalence and stress correlation, suggesting the use of neurosteroid drugs as a possible solution to currently unsolved problems in the clinical treatment of the disease.
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Affiliation(s)
- Ilaria Demori
- Department of Pharmacy, DIFAR, University of Genova, Genova, Italy
| | - Serena Losacco
- Department of Pharmacy, DIFAR, University of Genova, Genova, Italy
| | - Giulia Giordano
- Department of Industrial Engineering, University of Trento, Trento, (TN), Italy
- Delft Center for Systems and Control, Delft University of Technology, Delft, The Netherlands
| | - Viviana Mucci
- School of Science, Western Sydney University, Penrith, Australia
| | - Franco Blanchini
- Department of Mathematics, Computer Science and Physics, University of Udine, Udine, Italy
| | - Bruno Burlando
- Department of Pharmacy, DIFAR, University of Genova, Genova, Italy
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Barría P, Gaitán-Padilla M, Gomez-Vargas D, Cardenas Ampuero G, Gitterman K, Cordova B, Diaz CAR, Roberti F. Comparative Analysis of Ventilatory Responses during Stress Tests in Patients with Chronic Pain: Implications for Therapeutic Interventions. J Funct Morphol Kinesiol 2024; 9:122. [PMID: 39051283 PMCID: PMC11270440 DOI: 10.3390/jfmk9030122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024] Open
Abstract
Understanding the differences in ventilatory responses during exercise between patients with fibromyalgia and those with other chronic pain disorders is crucial for developing effective therapeutic interventions, especially in exercise to identify the better physical therapy prescription. Both populations face unique challenges that impact their ability to engage in physical activity; yet, the underlying physiological responses can vary significantly. In this context, the methodology of this study entailed conducting a comparative analysis of the ventilatory response during exercise in patients with fibromyalgia and those with other chronic pain disorders. The experimental protocol included a total of 31 participants (n = 13 diagnosed with fibromyalgia and n = 18 diagnosed with other chronic pain conditions). All participants completed a stress test, where the ventilatory parameters were measured in three stages (i.e., resting, incremental exercise, and recovery). The results revealed significant differences (p<0.05) in ventilatory responses between both groups. Patients with fibromyalgia exhibited reduced time for the aerobic threshold and a higher respiratory frequency in the anaerobic threshold compared to those with other chronic pain disorders. Furthermore, fibromyalgia patients demonstrated higher values in the ventilatory coefficient during the test and in the recovery stage. In conclusion, these differences underscore the need for tailored exercise programs that specifically address the unique ventilatory challenges faced by fibromyalgia patients to improve their physical function and overall quality of life.
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Affiliation(s)
- Patricio Barría
- Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas 02281, Chile; (P.B.); (G.C.A.); (K.G.); (B.C.)
| | - María Gaitán-Padilla
- Telecommunications Laboratory (Labtel), Electrical Engineering Department, Federal University of Espírito Santo, Vitória 29047-105, Brazil; (M.G.-P.); (C.A.R.D.)
| | - Daniel Gomez-Vargas
- Institute of Automatics, National University of San Juan, San Juan 5400, Argentina;
| | - Gonzalo Cardenas Ampuero
- Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas 02281, Chile; (P.B.); (G.C.A.); (K.G.); (B.C.)
| | - Kay Gitterman
- Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas 02281, Chile; (P.B.); (G.C.A.); (K.G.); (B.C.)
- Clinical Hospital Dr. Lautaro Navarro Avaria, Punta Arenas 01364, Chile
| | - Bessie Cordova
- Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas 02281, Chile; (P.B.); (G.C.A.); (K.G.); (B.C.)
| | - Camilo A. R. Diaz
- Telecommunications Laboratory (Labtel), Electrical Engineering Department, Federal University of Espírito Santo, Vitória 29047-105, Brazil; (M.G.-P.); (C.A.R.D.)
| | - Flavio Roberti
- Institute of Automatics, National University of San Juan, San Juan 5400, Argentina;
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Úbeda-D’Ocasar E, González-Gerstner D, Cimadevilla-Fernández-Pola E, Ojedo-Martín C, Hernández-Lougedo J, Hervás-Pérez JP. Effects of Diathermy on Pain in Women with Fibromyalgia: A Randomized Controlled Trial. Biomedicines 2024; 12:1465. [PMID: 39062038 PMCID: PMC11275016 DOI: 10.3390/biomedicines12071465] [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: 04/22/2024] [Revised: 05/23/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: The main characteristic of fibromyalgia (FM) is generalized musculoskeletal pain. This may be accompanied by muscle and joint stiffness, sleep and mood disorders, anxiety and depression, cognitive dysfunction, and chronic fatigue. It is endemic in developed countries, with a higher prevalence among women than men, and its etiology is still unknown. Diagnosis is made based on chronic generalized pain and through the presence of tender points. The objective of this study was to analyze the efficacy of diathermy on pain in patients with fibromyalgia. (2) Methods: A single, blind, randomized experimental study was developed with a sample of 31 participants. Measurements were taken and recorded at three different intervals using the following measurement tools: the pressure pain threshold (PPT) at the tender points (TP) of the right and left trochanteric prominence with an algometer, the pain measurement scale, the Fibromyalgia Impact Questionnaire, the sleep quality index (PSQI, Pittsburgh), the Multidimensional Fatigue Inventory (MFI-S), and the scale for anxiety and depression (Hospital Anxiety and Depression Scale). Sociodemographic data were collected through Google Forms (age, height, weight, Body Mass Index). The intervention took place twice weekly across four weeks of sessions. (3) Results: Statistically significant results were obtained in the right and left trochanter PPT, as well as for anxiety and fatigue in the experimental group. The results obtained show that this treatment has managed to improve the quality of sleep, the impact of disease, chronic fatigue, and anxiety in patients with FM. (4) Conclusions: Diathermy is a tool that can help reduce pain. It can also improve the baseline levels of chronic fatigue, anxiety, the impact of the disease, and sleep quality in patients with fibromyalgia.
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Affiliation(s)
- Edurne Úbeda-D’Ocasar
- Faculty of Health Sciences-HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49, 28692 Madrid, Spain; (E.Ú.-D.); (D.G.-G.); (E.C.-F.-P.); (C.O.-M.); (J.H.-L.)
- Instituto de Investigación Sanitaria HM Hospitales, 28015 Madrid, Spain
| | - Daniela González-Gerstner
- Faculty of Health Sciences-HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49, 28692 Madrid, Spain; (E.Ú.-D.); (D.G.-G.); (E.C.-F.-P.); (C.O.-M.); (J.H.-L.)
| | - Eduardo Cimadevilla-Fernández-Pola
- Faculty of Health Sciences-HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49, 28692 Madrid, Spain; (E.Ú.-D.); (D.G.-G.); (E.C.-F.-P.); (C.O.-M.); (J.H.-L.)
- Instituto de Investigación Sanitaria HM Hospitales, 28015 Madrid, Spain
| | - Cristina Ojedo-Martín
- Faculty of Health Sciences-HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49, 28692 Madrid, Spain; (E.Ú.-D.); (D.G.-G.); (E.C.-F.-P.); (C.O.-M.); (J.H.-L.)
- Instituto de Investigación Sanitaria HM Hospitales, 28015 Madrid, Spain
| | - Juan Hernández-Lougedo
- Faculty of Health Sciences-HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49, 28692 Madrid, Spain; (E.Ú.-D.); (D.G.-G.); (E.C.-F.-P.); (C.O.-M.); (J.H.-L.)
- Instituto de Investigación Sanitaria HM Hospitales, 28015 Madrid, Spain
| | - Juan Pablo Hervás-Pérez
- Faculty of Health Sciences-HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49, 28692 Madrid, Spain; (E.Ú.-D.); (D.G.-G.); (E.C.-F.-P.); (C.O.-M.); (J.H.-L.)
- Instituto de Investigación Sanitaria HM Hospitales, 28015 Madrid, Spain
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Eseoğlu İ, Yılmaz AK, Anıl B, Korkmaz E, Akdemir E, Yılmaz C, Kehribar L, Aydın NG, Ermiş E, Yoldaş B, İmamoğlu O. Effects of Electro-Muscle Stimulation Exercise Combined with Mat Pilates on Pain, Anxiety, and Strength in Sedentary Females with Fibromyalgia: A Single-Blind Randomized Controlled Trial. J Pers Med 2024; 14:697. [PMID: 39063951 PMCID: PMC11278430 DOI: 10.3390/jpm14070697] [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: 05/16/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Fibromyalgia syndrome (FM) is a chronic pain disorder that is ranked as one of the four most common rheumatological diseases in the world. This study aims to investigate the effects of an eight-week mat Pilates and electro-muscle stimulation (EMS) with combined mat Pilates exercises on pain, depression, anxiety, and strength in sedentary women. METHODS This study is a single-blind randomized controlled trial. A total of 30 sedentary female patients (Pilates (n = 15), EMS (n = 15)) diagnosed with FM were included in the study. The patients were subjected to Beck Depression (BDIs) and Anxiety Inventories (BAIs); a Fibromyalgia Impact Questionnaire (FIQ); five different Single-Leg Hop Tests (SLHTs); modified push-up (MPU), Handgrip Strength (HGS), Deep Squat (DSQ), V-Sit Flexor, bent-arm hang (BA), sit-up and Biering-Sørensen tests; and anthropometric tests before and after the 8-week exercise program. RESULTS The eight weeks of mat Pilates exercises combined with mat Pilates and EMS revealed significant results (p < 0.05) in anthropometric data (abdomen, lower abdomen, hips) (p < 0.05) except for the results of chest circumference measurements (p > 0.05). In addition, there were statistically significant positive results in BDIs, BAIs, FIQs, lower extremity (all SLHTs and DSQ), upper extremity (MPU, HGS, BA), and core (V-SIT, sit-up, Biering-Sørensen test) strength test findings (p < 0.05). CONCLUSIONS Combining the mat Pilates exercises with EMS is an effective and reliable method to improve the pain, anxiety, depression, and strength of female patients diagnosed with FM.
