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Elkholy NS, Mohammed HS, Shafaa MW. Assessment of the therapeutic potential of lutein and beta-carotene nanodispersions in a rat model of fibromyalgia. Sci Rep 2023; 13:19712. [PMID: 37953299 PMCID: PMC10641082 DOI: 10.1038/s41598-023-46980-6] [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: 08/04/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023] Open
Abstract
Fibromyalgia (FM) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and cognitive impairment. Despite the availability of various treatment options, FM remains a challenging condition to manage. In the present study, we investigated the efficacy of formulated nanodispersions of lutein and beta-carotene in treating FM-related symptoms induced by reserpine in female Wistar rats. Several techniques have been implemented to assess this efficacy at various levels, including biochemical, bioelectrical, and behavioral. Namely, oxidative stress markers, monoamine levels, electrocorticography, pain threshold test, and open field test were conducted on control, FM-induced, and FM-treated groups of animals. Our results provided compelling evidence for the efficacy of carotenoid nanodispersions in treating FM-related symptoms. Specifically, we found that the dual action of the nanodispersion, as both antioxidant and antidepressant, accounted for their beneficial effects in treating FM. With further investigation, nano-carotenoids and particularly nano-lutein could potentially become an effective alternative treatment for patients with FM who do not respond to current treatment options.
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Affiliation(s)
- Nourhan S Elkholy
- Medical Biophysics Division, Physics Department, Faculty of Science, Helwan University, Cairo, Egypt
- Nawah Scientific Co., Cairo, Egypt
| | - Haitham S Mohammed
- Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt.
| | - Medhat W Shafaa
- Medical Biophysics Division, Physics Department, Faculty of Science, Helwan University, Cairo, Egypt
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2
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Nutraceuticals: A source of benefaction for neuropathic pain and fibromyalgia. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
Background:Burning mouth syndrome (BMS) is a chronic and debilitating oral pain of the normal oral mucosa. It mainly affects women in their fifth to seventh decade. Its aetiopathogenesis remains unclear and is probably of multifactorial origin, with increasing evidence that BMS may be a neuropathic disorder. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The diagnosis of BMS, having excluded ‘oral burning mouth symptoms’, has evolved from basic intraoral exclusion screening to extensive clinical and laboratory investigations, which include the screening of comorbidities and other chronic pains and somatosensory testing. There is no standardised treatment in managing BMS, but a proposed combination of supportive and pharmacological treatment has been recommended.Aim:To review the current concepts of BMS definitions, classifications, aetiopathogenesis, diagnosis techniques, and evidence-based treatments in managing BMS patients.Conclusion:As BMS is a diagnosis by exclusion, thus a stratified approach is required for assessment of patients presenting BMS. A BMS diagnosis protocol is desired using a standardised screening to distinguish BMS from patient’s presenting with ‘oral burning symptoms’, and evaluation of comorbid chronic pain disorders or other medical comorbidities, which will include haematological, fungal, salivary flow, and qualitative sensory testing. Axis II and other additional quantitative sensory testing may further elucidate the causes of this condition. For future BMS prediction and prevention, will be based upon research on the relationship between other chronic pain disorders and familial history, environmental and genetic information.
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Affiliation(s)
- Huann Lan Tan
- King’s College London, London, UK
- Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Tara Renton
- Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
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Li JH, Yang JL, Wei SQ, Li ZL, Collins AA, Zou M, Wei F, Cao DY. Contribution of central sensitization to stress-induced spreading hyperalgesia in rats with orofacial inflammation. Mol Brain 2020; 13:106. [PMID: 32723345 PMCID: PMC7385893 DOI: 10.1186/s13041-020-00645-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/15/2020] [Indexed: 12/15/2022] Open
Abstract
Temporomandibular disorder (TMD) is commonly comorbid with fibromyalgia syndrome (FMS). The incidence of these pain conditions is prevalent in women and prone to mental stress. Chronic pain symptoms in patients with FMS and myofascial TMD (mTMD) are severe and debilitating. In the present study, we developed a new animal model to mimic the comorbidity of TMD and FMS. In ovariectomized female rats, repeated forced swim (FS) stress induced mechanical allodynia and thermal hyperalgesia in the hindpaws of the 17β-estradiol (E2) treated rats with orofacial inflammation. Subcutaneous injection of E2, injection of complete Freund’s adjuvant (CFA) into masseter muscles or FS alone did not induce somatic hyperalgesia. We also found that the somatic hyperalgesia was accompanied by upregulation of GluN1 receptor and serotonin (5-hydroxytryptamine, 5-HT)3A receptor expression in the dorsal horn of spinal cord at L4-L5 segments. Intrathecal injection of N-methyl-D-aspartic acid receptor (NMDAR) antagonist 2-amino-5-phosphonovaleric acid (APV) or 5-HT3 receptor antagonist Y-25130 blocked stress-induced wide-spreading hyperalgesia. These results suggest that NMDAR-dependent central sensitization in the spinal dorsal horn and 5-HT-dependent descending facilitation contribute to the development of wide-spreading hyperalgesia in this comorbid pain model.