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Affiliation(s)
- İsmail Eseoğlu
- Vocational School of Health Services, Dokuz Eylül University, İzmir 35340, Türkiye;
| | - Ali Kerim Yılmaz
- Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye; (A.K.Y.); (B.A.); (E.K.); (E.E.); (O.İ.)
| | - Berna Anıl
- Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye; (A.K.Y.); (B.A.); (E.K.); (E.E.); (O.İ.)
| | - Esra Korkmaz
- Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye; (A.K.Y.); (B.A.); (E.K.); (E.E.); (O.İ.)
| | - Enes Akdemir
- Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye; (A.K.Y.); (B.A.); (E.K.); (E.E.); (O.İ.)
| | - Coşkun Yılmaz
- Kelkit Aydın Doğan Vocational School, Gümüşhane University, Gümüşhane 29600, Türkiye;
| | - Lokman Kehribar
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Dokuz Eylül University, İzmir 35340, Türkiye;
| | - Nur Gökçe Aydın
- Department of Medical Ecology and Hydroclimatology, Samsun Training and Research Hospital, Samsun 55090, Türkiye;
| | - Egemen Ermiş
- Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye; (A.K.Y.); (B.A.); (E.K.); (E.E.); (O.İ.)
| | - Burak Yoldaş
- Department of Orthopedics and Traumatology, Samsun Havza State Hospital, Samsun 55700, Türkiye
| | - Osman İmamoğlu
- Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Türkiye; (A.K.Y.); (B.A.); (E.K.); (E.E.); (O.İ.)
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10
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Bornemann J, Close JB, Ahmad K, Barba T, Godfrey K, Macdonald L, Erritzoe D, Nutt D, Carhart-Harris R. Study protocol for "Psilocybin in patients with fibromyalgia: brain biomarkers of action". Front Psychiatry 2024; 15:1320780. [PMID: 38983371 PMCID: PMC11232672 DOI: 10.3389/fpsyt.2024.1320780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/04/2024] [Indexed: 07/11/2024] Open
Abstract
Background Chronic pain is a leading cause of disability worldwide. Fibromyalgia is a particularly debilitating form of widespread chronic pain. Fibromyalgia remains poorly understood, and treatment options are limited or moderately effective at best. Here, we present a protocol for a mechanistic study investigating the effects of psychedelic-assisted-therapy in a fibromyalgia population. The principal focus of this trial is the central mechanism(s) of psilocybin-therapy i.e., in the brain and on associated mental schemata, primarily captured by electroencephalography (EEG) recordings of the acute psychedelic state, plus pre and post Magnetic Resonance Imaging (MRI). Methods Twenty participants with fibromyalgia will complete 8 study visits over 8 weeks. This will include two dosing sessions where participants will receive psilocybin at least once, with doses varying up to 25mg. Our primary outcomes are 1) Lempel-Ziv complexity (LZc) recorded acutely using EEG, and the 2) the (Brief Experiential Avoidance Questionnaire (BEAQ) measured at baseline and primary endpoint. Secondary outcomes will aim to capture broad aspects of the pain experience and related features through neuroimaging, self-report measures, behavioural paradigms, and qualitative interviews. Pain Symptomatology will be measured using the Brief Pain Inventory Interference Subscale (BPI-IS), physical and mental health-related function will be measured using the 36-Item Short Form Health Survey (SF-36). Further neurobiological investigations will include functional MRI (fMRI) and diffusion tensor imaging (changes from baseline to primary endpoint), and acute changes in pre- vs post-acute spontaneous brain activity - plus event-related potential functional plasticity markers, captured via EEG. Discussion The results of this study will provide valuable insight into the brain mechanisms involved in the action of psilocybin-therapy for fibromyalgia with potential implications for the therapeutic action of psychedelic-therapy more broadly. It will also deliver essential data to inform the design of a potential subsequent RCT.
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Affiliation(s)
- Julia Bornemann
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - James B. Close
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - Kirran Ahmad
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - Tommaso Barba
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - Kate Godfrey
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - Lauren Macdonald
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - David Nutt
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, London, United Kingdom
- Psychedelics Division, Neurology, Psychiatry and Behavioural Sciences Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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11
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Sarı N, Kulaklı S, Oğuz ID, Akşan B, Sarı İF. Evaluation of fibromyalgia frequency and quality of life in Notalgia paresthetica patients. Arch Dermatol Res 2024; 316:317. [PMID: 38822886 PMCID: PMC11144133 DOI: 10.1007/s00403-024-03027-8] [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: 04/21/2024] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 06/03/2024]
Abstract
Based on the presence of chronic pain and the potential use of common treatment agents in Notalgia Paresthetica (NP) and Fibromyalgia Syndrome (FMS) for improvement, we aimed to investigate the frequency of FMS symptoms in NP patients and its impact on quality of life. This study is a case control cohort study including 26 patients diagnosed with NP and a total of 26 controls matched for age and gender. The 2016 revised fibromyalgia diagnostic criteria by the American College of Rheumatology (ACR) were used to inquire about FMS diagnosis criteria in the study. According to the 2016 ACR revised FMS diagnostic criteria, the frequency of FMS was significantly higher in the patient group (n = 9, 34.6%) compared to the control group (n = 2, 7.7%) (p = 0.042). The Wide Pain Index (WPI) score in the control group was 2.00 (3.25), while in the patient group, it was 4.00 (8.00), with a statistically significant difference between them (p < 0.035). Furthermore, significant statistical differences were found between the two groups in terms of Symptom Severity Scale (SSS), Fibromyalgia Score (FS), and FIQ (p < 0.035, p < 0.001, p < 0.001, respectively). In NP patients with accompanying FMS, Dermatology Life Quality Index was significantly more affected compared to those without FMS (p = 0.025). In conclusion, we recommend that NP patients be questioned about FMS, which is characterized by generalized pain, as well as regional neuropathic symptoms. Treatment success can be enhanced by using common agents in the treatment choice for accompanying FMS.
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Affiliation(s)
- Nihal Sarı
- Department of Dermatology and Venereology, Bulancak State Hospital, Giresun, Turkey.
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey.
| | - Sevgi Kulaklı
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Işıl Deniz Oğuz
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Burak Akşan
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - İlker Fatih Sarı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Giresun, Turkey
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12
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Proietti E, Rapallo F, Molinari E, Mucci V, Marinelli L, Borgarelli C, Burlando B, Pisciotta L, Demori I. Online Questionnaire with Fibromyalgia Patients Shows Negative Correlations between Disease Severity and Adherence to Mediterranean Diet. Nutrients 2024; 16:1078. [PMID: 38613111 PMCID: PMC11013287 DOI: 10.3390/nu16071078] [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: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Fibromyalgia (FM) is a multidimensional disorder in which intense chronic pain is accompanied by a variety of psychophysical symptoms that impose a burden on the patients' quality of life. Despite the efforts and the recent advancement in research, FM pathogenesis and effective treatment remain unknown. Recently, the possible role of dietary patterns and/or components has been gaining attention. The current study aimed to investigate a potential correlation between adherence to the Mediterranean diet (MedDiet) and FM severity in a sample of Italian FM patients. An online survey was designed, composed of customized questions and validated questionnaires with the aim of investigating the intensity and type of pain, the presence of other psychophysical symptoms, the overall impact of FM, general food and lifestyle habits, and adherence to the MedDiet. The collected responses were analyzed for descriptive statistics, linear regression, and propensity score analyses. The results show that, despite considerable use of pharmaceuticals and supplements, FM participants suffered from a high-severity grade disease. However, those with good adherence to the MedDiet experienced a lower pain intensity and overall FM impact. A propensity score analysis indicates a positive influence of the MedDiet against FM severity, thus unveiling the need for well-designed intervention studies to evaluate the therapeutic potential of different dietary patterns.
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Affiliation(s)
- Elisa Proietti
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
| | - Fabio Rapallo
- Department of Economics (DIEC), University of Genova, Via Vivaldi, 5, 16126 Genova, Italy;
| | - Elena Molinari
- Clincal Psychology Center, Division of Neurology, E.O. Ospedali Galliera, Via Mura delle Cappuccine 14, 16128 Genova, Italy;
| | - Viviana Mucci
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia;
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo P. Daneo 3, 16132 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Clinical Neurophysiology, Largo R. Benzi 10, 16132 Genova, Italy
| | - Consuelo Borgarelli
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
| | - Bruno Burlando
- Department of Pharmacy (DIFAR), University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy;
| | - Livia Pisciotta
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
- IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine, Operative Unit of Dietetics and Clinical Nutrition, Largo R. Benzi 10, 16132 Genova, Italy
| | - Ilaria Demori
- Department of Pharmacy (DIFAR), University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy;
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13
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Úbeda D'Ocasar E, Pichel García EP, Hervás Pérez JP, Jiménez Díaz-Benito V. Effectiveness of manual lymphatic drainage in women with fibromyalgia: A pilot study. J Bodyw Mov Ther 2024; 38:483-488. [PMID: 38763597 DOI: 10.1016/j.jbmt.2024.03.040] [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: 04/19/2022] [Revised: 02/22/2024] [Accepted: 03/13/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Currently there is no treatment capable of significantly alleviating all the symptoms of fibromyalgia (FM), even though it is a complex syndrome with a high prevalence in the population. DESIGN Experimental study using a single-blind, randomised, clinical trial. OBJECTIVE To analyse the efficacy of manual lymphatic drainage (MLD) as an alternative to traditional treatment of fibromyalgia (FM) in women. METHODS This was an experimental study using a single-blind, randomised, clinical trial of 20 women between 30 and 55 years old with FM. Patients were divided into an experimental group (n = 10) and a control group (n = 10). During the study, 3 measurements of pain (visual analogue scale and algometry), FM impact (Fibromyalgia Impact Questionnaire), sleep quality (Index Pittsburgh), anxiety and depression (Hospital Anxiety and Depression Scale) were recorded. Treatment of the experimental group consisted of 2 weekly MLD sessions for 6 weeks. RESULTS The effect of the interaction of MLD showed statistically significant results in Right intercostal space (F2,36 = 3.54; p = 0.04; n2p = 0.16). The sleep quality was significantly better favour of the treatment (F2,36 = 4.16; p = 0.01; n2p = 0.20). CONCLUSIONS MLD therapy demonstrated effects in the experimental group in contrast to the control group across the intervention period concerning the right intercostal space and sleep-related factors. However, MLD did not result in observable alterations in pain perception.
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Affiliation(s)
- Edurne Úbeda D'Ocasar
- Faculty of Health Sciences - HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49. 28692, Villanueva de la Cañada, Madrid, Spain
| | - Elena Paula Pichel García
- Faculty of Health Sciences - HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49. 28692, Villanueva de la Cañada, Madrid, Spain
| | - Juan Pablo Hervás Pérez
- Faculty of Health Sciences - HM Hospitals, University Camilo José Cela, Urb. Villafranca del Castillo, 49. 28692, Villanueva de la Cañada, Madrid, Spain
| | - Víctor Jiménez Díaz-Benito
- Department of Sport Sciences, Faculty of Physical Activity and Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain.