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Affiliation(s)
- Jia-Heng Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China.,Department of Orthodontics, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China.,Department of Neural and Pain Sciences, University of Maryland School of Dentistry; the UM Center to Advance Chronic Pain Research, 650 West Baltimore Street, Baltimore, MD, 21201, USA
| | - Jia-Le Yang
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry; the UM Center to Advance Chronic Pain Research, 650 West Baltimore Street, Baltimore, MD, 21201, USA
| | - Si-Qi Wei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Zhuo-Lin Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Anna A Collins
- Department of Orthodontics, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Min Zou
- Department of Orthodontics, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Feng Wei
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry; the UM Center to Advance Chronic Pain Research, 650 West Baltimore Street, Baltimore, MD, 21201, USA.
| | - Dong-Yuan Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, People's Republic of China.
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Walzer M, Marek GJ, Wu R, Nagata M, Han D. Single- and Multiple-Dose Safety, Tolerability, and Pharmacokinetic Profiles of ASP8062: Results From 2 Phase 1 Studies. Clin Pharmacol Drug Dev 2020; 9:297-306. [PMID: 31926000 DOI: 10.1002/cpdd.766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 11/19/2019] [Indexed: 12/29/2022]
Abstract
ASP8062 is an orally active γ-amino-butyric acid type B (GABAB ) receptor positive allosteric modulator currently in phase 2 development. Safety and pharmacokinetic (PK) profiles of ASP8062 were evaluated in 2 studies in healthy subjects. The first study (a first-in-human study) evaluated single ascending doses (SAD) of ASP8062. The second study was composed of 2 parts: part 1 evaluated multiple ascending doses (MAD) of ASP8062 for 14 days, and part 2 was a single-dose arm to assess the PK of ASP8062 in cerebrospinal fluid (CSF). Fifty-six men (SAD) and 56 subjects (24 women and 32 men; MAD) were enrolled. Across the SAD dosing range, area under the concentration-time curve was dose proportional; increases in maximum plasma concentration appeared linear but were slightly less than dose proportional. Time to maximal concentration and half-life were 1-4 hours and ∼40-50 hours, respectively; no food effect was observed. ASP8062 PK properties at steady state were similar to those following a single dose. Steady state was achieved by ∼day 9 with ∼2-fold accumulation, and ASP8062 was detected in CSF. ASP8062 was well tolerated; no clear evidence of ASP8062's effects on safety, cognition, drug withdrawal, or suicidal ideation/behavior was observed. These data support the development of ASP8062 in indications where the GABAB receptor is a target.
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Affiliation(s)
- Mark Walzer
- Astellas Pharma Global Development, Northbrook, Illinois, USA
| | - Gerard J Marek
- Astellas Pharma Global Development, Northbrook, Illinois, USA
| | - Ruishan Wu
- Astellas Pharma Global Development, Northbrook, Illinois, USA
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Karlsson B, Burell G, Kristiansson P, Björkegren K, Nyberg F, Svärdsudd K. Decline of substance P levels after stress management with cognitive behaviour therapy in women with the fibromyalgia syndrome. Scand J Pain 2019; 19:473-482. [DOI: 10.1515/sjpain-2018-0324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/22/2019] [Indexed: 12/25/2022]
Abstract
Abstract
Background and aims
Substance P (CSF-SP) is known to be elevated in females with fibromyalgia syndrome (FMS). The aims of this study were to evaluate the effect of cognitive behaviour therapy (CBT) on plasma SP levels in women with FMS and to find possible clinical behavioural correlates to plasma SP level changes.
Methods
Forty-eight women with FMS were randomly allocated into two groups. Group 1 received the CBT treatment intervention over the course of 6 months while group 2 was waitlisted. CBT was given with a protocol developed to diminish stress and pain. After 6 months, group 2 was given the same CBT treatment as well. All were followed up 1 year after the start of CBT treatment. This approach allowed for two analytical designs – a randomised controlled trial (RCT) (n=24 vs. n=24) and a before-and-after treatment design (n=48). All women were repeatedly evaluated by the West Haven-Yale Multidimensional Pain Inventory (MPI) and three other psychometric questionnaires and plasma SP was analysed.
Results
In the RCT design, the plasma SP level was 8.79 fmol/mL in both groups at the start of the trial, after adjustment for initial differences. At the end of the RCT, the plasma SP level was 5.25 fmol/mL in the CBT intervention group compared to 8.39 fmol/mL in the control group (p=0.02). In the before-and-after design, the plasma SP was reduced by 33% (p<0.01) after CBT, but returned to the pre-treatment level at follow-up 1 year after the start of CBT treatment. Plasma SP was associated with the MPI dimensions experienced “support from spouses or significant others” and “life control”.
Conclusions
Plasma SP might be a marker of the effect of CBT in FMS associated with better coping strategies and reduced stress rather than a biochemical marker of pain.
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Affiliation(s)
- Bo Karlsson
- Department of Public Health and Caring Sciences , Uppsala University , Uppsala SE-751 22 , Sweden
| | - Gunilla Burell
- Department of Public Health and Caring Sciences , Uppsala University , Uppsala SE-751 22 , Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences , Uppsala University , Uppsala SE-751 22 , Sweden
| | - Karin Björkegren
- Department of Public Health and Caring Sciences , Uppsala University , Uppsala SE-751 22 , Sweden
| | - Fred Nyberg
- Department of Pharmaceutical Biosciences , Uppsala University , Uppsala SE-751 22 , Sweden
| | - Kurt Svärdsudd
- Department of Public Health and Caring Sciences , Uppsala University , Uppsala SE-751 22 , Sweden
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7
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Ciregia F, Giacomelli C, Giusti L, Boldrini C, Piga I, Pepe P, Consensi A, Gori S, Lucacchini A, Mazzoni MR, Bazzichi L. Putative salivary biomarkers useful to differentiate patients with fibromyalgia. J Proteomics 2018; 190:44-54. [PMID: 29654921 DOI: 10.1016/j.jprot.2018.04.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/13/2018] [Accepted: 04/05/2018] [Indexed: 12/17/2022]
Abstract
Fibromyalgia (FM) is a chronic pain disorder characterized by widespread pain and associated with unspecific symptoms. So far, no laboratory tests have been validated. The aim of the present study was to investigate the presence in saliva of potential diagnostic and/or prognostic biomarkers which could be useful for the management of FM patients. Specifically, the salivary profile of FM patients was compared with those of healthy subjects, subjects suffering migraine (model of non-inflammatory chronic pain), and patients affected by rheumatoid arthritis (model of inflammatory chronic pain). For proteomics analysis 2-DE and SELDI-TOF-MS were applied. From 2-DE serotransferrin and alpha-enolase were found differentially expressed in FM. Hence, their expression was validated by ELISA together with phosphoglycerate-mutase-I and transaldolase, which were found in a previous work. Moreover, ROC curve was calculated by comparing FM patients versus control subjects (healthy plus migraine) to investigate the discriminative power of biomarkers. The best performance was obtained by combining alpha-enolase, phosphoglycerate-mutase-I and serotransferrin. On the other hand, none of the candidate proteins showed a statistical correlation with clinical features. Finally, preliminary SELDI analysis highlighted two peaks whose identification need to be validated. Overall, these results could be useful in supporting the clinical diagnosis of FM. SIGNIFICANCE: FM is one of the most common chronic pain condition which is associated with significant disability. The fibromyalgic pain is a peculiar characteristic of this disease and FM patients suffer from reduced quality of life, daily functioning and productivity. Considering the deep complexity of FM, the discovery of more objective markers is crucial for supporting clinical diagnosis. Therefore, the aim of the present study was the selection of biomarkers effectively associated with fibromyalgic pain which will enable clinicians to achieve an unambiguous diagnosis, and to improve approaches to patients' management. We defined a panel of 3 salivary proteins which could be one of the criteria to be taken into account. Consequently, the identification of disease salivary biomarkers could be helpful in detecting FM clusters and targeted treatment. Actually, our future perspective foresees to develop a simple, rapid and not invasive point-of-care testing which will be of use during the diagnostic process. In addition, the present results can offer a clue for shedding light upon the complex entity of such a disease like FM.