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14
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García-López H, Calle-Ortega F, García-Robles P, Del-Rey RR, Obrero-Gaitán E, Cortés-Pérez I. Effectiveness of transcutaneous electrical nerve stimulation improves pain intensity, disability and quality of life in patients with fibromyalgia syndrome: a systematic review with meta-analysis. Disabil Rehabil 2024:1-11. [PMID: 38511391 DOI: 10.1080/09638288.2024.2331069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE The transcutaneous electrical nerve stimulation (TENS) is one of the most frequently electrophysical agents employed in reducing the impact of FMS. This meta-analysis intended to determine the effectiveness of TENS on pain, disability, and quality of life (QoL) in patients with FMS. METHODS According to PRISMA, we performed a meta-analysis (CRD42023456439), searching in PubMed Medline, PEDro, CINAHL Complete, Web of Science, and Scopus, since inception up to October 2023. This review focused on controlled clinical trials evaluating the effect of TENS on pain, disability, and QoL in patients with FMS. The pooled effect was estimated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95%CI). RESULTS Twelve studies, providing data from 944 patients, were included (PEDro score of 5.6 points). Meta-analyses showed that TENS interventions are effective in improving pain (SMD = -0.61; 95%CI -1 to -0.16); disability (SMD = -0.27; 95%CI -0.41 to -0.12); and physical dimension of QoL (SMD = 0.26; 95%CI 0.08 to 0.44). Additionally, when TENS is used as a unique therapy, it represents the best therapeutic option for improving pain, disability, and QoL. CONCLUSIONS This meta-analysis, including the largest number of studies, showed that TENS intervention is an effective therapy to reduce pain and disability and increase QoL in FMS patients.
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Affiliation(s)
- Héctor García-López
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
| | - Fabián Calle-Ortega
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
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15
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Li H, Cheng J. 2-Phenylcyclopropylmethylamine (PCPMA) as a privileged scaffold for central nervous system drug design. Bioorg Med Chem Lett 2024; 101:129654. [PMID: 38360418 DOI: 10.1016/j.bmcl.2024.129654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
The use of privileged scaffolds in medicinal chemistry is an effective way to accelerate the drug discovery process, especially at the hit/lead optimization stage. 2-Phenylcyclopropylmethylamine (PCPMA) is a less commonly used chemical scaffold in medicinal chemistry, but many PCPMA-containing compounds exert therapeutic effects for various diseases, in particular central nervous system (CNS) diseases such as depression, schizophrenia, sleep disorder, and Parkinson's disease. The backbone of the PCPMA scaffold enables a unique structure of an amino group linked to a benzene ring through an alkyl linker, making it a useful template for the design of bioactive compounds especially for CNS drug targets including aminergic GPCRs and transporters. This review summarizes the medicinal chemistry studies of PCPMA-containing drugs and drug-like molecules, their mechanisms of action, and biological activities. We conclude that PCPMA is a unique and useful privileged scaffold for CNS drug design.
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Affiliation(s)
- Huiqiong Li
- iHuman Institute and School of Life Science and Technology, ShanghaiTech University, 393 Middle Huaxia Road, Shanghai 201210, China
| | - Jianjun Cheng
- iHuman Institute and School of Life Science and Technology, ShanghaiTech University, 393 Middle Huaxia Road, Shanghai 201210, China.
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16
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Calzavara-Pinton P, Tonon F, Calzavara-Pinton I. Sun pain and solar dysesthesia: A new challenge in clinical practice. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12955. [PMID: 38361492 DOI: 10.1111/phpp.12955] [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: 12/13/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND A few patients report intense pain and other unpleasant sensations, such as burning, dysesthesia and hyperalgesia, after even brief exposure to the sun and in the absence of any skin lesion. Sometimes they also develop systemic symptoms, such as mild fever, fatigue, faintness and fainting. As a result, these patients carefully avoid even short-term sun exposure with a consequent severe negative impact on their lives. METHODS We have reviewed the clinical findings and the results of photobiological investigations of 10 patients who presented this clinical picture. Six of these patients were previously described by our group with the diagnosis of sun pain. We have reviewed the similarities with other previously described disorders such as solar dysesthesia and PUVA pain and have evaluated possible pathogenetic mechanisms. RESULTS During phototesting our patients experienced intense pain in the exposed area and in the surrounding skin, without any visible lesion, even with very low sub-erythemal doses. At follow-up, five patients were diagnosed with fibromyalgia, three with a major depressive disorder, one with bipolar syndrome and one with a conversion disorder. The pathogenesis remains unclear, but the use of a psychopharmacological treatment with antidepressants improved both the neuropsychiatric symptoms and sensitivity to the sun in most subjects. CONCLUSION For patients with pain and other severe symptoms in the absence of skin lesions and clinical and laboratory manifestations of known photodermatoses, a neuropsychiatric evaluation should be suggested.
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Affiliation(s)
| | - Francesco Tonon
- Dermatology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Irene Calzavara-Pinton
- Department of Mental Health and Addictions, ASST Spedali Civili and University of Brescia, Brescia, Italy
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17
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Mohapatra G, Dachet F, Coleman LJ, Gillis B, Behm FG. Identification of unique genomic signatures in patients with fibromyalgia and chronic pain. Sci Rep 2024; 14:3949. [PMID: 38366049 PMCID: PMC10873305 DOI: 10.1038/s41598-024-53874-8] [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: 12/02/2022] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain. The pathophysiology of fibromyalgia is not clearly understood and there are no specific biomarkers available for accurate diagnosis. Here we define genomic signatures using high throughput RNA sequencing on 96 fibromyalgia and 93 control cases. Our findings revealed three major fibromyalgia-associated expression signatures. The first group included 43 patients with a signature enriched for gene expression associated with extracellular matrix and downregulation of RhoGDI signaling pathway. The second group included 30 patients and showed a profound reduction in the expression of inflammatory mediators with an increased expression of genes involved in the CLEAR signaling pathway. These results suggest defective tissue homeostasis associated with the extra-cellular matrix and cellular program that regulates lysosomal biogenesis and participates in macromolecule clearance in fibromyalgia. The third group of 17 FM patients showed overexpression of pathways that control acute inflammation and dysfunction of the global transcriptional process. The result of this study indicates that FM is a heterogeneous and complex disease. Further elucidation of these pathways will lead to the development of accurate diagnostic markers, and effective therapeutic options for fibromyalgia.
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Affiliation(s)
- Gayatry Mohapatra
- Laboratory of Genomic Medicine, Department of Pathology, University of Illinois at Chicago (UIC) College of Medicine, 840 S. Wood St., Chicago, IL, 60612, USA.
| | - Fabien Dachet
- Laboratory of Genomic Medicine, Department of Pathology, University of Illinois at Chicago (UIC) College of Medicine, 840 S. Wood St., Chicago, IL, 60612, USA
| | - Louis J Coleman
- Laboratory of Genomic Medicine, Department of Pathology, University of Illinois at Chicago (UIC) College of Medicine, 840 S. Wood St., Chicago, IL, 60612, USA
| | - Bruce Gillis
- Department of Medicine, University of Illinois at Chicago (UIC) College of Medicine, Chicago, USA
| | - Frederick G Behm
- Laboratory of Genomic Medicine, Department of Pathology, University of Illinois at Chicago (UIC) College of Medicine, 840 S. Wood St., Chicago, IL, 60612, USA
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18
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Wang X, Luo H. Effects of traditional Chinese exercise therapy on pain scores, sleep quality, and anxiety-depression symptoms in fibromyalgia patients: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:99. [PMID: 38281020 PMCID: PMC10821260 DOI: 10.1186/s12891-024-07194-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.
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Affiliation(s)
- Xinzheng Wang
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China
| | - Hongbin Luo
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China.
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19
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Ye G, Miao R, Chen J, Huang J, Jiang M. Effectiveness of Complementary and Alternative Medicine in Fibromyalgia Syndrome: A Network Meta-Analysis. J Pain Res 2024; 17:305-319. [PMID: 38268732 PMCID: PMC10807275 DOI: 10.2147/jpr.s439906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
Objective Fibromyalgia (FM) is a prevalent chronic disorder characterized by widespread skeletal muscle pain. In recent years, complementary and alternative medicine (CAM) has increasingly been recognized for its potential in treating FM symptoms. This study aims to assess the efficacy of CAM therapies in mitigating the symptoms of FM. Methods This systematic review was registered with INPLASY. A thorough search of both English and Chinese databases was undertaken from their inception until April 15, 2023. The search criteria focused on prospective controlled trials examining CAM therapies in FM patients. The statistical analysis employed mean values and standard deviations. Additionally, an evaluation of the literature's quality and potential biases was conducted. Results The search yielded 41 articles, encompassing 2877 FM patients and involving 20 different interventions. All studies were randomized controlled trials (RCTs). The results of the network meta-analysis (NMA) indicated that a combination of Acupuncture and Massage therapy, as well as Navel Needling therapy, effectively alleviated pain symptoms in FM patients. Furthermore, Abdominal Acupuncture and Electroacupuncture were found to be beneficial in improving patients' mood and sleep quality. Conclusion Acupuncture + Massage and Umbilical Acupuncture emerged as the most efficacious therapies in relieving pain symptoms in FM patients. Abdominal Acupuncture and Electroacupuncture demonstrated their effectiveness in enhancing mood and sleep quality. Overall, CAM therapies exhibited a high safety profile for patients with fibromyalgia.