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Affiliation(s)
- Federica Ciregia
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126 Pisa, Italy; Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy.
| | - Camillo Giacomelli
- Rheumatology Operative Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Laura Giusti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Claudia Boldrini
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Isabella Piga
- School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Pasquale Pepe
- Rheumatology Operative Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Arianna Consensi
- Rheumatology Operative Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Sara Gori
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | | | - Maria R Mazzoni
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Laura Bazzichi
- Rheumatology Operative Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
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Favero G, Trapletti V, Bonomini F, Stacchiotti A, Lavazza A, Rodella LF, Rezzani R. Oral Supplementation of Melatonin Protects against Fibromyalgia-Related Skeletal Muscle Alterations in Reserpine-Induced Myalgia Rats. Int J Mol Sci 2017; 18:ijms18071389. [PMID: 28661421 PMCID: PMC5535882 DOI: 10.3390/ijms18071389] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/19/2017] [Accepted: 06/27/2017] [Indexed: 12/11/2022] Open
Abstract
Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain and an extensive array of other symptoms including disordered sleep, fatigue, depression and anxiety. Important factors involved in the pathogenic process of fibromyalgia are inflammation and oxidative stress, suggesting that ant-inflammatory and/or antioxidant supplementation might be effective in the management and modulation of this syndrome. Recent evidence suggests that melatonin may be suitable for this purpose due to its well known ant-inflammatory, antioxidant and analgesic effects. Thus, in the current study, the effects of the oral supplementation of melatonin against fibromyalgia-related skeletal muscle alterations were evaluated. In detail, 90 Sprague Dawley rats were randomly treated with reserpine, to reproduce the pathogenic process of fibromyalgia and thereafter they received melatonin. The animals treated with reserpine showed moderate alterations at hind limb skeletal muscles level and had difficulty in moving, together with significant morphological and ultrastructural alterations and expression of inflammatory and oxidative stress markers in the gastrocnemius muscle. Interestingly, melatonin, dose and/or time dependently, reduced the difficulties in spontaneous motor activity and the musculoskeletal morphostructural, inflammatory, and oxidative stress alterations. This study suggests that melatonin in vivo may be an effective tool in the management of fibromyalgia-related musculoskeletal morphofunctional damage.
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Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Valentina Trapletti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Francesca Bonomini
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Alessandra Stacchiotti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Antonio Lavazza
- OIE Reference Laboratory for RHD, Istituto Zooprofilattico Sperimentale della Lombardia e Emilia Romagna, 25124 Brescia, Italy.
| | - Luigi Fabrizio Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
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Nakajima F, Aratani S, Fujita H, Nakatani K, Makita K, Nakajima T. A case of fibromyalgia involving pain throughout the body treated with site-specific targeted pain control. SPRINGERPLUS 2016; 5:1027. [PMID: 27441146 PMCID: PMC4938810 DOI: 10.1186/s40064-016-2572-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/14/2016] [Indexed: 12/02/2022]
Abstract
Introduction Fibromyalgia is characterized by chronic pain and tenderness throughout the body. Patients with fibromyalgia are treated with pharmacotherapy and many other therapies. However, because the cause of fibromyalgia is unclear, there is currently no clinically effective treatment method. Case presentation We report the case of a patient who developed fibromyalgia after left femoral neck fracture. After several caudal epidural blocks for lumbar pain, the pain throughout the body and abnormal discomfort in the laryngopharyngeal region reduced. Site-specific targeted pain control was effective in treating his pain and discomfort. Conclusion The present case suggests that treatment targeting symptoms in one part of the body might produce a systemic therapeutic effect in patients with fibromyalgia.