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Affiliation(s)
- Guancheng Ye
- Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Ruiheng Miao
- Department of TCM, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jiaqi Chen
- Department of Dermatology, Beijing Hospital of Traditional Chinese Medicine, Beijing, People’s Republic of China
| | - Jian Huang
- Department of Acupuncture, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Min Jiang
- Department of TCM, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China
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20
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Wang Z, Jiang D, Zhang M, Teng Y, Huang Y. Causal association between gut microbiota and fibromyalgia: a Mendelian randomization study. Front Microbiol 2024; 14:1305361. [PMID: 38260871 PMCID: PMC10800605 DOI: 10.3389/fmicb.2023.1305361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Background Fibromyalgia (FM) is a syndrome characterized by chronic and widespread musculoskeletal pain. A number of studies have implied a potential association between gut microbiota and FM. However, the casual association between gut microbiota and FM remains unknown. Method Mendelian randomization (MR) study was conducted using the summary statistics of genetic variants from the genome-wide association study (GWAS). Inverse variance weighted (IVW), combined with MR-Egger and weighted median were used to investigate the causal association between 119 gut microbiota genera and FM. Sensitivity analyses were performed on the MR results, including heterogeneity test, leave-one-out test and pleiotropy test. Results A total of 1,295 single nucleotide polymorphism (SNPs) were selected as instrumental variables (IVs), with no significant heterogeneity and pleiotropy according to the sensitivity analyses. Five gut microbiota genera were found to have significant casual association with FM. Coprococcus2 (OR = 2.317, p-value = 0.005, 95% CI: 1.289-4.167), Eggerthella (OR = 1.897, p-value = 0.001, 95% CI: 1.313-2.741) and Lactobacillus (OR = 1.576, p-value =0.020, 95% CI: 1.073-2.315) can increase the risk of FM. FamillyXIIIUCG001 (OR = 0.528, p-value = 0.038, 95% CI: 0.289-0.964) and Olsenella (OR = 0.747, p-value = 0.050, 95% CI: 0.557-1.000) can decrease the risk of FM. Conclusion This MR study found that gut microbiota is casually associated with FM. New insights into the mechanisms of FM mediated by gut microbiota are provided.
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Affiliation(s)
- Zhaohua Wang
- Beijing Engineering Research Center of Food Environment and Public Health, Minzu University of China, Beijing, China
- College of life and Environmental Science, Minzu University of China, Beijing, China
| | - Dan Jiang
- College of Food Science and Engineering, Dalian Ocean University, Dalian, China
| | - Min Zhang
- Beijing Engineering Research Center of Food Environment and Public Health, Minzu University of China, Beijing, China
- College of life and Environmental Science, Minzu University of China, Beijing, China
| | - Yu Teng
- Beijing Engineering Research Center of Food Environment and Public Health, Minzu University of China, Beijing, China
- College of life and Environmental Science, Minzu University of China, Beijing, China
| | - Yaojiang Huang
- Beijing Engineering Research Center of Food Environment and Public Health, Minzu University of China, Beijing, China
- College of life and Environmental Science, Minzu University of China, Beijing, China
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21
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Kerzhner O, Berla E, Har-Even M, Ratmansky M, Goor-Aryeh I. Consistency of inconsistency in long-COVID-19 pain symptoms persistency: A systematic review and meta-analysis. Pain Pract 2024; 24:120-159. [PMID: 37475709 DOI: 10.1111/papr.13277] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/29/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Individuals recovering from acute COVID-19 episodes may continue to suffer from various ongoing symptoms, collectively referred to as Long-COVID. Long-term pain symptoms are amongst the most common and clinically significant symptoms to be reported for this post-COVID-19 syndrome. OBJECTIVES This systematic review and meta-analysis aimed to evaluate the proportions of persisting pain symptoms experienced by individuals past the acute phase of COVID-19 and to identify their associated functional consequences and inflammatory correlates. METHODS Two online databases were systematically searched from their inception until 31 March 2022. We searched primary research articles in English, which evaluated individuals after laboratory-confirmed COVID-19 acute phase resolution and specifically reported on pain symptoms and their inflammatory and/or functional outcomes. RESULTS Of the 611 identified articles, 26 were included, used for data extraction, and assessed for their methodological quality and risk of bias by two independent reviewers. Pain symptoms were grouped under one of six major pain domains, serving as our primary co-outcomes. Proportional meta-analyses of pooled logit-transformed values of single proportions were performed using the random-effects-restricted maximum-likelihood model. An estimated 8%, 6%, 18%, 18%, 17%, and 12% of individuals continued to report the persistence of chest, gastrointestinal, musculoskeletal joint, musculoskeletal muscle, general body, and nervous system-related pain symptoms, respectively, for up to one year after acute phase resolution of COVID-19. Considerable levels of heterogeneity were demonstrated across all results. Functional and quality-of-life impairments and some inflammatory biomarker elevations were associated with the persistence of long-COVID pain symptoms. CONCLUSION This study's findings suggest that although not well characterized, long-COVID pain symptoms are being experienced by non-negligible proportions of those recovering from acute COVID-19 episodes, thus highlighting the importance of future research efforts to focus on this aspect.
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Affiliation(s)
- Oleg Kerzhner
- Loewenstein Rehabilitation Medical Center, Ra'anana, Israel
| | - Einat Berla
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Meirav Har-Even
- Department of Anatomy and Anthropology, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Motti Ratmansky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pain Clinic, Sheba Medical Center, Ramat Gan, Israel
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22
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Rus A, López-Sánchez JA, Martínez-Martos JM, Ramírez-Expósito MJ, Molina F, Correa-Rodríguez M, Aguilar-Ferrándiz ME. Predictive Ability of Serum Amino Acid Levels to Differentiate Fibromyalgia Patients from Healthy Subjects. Mol Diagn Ther 2024; 28:113-128. [PMID: 37843759 DOI: 10.1007/s40291-023-00677-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Fibromyalgia is a complex illness to diagnose and treat. OBJECTIVES To evaluate a broad range of circulating free amino acid (AA) levels in fibromyalgia patients as well as the ability of the AAs to differentiate fibromyalgia patients from healthy subjects. DESIGN We carried out a case-control study to evaluate AA levels in 62 patients with fibromyalgia and 78 healthy subjects. This study adheres to the STROBE guidelines. METHODS AAs content was assayed by HPLC in serum samples. The predictive value of AA levels in fibromyalgia was determined by receiver operating characteristic (ROC) curve and forward binary logistic regression analyses. RESULTS Fibromyalgia patients showed higher serum levels of aspartic acid, glutamic acid, aminoadipic acid, asparagine, histidine, 3-methyl-histidine, 5-methyl-histidine, glycine, threonine, taurine, tyrosine, valine, methionine, isoleucine, phenylalanine, leucine, ornithine, lysine, branched chain AAs (BCAAs), large neutral AAs, essential AAs (EAAs), non-essential AAs (NEAAs), basic AAs, EAAs/NEAAs ratio, phenylalanine/tyrosine ratio, and global arginine bioavailability ratio than the controls. Serum alanine levels were lower in patients than in controls. According to ROC analysis, most of these AAs may be good markers for differentiating individuals with fibromyalgia from healthy subjects. Results of logistic regression showed that the combination of glutamic acid, histidine, and alanine had the greatest predictive ability to diagnose fibromyalgia. CONCLUSIONS Our results show an imbalance in serum levels of most AAs in patients with fibromyalgia, which suggest a metabolic disturbance. The determination of serum levels of these AAs may aid in the diagnosis of fibromyalgia, in combination with clinical data of the patient.
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Affiliation(s)
- Alma Rus
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
| | - José Alberto López-Sánchez
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
| | | | | | - Francisco Molina
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain.
| | - María Encarnación Aguilar-Ferrándiz
- Department of Cell Biology, University of Granada, Avenida de la Fuentenueva, s/n, 18071, Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016, Granada, Spain
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23
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Navarro-Ledesma S, Aguilar-García M, González-Muñoz A, Casas-Barragán A, Tapia-Haro RM. Association between elasticity of tissue and pain pressure threshold in the tender points present in subjects with fibromyalgia: a cross-sectional study. Sci Rep 2023; 13:22003. [PMID: 38086996 PMCID: PMC10716166 DOI: 10.1038/s41598-023-49550-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/09/2023] [Indexed: 12/18/2023] Open
Abstract
Fibromyalgia (FM) is a multicomponent illness and despite its worldwide prevalence, a complete understanding of its aetiology and pathogenesis remains unclear. The goal of the study is to analyze the level of association between elastic properties of tissue measured by strain elastography (SEL) and pain pressure threshold (PPT) in the characteristic painful points described in patients suffering from FM. This was a cross-sectional, observational study. A sample comprised of 42 subjects with FM was recruited from a private care centre. The occiput, low cervical, trapezius, supraspinatus, paraspinous, lateral pectoral, second rib, lateral epicondyle, medial epicondyle, gluteus, greater trochanter, knee, and anterior tibial PPTs were bilaterally assessed using a standard pressure algometer and elastic properties of tissue were evaluated by SEL. Linear regression analysis showed significant associations between SEL and dominant trapezius PPT (β = 0.487, 95% CI [0.045, 0.930], p = 0.032) after adjustments for the age, body mass index, and menopause status (higher SEL and higher pain sensitivity). No significant associations between SEL and the other PPTs variables were found in women diagnosed with FM. The PPT of the dominant trapezius is associated with SEL measurements in subjects suffering from FM. More studies are required to fully explain the underlying mechanisms.
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Affiliation(s)
- Santiago Navarro-Ledesma
- Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain
| | - María Aguilar-García
- Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain
- Biomedicine PhD Program, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071, Granada, Spain
| | - Ana González-Muñoz
- Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Melilla, Spain
- Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071, Granada, Spain
- Clinica Ana Gonzalez, Malaga, Spain
| | - Antonio Casas-Barragán
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
- Faculty of Health Sciencies, University of Granada (UGR), Ave. de la Ilustración, 60, 18016, Granada, Spain.
| | - Rosa María Tapia-Haro
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Faculty of Health Sciencies, University of Granada (UGR), Ave. de la Ilustración, 60, 18016, Granada, Spain
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24
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Tapia-Haro RM, Molina F, Rus A, Casas-Barragán A, Correa-Rodríguez M, Aguilar-Ferrándiz ME. Serum VEGF and CGRP Biomarkers: Relationships with Pain Intensity, Electric Pain, Pressure Pain Threshold, and Clinical Symptoms in Fibromyalgia-An Observational Study. Int J Mol Sci 2023; 24:15533. [PMID: 37958517 PMCID: PMC10649295 DOI: 10.3390/ijms242115533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Fibromyalgia (FM) is a multifactorial syndrome, mainly characterized by chronic widespread pain, whose physiopathology is yet to be determined. Reliable biomarkers for FM and how they are associated with the symptomatology have not yet been identified. We aimed to examine the relationships among serum vascular endothelial growth factor (VEGF) and calcitonin gene-related peptide (CGRP) levels with clinical manifestations and pain-related variables in women with FM. We conducted an observational case study with forty-seven women diagnosed with FM. Serum VEGF and CGRP levels were spectrophotometrically analyzed. We used questionnaires to measure the impact of FM and the degree of central sensitization, fatigue, and anxiety. We also assessed pain intensity, electric pain threshold and magnitude, and pressure pain threshold (PPT) in tender points. The linear regression analysis adjusting for age, menopause status, and body mass index showed that serum VEGF levels were significantly associated with the PPTs of non-dominant trapezius (β = 153.418; p = 0.033), non-dominant second metacarpal (β = 174.676; p = 0.008) and dominant tibialis anterior (β = 115.080; p = 0.049) in women with FM. We found no association between serum CGRP levels and the variables measured (p ≥ 0.152). Our results suggest that VEGF may be related to pain processing in patients with FM.
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Affiliation(s)
- Rosa Mª Tapia-Haro
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (R.M.T.-H.); (F.M.); (A.C.-B.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain;
| | - Francisco Molina
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (R.M.T.-H.); (F.M.); (A.C.-B.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain;
| | - Alma Rus
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain;
- Department of Cell Biology, Faculty of Sciences, University of Granada (UGR), 18016 Granada, Spain
| | - Antonio Casas-Barragán
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (R.M.T.-H.); (F.M.); (A.C.-B.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain;
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain;
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Ave. de la Ilustración, 60, 18016 Granada, Spain
| | - Mª Encarnación Aguilar-Ferrándiz
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), 18016 Granada, Spain; (R.M.T.-H.); (F.M.); (A.C.-B.); (M.E.A.-F.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain;
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25
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Zhang JH, Liang J, Yang ZW. Non-invasive brain stimulation for fibromyalgia: current trends and future perspectives. Front Neurosci 2023; 17:1288765. [PMID: 37928733 PMCID: PMC10620708 DOI: 10.3389/fnins.2023.1288765] [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: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Fibromyalgia, a common and enduring pain disorder, ranks as the second most prevalent rheumatic disease after osteoarthritis. Recent years have witnessed successful treatment using non-invasive brain stimulation. Transcranial magnetic stimulation, transcranial direct current stimulation, and electroconvulsion therapy have shown promise in treating chronic pain. This article reviews the literature concerning non-invasive stimulation for fibromyalgia treatment, its mechanisms, and establishes a scientific basis for rehabilitation, and discusses the future directions for research and development prospects of these techniques are discussed.
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Affiliation(s)
- Jia-Hao Zhang
- Laboratory of Laser Sports Medicine, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Jian Liang
- Laboratory of Sports Rehabilitation, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Zhong-Wei Yang
- Laboratory of Sports Rehabilitation, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
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26
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Gikaro JM, Bigambo FM, Minde VM, Swai EA. Efficacy of electrophysical agents in fibromyalgia: A systematic review and network meta-analysis. Clin Rehabil 2023; 37:1295-1310. [PMID: 37082791 DOI: 10.1177/02692155231170450] [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] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To examine the effectiveness of electrophysical agents in fibromyalgia. DATA SOURCES CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023. METHODS This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood. RESULTS Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms (P = 0.006 and P = 0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status (P = 0.018); and microcurrent (P = 0.001), repetitive transcranial magnetic stimulation (P = 0.022), and no treatment (P = 0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively). CONCLUSION This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia.
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Affiliation(s)
- John Marwa Gikaro
- Department of Physiotherapy, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Francis Manyori Bigambo
- Department of Orthopedics and Neurosurgery, Muhimbili Orthopaedic Institute, Dar Es Salaam, Tanzania
| | - Victor Mark Minde
- Department of Physiotherapy, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Elia Asanterabi Swai
- Department of Physiotherapy, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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27
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Injean P, Tan J, Lee S, Downey C. Could Some Patients With Fibromyalgia Potentially Have Hypophosphatasia? A Retrospective Single-Center Study. ACR Open Rheumatol 2023; 5:524-528. [PMID: 37661663 PMCID: PMC10570664 DOI: 10.1002/acr2.11591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE Hypophosphatasia (HPP) is a rare disease characterized by incomplete or defective bone mineralization due to a mutation in the alkaline phosphatase (ALP) gene causing low levels of ALP. Disease presentation is heterogeneous and can present as a chronic pain syndrome like fibromyalgia (FM). Our objective was to determine if there are any potential patients with HPP in the group of patients who were diagnosed with FM. Antiresorptive therapy use can trigger atypical femur fractures in patients with HPP. METHODS We performed a retrospective chart review of all patients 18 years or older at a single academic center who were diagnosed with FM and had either a low or a normal ALP level. The following characteristics were reviewed: biological sex; age; history of fractures; diagnosis of osteoporosis, osteopenia, osteoarthritis, and chondrocalcinosis; genetic testing; vitamin B6 level testing; and medications. RESULTS Six hundred eleven patients with FM were identified. Two hundred had at least one low ALP level, and 57 had at least three consecutively low measurements of ALP, 44% of which had a history of fractures. No patients had vitamin B6 levels checked. None of the patients had previous genetic testing for HPP or underwent testing for zinc or magnesium levels. CONCLUSION The percentage of patients with FM who were found to have consistently low ALP levels was 9.3%. None had vitamin B6 level or genetic testing, suggesting that the diagnosis was not suspected. It is important to diagnose HPP given the availability of enzyme replacement therapy to prevent complications from HPP such as fractures. Our data support screening for this condition as a part of the initial workup of FM.
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Affiliation(s)
- Patil Injean
- Cedars Sinai Medical CenterLos AngelesCalifornia
| | - John Tan
- Huckleberry LabsIrvineCalifornia
| | - Sandy Lee
- University of Southern CaliforniaLos Angeles
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28
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Lee CH, Lee EY, Yang M, Won HS, Kim YD. The current status of fibromyalgia in Korea: an electronic population health data study in Korea. Korean J Pain 2023; 36:458-464. [PMID: 37752664 PMCID: PMC10551395 DOI: 10.3344/kjp.23204] [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: 07/11/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
Background Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and tenderness in the muscles, ligaments, and soft tissues. It is a chronic pain condition often accompanied by other symptoms and comorbidities. To effectively manage FM, it is crucial to obtain fundamental epidemiological data pertaining to the target population. Therefore, this study was conducted to elucidate the epidemiological characteristics of FM in the Korean population. Methods Population-based medical data of 51,276,314 subscribers to the National Health Insurance Service of Korea from 2014 to 2018 were used in this study. Results The overall incidence of FM ranged from 441 (2014) to 541 (2018) cases per 100,000 person-years, with a higher prevalence observed among female patients compared to male patients. The incidence gradually increased until middle age, followed by a decrease. The highest incidence rates were observed in the fifth decade of life for females and the sixth decade of life for males. When categorizing the affected parts of the body, the shoulder region was observed to be the most frequently affected. A comparison of the drug prescriptions based on medical specialty showed that antidepressants were the most commonly prescribed medications. The management of FM leads to consistent increases in medical expenses, regional disparities, and variations in prescription patterns across different medical specialties. Conclusions The findings of this study will not only contribute to the understanding of FM characteristics but also provide a vital foundation for efficient management of FM in Korea.
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Affiliation(s)
- Cheol-Hyeong Lee
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Eun Young Lee
- Health Insurance Review and Assessment Service, Gwangju, Korea
| | - Miyoung Yang
- Department of Anatomy, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
- Sarcopenia Total Solution Center, Wonkwang University School of Medicine, Iksan, Korea
| | - Hyung-Sun Won
- Department of Anatomy, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
| | - Yeon-Dong Kim
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
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29
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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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González-Flores D, López-Pingarrón L, Castaño MY, Gómez MÁ, Rodríguez AB, García JJ, Garrido M. Melatonin as a Coadjuvant in the Treatment of Patients with Fibromyalgia. Biomedicines 2023; 11:1964. [PMID: 37509603 PMCID: PMC10377739 DOI: 10.3390/biomedicines11071964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome that is accompanied by fatigue, sleep disturbances, anxiety, depression, lack of concentration, and neurocognitive impairment. As the currently available drugs are not completely successful against these symptoms and frequently have several side effects, many scientists have taken on the task of looking for nonpharmacological remedies. Many of the FMS-related symptoms have been suggested to be associated with an altered pattern of endogenous melatonin. Melatonin is involved in the regulation of several physiological processes, including circadian rhythms, pain, mood, and oxidative as well as immunomodulatory balance. Preliminary clinical studies have propounded that the administration of different doses of melatonin to patients with FMS can reduce pain levels and ameliorate mood and sleep disturbances. Moreover, the total antioxidant capacity, 6-sulfatoxymelatonin and urinary cortisol levels, and other biological parameters improve after the ingestion of melatonin. Recent investigations have proposed a pathophysiological relationship between mitochondrial dysfunction, oxidative stress, and FMS by looking at certain proteins involved in mitochondrial homeostasis according to the etiopathogenesis of this syndrome. These improvements exert positive effects on the quality of life of FMS patients, suggesting that the use of melatonin as a coadjuvant may be a successful strategy for the management of this syndrome.
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Affiliation(s)
- David González-Flores
- Department of Anatomy, Cell Biology and Zoology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
| | - Laura López-Pingarrón
- Oxidative Stress and Aging Research Group, Department of Pharmacology, Physiology, Legal and Forensic Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Yolanda Castaño
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Nursing, Merida University Center, University of Extremadura, 06006 Badajoz, Spain
| | - María Ángeles Gómez
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Physiology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
| | - Ana B Rodríguez
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Physiology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
| | - Joaquín J García
- Oxidative Stress and Aging Research Group, Department of Pharmacology, Physiology, Legal and Forensic Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Garrido
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Physiology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
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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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Conde-Antón Á, Heranando-Garijo I, Jiménez-Del-Barrio S, Mingo-Gómez MT, Medrano-de-la-Fuente R, Ceballos-Laita L. Effects of transcranial direct current stimulation and transcranial magnetic stimulation in patients with fibromyalgia. A systematic review. Neurologia 2023:S2173-5808(23)00009-3. [PMID: 37031798 DOI: 10.1016/j.nrleng.2020.07.025] [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: 06/06/2020] [Accepted: 07/19/2020] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Fibromyalgia syndrome (FM) is a chronic pathology characterized by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The aim of the current review is to determine the effects of tDCS and TMS on the main symptoms of patients with FM. DEVELOPMENT A systematic review based on PRISMA guidelines was carried out. The search strategy was performed in MEDLINE, SCOPUS, PEDro and Cochrane Library. Randomized controlled trials based on the effects of tDCS and TMS on pain, pressure pain threshold (PPT), fatigue, anxiety and depression, catastrophizing and quality of life in patients with FM were analysed. Fourteen studies were included. CONCLUSIONS The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in PPT, catastrophizing and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex. The effects of these interventions on anxiety and depression are unclear.