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Affiliation(s)
- Fukami Nakajima
- Daiichi Rehabilitation Hospital, 2-14 Kutanda Kochi-shi, Kochi, 781-0112 Japan ; Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402 Japan ; Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoko Aratani
- Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402 Japan ; Physician, Student, and Researcher Support Center, Tokyo Medical University, Tokyo, Japan
| | - Hidetoshi Fujita
- Future Medical Science Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | | | - Koshi Makita
- Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshishiro Nakajima
- Daiichi Rehabilitation Hospital, 2-14 Kutanda Kochi-shi, Kochi, 781-0112 Japan ; Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402 Japan ; Future Medical Science Institute of Medical Science, Tokyo Medical University, Tokyo, Japan ; Bayside Misato Medical Center, Kochi, Japan
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Leombruni P, Zizzi F, Miniotti M, Colonna F, Castelli L, Fusaro E, Torta R. Harm Avoidance and Self-Directedness Characterize Fibromyalgic Patients and the Symptom Severity. Front Psychol 2016; 7:579. [PMID: 27199814 PMCID: PMC4842927 DOI: 10.3389/fpsyg.2016.00579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/07/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Evidence in the literature suggests peculiar personality traits for fibromyalgic (FM) patients, and it has been suggested that personality characteristics may be involved in patients' different symptomatic events and responses to treatment. The aim of the study is to investigate the personality characteristics of Italian FM patients and to explore the possibility of clustering them considering both personality traits and clinical characteristics. DESIGN The study used a cross-sectional methodology and involved a control group. A self-assessment procedure was used for data gathering. The study included 87 female FM patients and 83 healthy females. Patients were approached and interviewed in person during a psychiatric consultation. Healthy people were recruited from general practices with previous telephone contact. MAIN OUTCOME MEASURES Participants responded to the Hospital Anxiety and Depression Scale, the Temperament and Character Inventory, the Fibromyalgia Impact Questionnaire and the Short-Form-36 Health Survey. RESULTS FM patients scored significantly different from healthy participants on the Harm avoidance (HA), Novelty seeking (NS) and Self-directedness (SD). Two clusters were identified: patients in Cluster1 (n = 37) had higher scores on HA and lower scores on RD, SD, and Cooperativeness and reported more serious fibromyalgia and more severe anxious-depressive symptomatology than did patients in Cluster2 (n = 46). CONCLUSION This study confirms the presence of certain personality traits in the FM population. In particular, high levels of HA and low levels of SD characterize a subgroup of FM patients with more severe anxious-depressive symptomatology. According to these findings, personality assessment could be useful in the diagnostic process to tailor therapeutic interventions to the personality characteristics.
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Affiliation(s)
- Paolo Leombruni
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Francesca Zizzi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Marco Miniotti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Fabrizio Colonna
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Azienda Ospedaliero-Universitaria Cittá della Salute e della Scienza di Torino Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
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11
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Nakajima F, Komoda A, Aratani S, Fujita H, Kawate M, Nakatani K, Akiyama M, Makita K, Nakajima T. Effects of xenon irradiation of the stellate ganglion region on fibromyalgia. J Phys Ther Sci 2015; 27:209-12. [PMID: 25642075 PMCID: PMC4305564 DOI: 10.1589/jpts.27.209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/03/2014] [Indexed: 12/03/2022] Open
Abstract
[Purpose] The aim of the study was to determine the effect of xenon irradiation of the
stellate ganglion region on fibromyalgia. [Subjects] The study included 5 men and 22 women
(age, 56.4 ± 16.3 years [range, 25–84 years]) who were diagnosed with fibromyalgia
according to the modified 2010 criteria of the American College of Rheumatology between
July and August 2013. [Methods] Bilateral xenon light irradiation (0.38–1.1 μm) around the
stellate ganglion was performed in the supine position by physical therapists using a
xenon phototherapy device. We evaluated pain before and after irradiation using the visual
analogue scale. [Results] We did not observe a relationship between the change in the
visual analogue scale score and duration of fibromyalgia. However, we observed a
relationship between the change in the visual analogue scale score and the score for the
Japanese version of the Fibromyalgia Impact Questionnaire using the Cochran-Armitage test
for trend. [Conclusion] Xenon light irradiation of the stellate ganglion significantly
decreased the visual analogue scale score in patients with fibromyalgia having a higher
score in the Fibromyalgia Impact Questionnaire, suggesting that a stronger effect could be
obtained in patients with more severe fibromyalgia.
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Affiliation(s)
- Fukami Nakajima
- Daiichi Rehabilitation Hospital, Japan ; Department of Anesthesiology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan ; Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, Japan ; Nishiogi Pain Clinic, Japan
| | | | - Satoko Aratani
- Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, Japan ; Future Medical Science Institute of Medical Science, Tokyo Medical University, Japan ; Integrated Genome Editing Section (iGES) Institute of Medical Science, Tokyo Medical University, Japan
| | - Hidetoshi Fujita
- Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, Japan ; Future Medical Science Institute of Medical Science, Tokyo Medical University, Japan ; Integrated Genome Editing Section (iGES) Institute of Medical Science, Tokyo Medical University, Japan
| | | | | | - Masako Akiyama
- University Research Administration Office, Tokyo Medical and Dental University, Japan
| | - Koshi Makita
- Department of Anesthesiology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Japan
| | - Toshihiro Nakajima
- Daiichi Rehabilitation Hospital, Japan ; Department of Locomotor Science, Institute of Medical Science, Tokyo Medical University, Japan ; Bayside Misato Medical Center, Japan ; Future Medical Science Institute of Medical Science, Tokyo Medical University, Japan ; Integrated Genome Editing Section (iGES) Institute of Medical Science, Tokyo Medical University, Japan
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Abstract
PURPOSE OF REVIEW Chronic pain is an important public health problem that negatively impacts quality of life of affected individuals and exacts an enormous socio-economic cost. Currently available therapeutics provide inadequate management of pain in many patients. Acute pain states generally resolve in most patients. However, for reasons that are poorly understood, in some individuals, acute pain can transform to a chronic state. Our understanding of the risk factors that underlie the development of chronic pain is limited. Recent studies have suggested an important contribution of dysfunction in descending pain modulatory circuits to pain 'chronification'. Human studies provide insights into possible endogenous and exogenous factors that may promote the conversion of pain into a chronic condition. RECENT FINDINGS Descending pain modulatory systems have been studied and characterized in animal models. Human brain imaging techniques, deep brain stimulation and the mechanisms of action of drugs that are effective in the treatment of pain confirm the clinical relevance of top-down pain modulatory circuits. Growing evidence supports the concept that chronic pain is associated with a dysregulation in descending pain modulation. Disruption of the balance of descending modulatory circuits to favour facilitation may promote and maintain chronic pain. Recent findings suggest that diminished descending inhibition is likely to be an important element in determining whether pain may become chronic. This view is consistent with the clinical success of drugs that enhance spinal noradrenergic activity, such as serotonin/norepinephrine reuptake inhibitors (SNRIs), in the treatment of chronic pain states. Consistent with this concept, a robust descending inhibitory system may be normally engaged to protect against the development of chronic pain. Imaging studies show that higher cortical and subcortical centres that govern emotional, motivational and cognitive processes communicate directly with descending pain modulatory circuits providing a mechanistic basis to explain how exogenous factors can influence the expression of chronic pain in a susceptible individual. SUMMARY Preclinical studies coupled with clinical pharmacologic and neuroimaging investigations have advanced our understanding of brain circuits that modulate pain. Descending pain facilitatory and inhibitory circuits arising ultimately in the brainstem provide mechanisms that can be engaged to promote or protect against pain 'chronification'. These systems interact with higher centres, thus providing a means through which exogenous factors can influence the risk of pain chronification. A greater understanding of the role of descending pain modulation can lead to novel therapeutic directions aimed at normalizing aberrant processes that can lead to chronic pain.
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Affiliation(s)
- Michael H Ossipov
- Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, Arizona, USA
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Chopade A, Sayyad F. Antifibromyalgic activity of standardized extracts of Phyllanthus amarus and Phyllanthus fraternus in acidic saline induced chronic muscle pain. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.biomag.2014.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ablin JN, Buskila D. Predicting fibromyalgia, a narrative review: are we better than fools and children? Eur J Pain 2014; 18:1060-6. [PMID: 24619570 DOI: 10.1002/j.1532-2149.2014.00481.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2014] [Indexed: 12/28/2022]
Abstract
Fibromyalgia syndrome (FMS) is a common and intriguing condition, manifest by chronic pain and fatigue. Although the pathogenesis of FMS is not yet completely understood, predicting the future development of FMS and chronic pain is a major challenge with great potential advantages, both from an individual as well as an epidemiological standpoint. Current knowledge indicates a genetic underpinning for FMS, and as increasing data are accumulated regarding the genetics involved, the prospect of utilizing these data for prediction becomes ever more attractive. The co-existence of FMS with multiple other functional disorders indicates that the clinical identification of such symptom constellations in a patient can alert the physician to the future development of FMS. Hypermobility syndrome is another clinical (as well as genetic) phenotype that has emerged as a risk factor for the development of FMS. Stressful events, including early life trauma, are also harbingers of the future development of FMS. Functional neuroimaging may help to elucidate the neural processes involved in central sensitization, and may ultimately also evolve into markers of predictive value. Last but not least, obesity and disturbed sleep are clinical (inter-related) features relevant for this spectrum. Future efforts will aim at integrating genetic, clinical and physiological data in the prediction of FMS and chronic pain.
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Affiliation(s)
- J N Ablin
- Institute of Rheumatology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel
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