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Affiliation(s)
- Ángela Conde-Antón
- Facultad de Fisioterapia, Universidad de Valladolid, c/Universidad s/n Soria, Spain.
| | | | | | | | | | - Luis Ceballos-Laita
- Facultad de Fisioterapia, Universidad de Valladolid, c/Universidad s/n Soria, Spain.
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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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Molero-Chamizo A, Nitsche MA, Barroso RTA, Bailén JRA, Palomeque JCG, Rivera-Urbina GN. Non-Invasive Electric and Magnetic Brain Stimulation for the Treatment of Fibromyalgia. Biomedicines 2023; 11:biomedicines11030954. [PMID: 36979932 PMCID: PMC10046115 DOI: 10.3390/biomedicines11030954] [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: 02/13/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Although fibromyalgia is defined by its core muscular nociceptive component, it also includes multiple dysfunctions that involve the musculoskeletal, gastrointestinal, immune, endocrine, as well as the central and peripheral nervous systems, amongst others. The pathogenic involvement of the nervous system and the numerous neurological and neuroinflammatory symptoms of this disease may benefit from neuromodulatory stimulation techniques that have been shown to be effective and safe in diverse nervous system pathologies. In this systematic review, we outline current evidence showing the potential of non-invasive brain stimulation techniques, such as therapeutic strategies in fibromyalgia. In addition, we evaluate the contribution of these tools to the exploration of the neurophysiological characteristics of fibromyalgia. Considering that the pathogenesis of this disease is unknown, these approaches do not aim to causally treat this syndrome, but to significantly reduce a range of key symptoms and thus improve the quality of life of the patients.
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Affiliation(s)
- Andrés Molero-Chamizo
- Department of Clinical and Experimental Psychology, University of Huelva, Campus El Carmen, 21071 Huelva, Spain
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, 44139 Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, 33615 Bielefeld, Germany
| | | | - José R Alameda Bailén
- Department of Clinical and Experimental Psychology, University of Huelva, Campus El Carmen, 21071 Huelva, Spain
| | - Jesús Carlos García Palomeque
- Histology Department, School of Medicine, Cadiz University, 11001 Cádiz, Spain
- Cadiz Bahia Sur District, Andalusian Health Service, 11006 Cádiz, Spain
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Neck Pain in Fibromyalgia: Treatment with Exercise and Mesotherapy. Biomedicines 2023; 11:biomedicines11030892. [PMID: 36979871 PMCID: PMC10045341 DOI: 10.3390/biomedicines11030892] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Background and Objectives: Fibromyalgia is a very common musculoskeletal disease. The purpose of this study is to assess, on a population of fibromyalgic patients, the clinical efficacy of antalgic mesotherapy with diclofenac and thiocolchicoside in the treatment of cervical pain reduction for improvement of the functional capacity and quality of life of these patients. Materials and Methods: We conducted an observational study of 78 fibromyalgia patients recruited using our hospital database. Based on the different types of treatment received, the patients were divided into two groups: the treatment group (TG), who received antalgic mesotherapy with diclofenac, thiococolchicoside, and mepivacaina; and the placebo group (PG), who received mesotherapy with sodium chloride solution. Patients in both groups also received the same rehabilitation protocol of 20 sessions. The primary outcome evaluated was the extent of pain. The secondary outcomes were the functional capacity and quality of life. Results: Pain improved both in the treatment group (7.4 ± 1.2 vs. 5.1 ± 1.1; p < 0.05) and placebo group (7.5 ± 1.4 vs. 6.1 ± 1.6; p < 0.05). The treatment group, compared to the placebo group, also showed significant statistical improvements in functional capacity (NDI: 35.6 ± 5.23 vs. 19.3 ± 3.41; p < 0.05) and quality of life (SF-12: 18.3 ± 4.11 vs. 33.1 ± 2.41; p < 0.05). Conclusions: Mesotherapy treatment with diclofenac and thiocolchicoside is a safe and effective procedure in the management of neck pain in fibromyalgia patients in the short term in terms of pain reduction, functional recovery and quality of life.
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Mucci V, Demori I, Browne CJ, Deblieck C, Burlando B. Fibromyalgia in Pregnancy: Neuro-Endocrine Fluctuations Provide Insight into Pathophysiology and Neuromodulation Treatment. Biomedicines 2023; 11:biomedicines11020615. [PMID: 36831148 PMCID: PMC9953487 DOI: 10.3390/biomedicines11020615] [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: 01/06/2023] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Fibromyalgia (FM) is a chronic pain disorder with unclear pathophysiological mechanisms, which leads to challenges in patient management. In addition to pain, the disorder presents with a broad range of symptoms, such as sleep disruption, chronic fatigue, brain fog, depression, muscle stiffness, and migraine. FM has a considerable female prevalence, and it has been shown that symptoms are influenced by the menstrual cycle and periods of significant hormonal and immunological changes. There is increasing evidence that females with FM experience an aggravation of symptoms in pregnancy, particularly during the third trimester and after childbirth. In this perspective paper, we focus on the neuro-endocrine interactions that occur between progesterone, allopregnanolone, and cortisol during pregnancy, and propose that they align with our previously proposed model of FM pathogenesis based on GABAergic "weakening" in a thalamocortical neural loop system. Based on our hypothesis, we introduce the possibility of utilizing transcranial direct current stimulation (tDCS) as a non-invasive treatment potentially capable of exerting sex-specific effects on FM patients.
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Affiliation(s)
- Viviana Mucci
- School of Science, Western Sydney University, Campbelltown, NSW 2560, Australia
- Correspondence:
| | - Ilaria Demori
- Department of Earth, Environmental and Life Sciences (DISTAV), University of Genova, Corso Europa, 26, 16132 Genova, Italy
| | - Cherylea J. Browne
- School of Science, Western Sydney University, Campbelltown, NSW 2560, Australia
- Translational Neuroscience Facility, School of Medical Sciences, UNSW Sydney, Kensington, NSW 2052, Australia
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Choi Deblieck
- Antwerp Management School, University of Antwerp, Boogkeers 5, 2000 Antwerp, Belgium
| | - Bruno Burlando
- Department of Pharmacy, DIFAR, University of Genova, Viale Benedetto XV, 3, 16132 Genova, Italy
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Li YT, Jiang Q, Jia Y, Zhang YF, Xiao YY, Wang H, Zhao YY, Jiao J. A Chinese version of the revised Fibromyalgia Impact Questionnaire: A validation study. Int J Rheum Dis 2023; 26:242-249. [PMID: 36261882 DOI: 10.1111/1756-185x.14472] [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: 04/11/2022] [Revised: 08/22/2022] [Accepted: 10/05/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The revised Fibromyalgia Impact Questionnaire (FIQR) was developed to measure the quality of life of patients with fibromyalgia in randomized controlled trials and routine care. The purpose of this study was to translate and adapt the FIQR from English to Chinese, and to examine the validity and reliability of the Chinese version of the FIQR (CFIQR). METHODS Following the translation of the FIQR, fibromyalgia patients from 6 centers were recruited and completed the CFIQR, the validated Chinese version of the Medical Outcome Study Short Form 36 Health Survey (SF-36) and the Beck Depression Inventory (BDI). In this study, Cronbach's alpha coefficient, test-retest reliability and item total correlation were used for evaluating external and internal reliability; and criterion and structural validity were evaluated. RESULTS A total of 200 fibromyalgia patients completed the study. The internal consistency was excellent (Cronbach's alpha .90, .88, .88 and .93 for function, overall impact, symptoms scales and total score, respectively; item-total correlations from .25 to .83.) Test-retest reliability levels of the CFIQR total and subscale scores were strong correlation (intraclass correlation coefficient >0.75). Furthermore, there were significant correlations between the 3 subscale and the total score of the CFIQR and the SF-36, as well as the CFIQR and the BDI, by criterion validity (P < .01). Confirmatory factor analysis gave an acceptable value for structural validity according to the 3-factor structures of function, overall impact and symptoms. CONCLUSIONS The CFIQR is a valid and reliable instrument for both clinical practice and research purposes with Chinese speakers globally. [ClinicalTrials.gov: NCT03381131].
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Affiliation(s)
- Yan-Ting Li
- Rheumatology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Quan Jiang
- Rheumatology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuan Jia
- Department of Rheumatology and Immunology, Peking University People's Hospital & Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis, Beijing, China
| | - Yong-Feng Zhang
- Department of Rheumatology and Clinical Immunology, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Yu-Ya Xiao
- Rheumatology Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Hui Wang
- Department of Rheumatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ya-Yun Zhao
- Rheumatology Department, Hebei Hospital of Traditional Chinese Medicine, Hebei, China
| | - Juan Jiao
- Rheumatology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Casas-Barragán A, García-Ríos MC, Rus A, Tapia-Haro RM, Correa-Rodríguez M, Aguilar-Ferrándiz ME. Associations among serum VEGF and CGRP levels with the peripheral vascular blood flow of the skin of the hands in women with Fibromyalgia. J Therm Biol 2023; 112:103469. [PMID: 36796914 DOI: 10.1016/j.jtherbio.2023.103469] [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: 08/13/2022] [Revised: 12/23/2022] [Accepted: 12/23/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is a long-term condition of unknown physiopathology, whose hallmark symptoms are diffuse musculoskeletal chronic pain and fatigue. OBJECTIVES We aimed to analyze the associations among serum vascular endothelial growth factor (VEGF) and calcitonin gene-related peptide (CGRP) levels with the peripheral temperature of the skin of both hands and the core body temperature in patients with FM and healthy controls. METHODS We conducted a case-control observational study with fifty-three women diagnosed with FM and twenty-four healthy women. VEGF and CGRP levels were spectrophotometrically analyzed in serum by enzyme-linked immunosorbent assay. We used an infrared thermography camera to assess the peripheral temperature of the skin of the dorsal thumb, index, middle, ring, and pinkie fingertips and dorsal centre as well as the palm thumb, index, middle, ring, and pinkie fingertips, palm centre and thenar and hypothenar eminences of both hands and an infrared thermographic scanner to record the tympanic membrane and axillary temperature. RESULTS Linear regression analysis adjusting for age, menopause status, and body mass index showed that serum VEGF levels were positively associated with the maximum (β = 65.942, 95% CI [4.100,127.784], p = 0.037), minimum (β = 59.216, 95% CI [1.455,116.976], p = 0.045), and mean (β = 66.923, 95% CI [3.142,130.705], p = 0.040) temperature of the thenar eminence of the non-dominant hand, as well as with the maximum temperature of the hypothenar eminence of the non-dominant hand (β = 63.607, 95% CI [3.468,123.747], p = 0.039) in women diagnosed with FM. CONCLUSIONS Mild associations were observed between serum VEGF levels and the peripheral temperature of the skin in hand areas in patients with FM; therefore, it is not possible to establish a clear relationship between this vasoactive molecule and vasodilation of the hands in these patients.
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Affiliation(s)
- Antonio Casas-Barragán
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - María Carmen García-Ríos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Alma Rus
- Department of Cell Biology, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Rosa María Tapia-Haro
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - María Encarnación Aguilar-Ferrándiz
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
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Effectiveness of aquatic therapy on sleep in persons with fibromyalgia. A meta-analysis. Sleep Med 2023; 102:76-83. [PMID: 36603514 DOI: 10.1016/j.sleep.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
CONTEXT Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition characterized by persistent, widespread pain, myofascial tenderness, negative affect, fatigue, memory problems and sleep disturbances. OBJECTIVE To summarize the evidence of the effects of aquatic therapy on sleep quality in patients with FMS. METHODS This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2020 (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO), whit the registration number CRD42021249982. Cochrane library, Medline (PubMed), Science Direct Web of Science (WOS), Scopus, and PEDro were searched from inception until September 2021. The search included only randomized clinical trials. RESULTS Of the 7711 studies identified in the initial search, a total of 7 trials (361 participants) satisfied the eligibility criteria. Finally, a meta-analysis was conducted with 6 studies (311 participants). The overall pooled effect favored aquatic therapy interventions in improving sleep quality in patients with FMS (pooled MD, -2.05; 95% CI, -4.35 to 0.25). CONCLUSIONS The results of this systematic review and meta-analysis provide evidence that aquatic therapy improved sleep quality in patients with FMS. This study highlights the importance of aquatic therapy for sleep. Nonetheless, although an aquatic therapy intervention may represent a good option to improve sleep, given the low number of studies the evidence should be taken with caution.
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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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Calcitonin Gene-Related Peptide, Vascular Endothelial Growth Factor, and Clinical Manifestations in Women With Fibromyalgia. Nurs Res 2023; 72:E1-E7. [PMID: 36075921 DOI: 10.1097/nnr.0000000000000622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Fibromyalgia is a complex illness to diagnose and treat, which significantly impairs patients' quality of life. OBJECTIVES The study aims were to compare levels of calcitonin gene-related peptide and vascular endothelial growth factor between patients with fibromyalgia and healthy controls and to examine their relationship with the main clinical manifestations of fibromyalgia. METHODS This case-control study included 42 women diagnosed with fibromyalgia and 22 healthy women. Serum calcitonin gene-related peptide and vascular endothelial growth factor levels were spectrophotometrically analyzed by enzyme-linked immunosorbent assay. Clinical manifestations were assessed by means of self-administered questionnaires, including functional capacity in daily living activities, musculoskeletal pain, fatigue, anxiety, and sleep quality. The predictive value of these parameters in fibromyalgia was determined by receiver operating characteristic curve analysis. RESULTS Serum calcitonin gene-related peptide levels significantly increased in the fibromyalgia group in comparison to the control group. However, there were no significant differences in vascular endothelial growth factor levels between patients and controls. No significant correlations were found between calcitonin gene-related peptide and vascular endothelial growth factor and the symptoms analyzed. DISCUSSION Serum calcitonin gene-related peptide levels were dysregulated in women with fibromyalgia and may be a reliable parameter to help diagnose this complex syndrome.
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Bains A, Kohrman S, Punko D, Fricchione G. A Link Between Inflammatory Mechanisms and Fibromyalgia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:357-378. [PMID: 36949318 DOI: 10.1007/978-981-19-7376-5_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Fibromyalgia (FM) is a condition characterized by chronic widespread pain, which has traditionally been considered psychogenic in nature due to lack of known underlying organic pathophysiology. In more recent years, inflammation of the nervous system has become increasingly recognized as a sign of neuropsychiatric conditions, and this association may enhance our knowledge of conditions such as FM. Emerging evidence has suggested inflammation, particularly neuroinflammation, as a potential contributor underlying the etiology of FM. Studies have searched for linked biomarkers with mixed results, though the literature is beginning to point to increased systemic levels of pro-inflammatory cytokines such as IL-6 and IL-8 in patients with FM relative to healthy controls. A multicenter imaging study has also reported results suggestive of microglial activation related to the presence of FM. Given the consistency in neuroinflammatory effects implicated in "sickness behavior" characteristic of chronic systemic inflammatory conditions such as cancer or rheumatic diseases, therein springs the hypothesis for a connection between FM and neuroinflammation as discussed in this chapter.
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Affiliation(s)
- Ashika Bains
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Avery Weisman Psychiatry Consultation Service, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Samuel Kohrman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Avery Weisman Psychiatry Consultation Service, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Diana Punko
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Avery Weisman Psychiatry Consultation Service, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Gregory Fricchione
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Avery Weisman Psychiatry Consultation Service, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Benson-Henry Institute for Mind Body Medicine, Boston, MA, USA.
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An Investigation of the Association between 3D Spinal Alignment and Fibromyalgia. J Clin Med 2022; 12:jcm12010218. [PMID: 36615020 PMCID: PMC9821294 DOI: 10.3390/jcm12010218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/05/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a common condition lacking strong diagnostic criteria; these criteria continue to evolve as more and more studies are performed to explore it. This investigation sought to identify whether participants with FMS have more frequent and larger postural/spinal displacements in comparison to a matched control group without the condition of FMS. A total of 67 adults (55 females) out of 380 participants with FMS were recruited. Participants with FMS were sex- and age-matched with 67 asymptomatic participants (controls) without FMS. We used a three-dimensional (3D) postural assessment device (Formetric system) to analyze five posture variables in each participant in both groups: (1) thoracic kyphotic angle, (2) trunk imbalance, (3) trunk inclination, (4) lumbar lordotic angle, and (5) vertebral rotation. In order to determine whether 3D postural measures could predict the likelihood of a participant having FMS, we applied the matched-pairs binary logistic regression analysis. The 3D posture measures identified statistically and clinically significant differences between the FMS and control groups for each of the five posture variables measured (p < 0.001). For three out of five posture measurements assessed, the binary logistic regression identified there was an increased probability of having FMS with an increased: (1) thoracic kyphotic angle proportional odds ratio [Prop OR] = 1.76 (95% CI = 1.03, 3.02); (2) sagittal imbalance Prop OR = 1.54 (95% CI = 0.973, 2.459); and (3) surface rotation Prop OR = 7.9 (95% CI = 1.494, 41.97). We identified no significant probability of having FMS for the following two postural measurements: (1) coronal balance (p = 0.50) and (2) lumbar lordotic angle (p = 0.10). Our study’s findings suggest there is a strong relationship between 3D spinal misalignment and the diagnosis of FMS. In fact, our results support that thoracic kyphotic angle, sagittal imbalance, and surface rotation are predictors of having FMS.
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Piras C, Pibiri M, Conte S, Ferranti G, Leoni VP, Liggi S, Spada M, Muntoni S, Caboni P, Atzori L. Metabolomics analysis of plasma samples of patients with fibromyalgia and electromagnetic sensitivity using GC-MS technique. Sci Rep 2022; 12:21923. [PMID: 36535959 PMCID: PMC9763344 DOI: 10.1038/s41598-022-25588-2] [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: 07/23/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Fibromyalgia (FM) is a chronic and systemic condition that causes widespread chronic pain, asthenia, and muscle stiffness, as well as in some cases depression, anxiety, and disorders of the autonomic system. The exact causes that lead to the development of FM are still unknown today. In a percentage of individuals, the symptoms of FM are often triggered and/or exacerbated by proximity to electrical and electromagnetic devices. Plasma metabolomic profile of 54 patients with fibromyalgia and self-reported electromagnetic sensitivity (IEI-EMF) were compared to 23 healthy subjects using gas chromatography-mass spectrometry (GC-MS) coupled with multivariate statistical analysis techniques. Before the GC-MS analysis the plasma samples were extracted with a modified Folch method and then derivatized with methoxamine hydrochloride in pyridine solution and N-trimethylsilyltrifuoroacetamide. The combined analysis allowed to identify a metabolomic profile able of distinguishing IEI-EMF patients and healthy subjects. IEI-EMF patients were therefore characterized by the alteration of 19 metabolites involved in different metabolic pathways such as energy metabolism, muscle, and pathways related to oxidative stress defense and chronic pain. The results obtained in this study complete the metabolomic "picture" previously investigated on the same cohort of IEI-EMF patients with 1H-NMR spectroscopy, placing a further piece for better understanding the pathophysiological mechanisms in patients with IEI-EMF.
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Affiliation(s)
- Cristina Piras
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, Blocco A, Cittadella Universitaria, Monserrato, CA Italy
| | - Monica Pibiri
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, Blocco A, Cittadella Universitaria, Monserrato, CA Italy
| | - Stella Conte
- grid.7763.50000 0004 1755 3242Department of Education, Psychology and Philosophy, University of Cagliari, Cagliari, Italy
| | - Gabriella Ferranti
- grid.7763.50000 0004 1755 3242Department of Education, Psychology and Philosophy, University of Cagliari, Cagliari, Italy
| | - Vera Piera Leoni
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, Blocco A, Cittadella Universitaria, Monserrato, CA Italy
| | - Sonia Liggi
- grid.7445.20000 0001 2113 8111Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Martina Spada
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, Blocco A, Cittadella Universitaria, Monserrato, CA Italy
| | - Sandro Muntoni
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, Blocco A, Cittadella Universitaria, Monserrato, CA Italy
| | - Pierluigi Caboni
- grid.7763.50000 0004 1755 3242Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Luigi Atzori
- grid.7763.50000 0004 1755 3242Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, Blocco A, Cittadella Universitaria, Monserrato, CA Italy
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Althobaiti NK, Amin BA, Alhamyani AD, Alzahrani SM, Alamri AM, Alhomayani FKH. Prevalence of Fibromyalgia Syndrome in Taif City, Saudi Arabia. Cureus 2022; 14:e32489. [DOI: 10.7759/cureus.32489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
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Gardoki-Souto I, Redolar-Ripoll D, Fontana M, Hogg B, Castro MJ, Blanch JM, Ojeda F, Solanes A, Radua J, Valiente-Gómez A, Cirici R, Pérez V, Amann BL, Moreno-Alcázar A. Prevalence and Characterization of Psychological Trauma in Patients with Fibromyalgia: A Cross-Sectional Study. Pain Res Manag 2022; 2022:2114451. [PMID: 36504759 PMCID: PMC9729049 DOI: 10.1155/2022/2114451] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/22/2022] [Accepted: 10/26/2022] [Indexed: 12/05/2022]
Abstract
Background Preliminary evidence suggests that psychological trauma, especially childhood trauma, is a risk factor for the onset of fibromyalgia (FM). Objective The main objective of this study consisted of evaluating the prevalence and detailed characteristics of psychological trauma in a sample of patients with FM, the chronology of trauma across the lifespan, and its clinical symptoms. We also calculated whether childhood trauma could predict the relationship with different clinical variables. Method Eighty-eight females underwent an interview to assess sociodemographic data, psychiatric comorbidities, level of pain, FM impact, clinical symptoms of anxiety, depression, insomnia, quality of life, and psychological trauma. Results The majority of participants (71.5%) met the diagnostic criteria for current post-traumatic stress disorder (PTSD). Participants reported having suffered traumatic events throughout their lifespan, especially in childhood and early adolescence, in the form of emotional abuse, emotional neglect, sexual abuse, and physical abuse. Traumatic events predict both poor quality of life and a level of pain in adulthood. All patients showed clinically relevant levels of anxiety, depression, insomnia, suicidal thoughts, and pain, as well as somatic comorbidities and poor quality of life. Pain levels predicted anxiety, depression, dissociation, and insomnia symptoms. 84% of the sample suffered one or more traumatic events prior to the onset of pain. Conclusions Our data highlight the clinical complexity of patients with FM and the role of childhood trauma in the onset and maintenance of FM, as well as the high comorbidity between anxiety, depression, somatic symptoms, and FM. Our data also supports FM patients experiencing further retraumatization as they age, with an extremely high prevalence of current PTSD in our sample. These findings underscore the need for multidisciplinary programs for FM patients to address their physical pain and their psychiatric and somatic conditions, pay special attention to the assessment of psychological trauma, and provide trauma-focused interventions. Trial registration: ClinicalTrials.gov NCT04476316. Registered on July 20th, 2020.
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Affiliation(s)
- Itxaso Gardoki-Souto
- Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous Universtiy of Barcelona (UAB), Barcelona, Spain
| | - Diego Redolar-Ripoll
- Cognitive NeuroLab, Open University of Catalonia (UOC), Barcelona, Spain
- Neuromodulation Unit, Brain 360 Institute, Barcelona, Spain
| | - Marta Fontana
- Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
| | - Bridget Hogg
- Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous Universtiy of Barcelona (UAB), Barcelona, Spain
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | | | - Josep M. Blanch
- Rheumatology Service, Parc de Salut Mar (PSMAR), Barcelona, Spain
| | - Fabiola Ojeda
- Rheumatology Service, Parc de Salut Mar (PSMAR), Barcelona, Spain
| | - Aleix Solanes
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Joaquim Radua
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Karolinska Institute (KI), Stockholm, Sweden
- King's College London, London, UK
| | - Alicia Valiente-Gómez
- Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Roser Cirici
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Víctor Pérez
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Benedikt L. Amann
- Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Hospital, Munich, Germany
| | - Ana Moreno-Alcázar
- Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
- ISOMAE Institute of Neurosciences and Psychosomatic Psychology, Sant Cugat Del Vallés, Barcelona, Spain
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Gyorfi M, Rupp A, Abd-Elsayed A. Fibromyalgia Pathophysiology. Biomedicines 2022; 10:3070. [PMID: 36551826 PMCID: PMC9776089 DOI: 10.3390/biomedicines10123070] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022] Open
Abstract
This article examines the biological, genetic, and environmental aspects of fibromyalgia that may have an impact on its pathogenesis. Symptoms of fibromyalgia may be related to aberrations in the endogenous inhibition of pain as well as changes in the central processing of sensory input. Genetic research has revealed familial aggregation of fibromyalgia and other related disorders like major depressive disorder. Dysfunctional pain processing may also be influenced by exposure to physical or psychological stressors, abnormal biologic reactions in the autonomic nervous system, and neuroendocrine responses. With more research the pathophysiology of fibromyalgia will be better understood, leading to more logical and focused treatment options for fibromyalgia patients.
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Affiliation(s)
- Michael Gyorfi
- Department of Anesthesia, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
| | - Adam Rupp
- Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesia, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
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Fibromyalgia in women: association of inflammatory plasma proteins, muscle blood flow, and metabolism with body mass index and pain characteristics. Pain Rep 2022; 7:e1042. [PMID: 36213597 PMCID: PMC9534367 DOI: 10.1097/pr9.0000000000001042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Metabolism and inflammation interact in fibromyalgia with obesity that can lead to chronic low-grade inflammation. Introduction: Obesity is a common comorbidity in fibromyalgia (FM). Both FM and obesity have been connected to low-grade inflammation, although it is possible that previously reported inflammatory alterations in FM primarily may be linked to increased body mass index (BMI). Objective: This study aimed to investigate whether the inflammatory plasma protein profile, muscle blood flow, and metabolism and pain characteristics (clinical parameters and patient-reported outcome measurements) differed between female patients with FM with and without obesity. Methods: Patients with FM underwent clinical examinations, physical tests, and answered questionnaires. They were dichotomized according to BMI (<30 kg/m2 [n = 14]; ≥30 kg/m2 [n = 13]). Blood samples were collected and analyzed using a panel of 71 inflammatory plasma proteins. Results: There were significant (P < 0.05) differences in blood pressure, pulse, max VO2, pain intensity, physical capacity, and Fibromyalgia Impact Questionnaire between the groups; the obese group had higher blood pressure, pulse, pain intensity, and Fibromyalgia Impact Questionnaire. There were 14 proteins that contributed to the group belonging. The 4 most important proteins for the group discrimination were MIP1β, MCP4, IL1RA, and IL6, which showed higher concentrations in obese patients with FM. Significantly decreased blood flow and increased concentration of pyruvate were detected in obese patients compared with nonobese patients. There was significant correlation between inflammatory proteins and sedentary behavior and health status in obese patients with FM. Conclusions: These findings suggest that metabolism and inflammation interact in female patients with FM with obesity and might cause chronic low-grade inflammation. Screening for obesity and monitoring of BMI changes should be considered in the treatment of patients with FM.
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Shomer L, Roll SC. Lifestyle Redesign® Intervention for Psychological Well-Being and Function in People With Fibromyalgia: A Retrospective Cohort Study. Am J Occup Ther 2022; 76:23976. [PMID: 36485013 DOI: 10.5014/ajot.2022.049243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Fibromyalgia is a complex chronic pain condition for which effective nonpharmacological treatment interventions are lacking. OBJECTIVE To explore the effects of an occupational therapy intervention for fibromyalgia on client-reported outcomes of pain interference, self-efficacy, mood, and function. DESIGN Retrospective cohort study using a chart review method. SETTING Outpatient clinic. PARTICIPANTS Twenty-one adults with fibromyalgia (M age = 54 yr). INTERVENTION A 10-wk occupational therapy group intervention using a Lifestyle Redesign® (LRD) approach. OUTCOMES AND MEASURES The Brief Pain Inventory, Pain Self-Efficacy Scale, Beck Depression Inventory (BDI), and the Fibromyalgia Impact Questionnaire (FIQ) or the Revised Fibromyalgia Impact Questionnaire were administered at the first and last sessions of the program. RESULTS Between 2015 and 2018, 37 clients entered the program, and 21 completed it. Changes in group averages exceeded the minimal clinically important difference for the BDI and the FIQ. Eighty-one percent of clients who completed the program had a clinically significant improvement on one or more of the outcome measures. CONCLUSIONS AND RELEVANCE The findings demonstrate the potential benefit of occupational therapy as a complementary approach to pharmacological treatment for people with fibromyalgia. Preliminary evidence suggests that a 10-wk occupational therapy group intervention using an LRD approach may reduce symptoms of depression and decrease the impact on daily function for people with fibromyalgia. What This Article Adds: Occupational therapy should be considered as a nonpharmacological intervention for adults with fibromyalgia to improve psychological well-being and function.
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Affiliation(s)
- Lindsey Shomer
- Lindsey Shomer, OTD, OTR/L, CEAS, is Associate Professor of Clinical Occupational Therapy, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Shawn C Roll
- Shawn C. Roll, PhD, OTR/L, RMSKS, FAOTA, FAIUM, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Online Questionnaire with Fibromyalgia Patients Reveals Correlations among Type of Pain, Psychological Alterations, and Effectiveness of Non-Pharmacological Therapies. Healthcare (Basel) 2022; 10:healthcare10101975. [PMID: 36292422 PMCID: PMC9602604 DOI: 10.3390/healthcare10101975] [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: 08/25/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/04/2022] Open
Abstract
Fibromyalgia (FM) is a chronic pain syndrome with an unclear etiology. In addition to pain, FM patients suffer from a diverse array of symptoms and comorbidities, encompassing fatigue, cognitive dysfunction, mood disorders, sleep deprivation, and dizziness. Due to the complexity of FM, the diagnosis and treatment of it are highly challenging. The aim of the present work was to investigate some clinical and psychological characteristics of FM patients, and to uncover possible correlations with pharmacological and non-pharmacological therapies. We conducted a cross-sectional, questionnaire-based study aimed at evaluating pain, psychological traits, and the self-perceived effectiveness of pharmacological and non-pharmacological treatments in an Italian population of FM patients. Descriptive statistics, correlation, and inference analyses were performed. We found a prevalence of a neuropathic/nociplastic type of pain, which correlated with psychological traits such as anxiety, low mood, psychophysical discomfort, and the inability to relax. The pain type and psychological traits proved to play a role in determining the self-perceived effectiveness of therapeutic interventions. Patients revealed a better response to non-pharmacological therapies, particularly dietary interventions, relaxation techniques, and psychotherapy rather than pharmacological interventions. The sum of our data indicates that for better outcomes, the type of pain and psychological traits should be considered for tailor-made treatments considering non-pharmacological protocols as a complement to the use of drugs.
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