A behavioral and brain imaging dataset with focus on emotion regulation of women with fibromyalgia

The interplay of pain, emotional regulation difficulties, and social support in individuals diagnosed with fibromyalgia: impact on depression, anxiety, functional disability, and quality of life

The purpose of this study was to evaluate the impacts of the interplay of pain, emotional regulation difficulties, and social support on depression, anxiety, functional disability, and quality of life in individuals diagnosed with fibromyalgia. This observational, descriptive study included 367 patients who met the 2016 diagnostic criteria for fibromyalgia set by the American College of Rheumatology (ACR). The demographic characteristics of all participants were recorded. Pain levels were measured using the Visual Analog Scale, emotional regulation difficulties were assessed using The Difficulties in Emotion Regulation Scale - 16 item version (DERS-16), and social support was evaluated using the Two-Way Social Support Scale (2-Way SSS). Functionality was assessed using the Revised Fibromyalgia Impact Questionnaire (FIQR), depression was measured using the Beck Depression Inventory (BDI), anxiety was evaluated using the Beck Anxiety Inventory (BAI), and quality of life was assessed using the World Health Organization Quality-of-Life Scale-Bref (WHOQOL-Bref). Depression scores were higher in the moderate and severe pain groups as determined by VAS activity scores and in the severe pain group as determined by VAS night scores. A statistically significant low positive correlation was observed between VAS night scores and both BAI scores and BDI scores. Higher WHOQoL-BREF physical health and psychological well-being scores were observed in the mild pain group as determined by VAS activity scores. A statistically significant positive correlation was found between FIQR scores and pain severity groups determined by both VAS activity and VAS night scores; between anxiety and depression levels and DERS-16 scores; between DERS-Total and FIQR-Global Impact. The relationship between pain, emotional regulation difficulties, and social support significantly influences mental health outcomes, functional disability, and quality of life in individuals diagnosed with fibromyalgia. Multidisciplinary interventions that address these interconnected factors are essential for improving the overall well-being and quality of life of individuals living with fibromyalgia.

Functional brain changes in Mexican women with fibromyalgia

Fibromyalgia (FM) is a chronic condition marked by widespread pain, fatigue, sleep problems, cognitive decline, and other symptoms. Despite extensive research, the pathophysiology of FM remains poorly understood, complicating diagnosis and treatment, which often relies on self-report questionnaires. This study explored structural and functional brain changes in women with FM, identified potential biomarkers, and examined their relationship with FM severity. MRI data from 33 female FM patients and 33 matched healthy controls were utilized, focusing on T1-weighted MRI and resting-state fMRI scans. Functional connectivity (FC) analysis was performed using a machine learning framework to differentiate FM patients from healthy controls and predict FM symptom severity. No significant differences were found in brain structural features, such as gray matter volume, white matter volume, deformation-based morphometry, and cortical thickness. However, significant differences in FC were observed between FM patients and healthy controls, particularly in the default mode network (DMN), somatomotor network (SMN), visual network (VIS), and dorsal attention network (DAN). The FC metrics were significantly associated with FM severity. Our prediction model differentiated FM patients from healthy controls with an area under the curve of 0.65. FC measures accurately estimated FM symptom severities with a significant correlation (r = 0.45, p = 0.007). Functional connections in the DMN, VIS, and DAN were crucial in determining FM severity. These findings suggest that integrating brain FC measurements could serve as valuable biomarkers for identifying FM patients from healthy individuals and predicting FM symptom severity, improving diagnostic accuracy and facilitating the development of targeted therapeutic strategies.

Efficacy and safety of transcranial direct current stimulation in the treatment of fibromyalgia: A systematic review and meta-analysis

OBJECTIVES

To update a systematic review of the efficacy and safety of transcranial direct current stimulation (tDCS) for analgesia, for antidepressant effects, and to reduce the impact of fibromyalgia (FM), looking for optimal areas of stimulation.

METHODS

We searched five databases to identify randomized controlled trials comparing active and sham tDCS for FM. The primary outcome was pain intensity, and secondary outcome measures included FM Impact Questionnaire (FIQ) and depression score. Meta-analysis was conducted using standardized mean difference (SMD). Subgroup analysis was performed to determine the effects of different regional stimulation, over the primary motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), opercular-insular cortex (OIC), and occipital nerve (ON) regions. We analyzed the minimal clinically important difference (MCID) by the value of the mean difference (MD) for an 11-point scale for pain, the Beck Depressive Inventory-II (BDI-II), and the Fibromyalgia Impact Questionnaire (FIQ) score. We described the certainty of the evidence (COE) using the tool GRADE profile.

RESULTS

Twenty studies were included in the analysis. Active tDCS had a positive effect on pain (SMD= -1.04; 95 % CI -1.38 to -0.69), depression (SMD= -0.46; 95 % CI -0.64 to -0.29), FIQ (SMD= -0.73; 95 % CI -1.09 to -0.36), COE is moderate. Only group M1 (SD=-1.57) and DLPFC (SD=-1.44) could achieve MCID for analgesia; For BDI-II, only group DLPFC (SD=-5.36) could achieve an MCID change. Adverse events were mild.

CONCLUSION

tDCS is a safe intervention that relieves pain intensity, reduces depression, and reduces the impact of FM on life. Achieving an MCID is related to the stimulation site and the target symptom.

Abnormal functional neurocircuitry underpinning emotional processing in fibromyalgia

Fibromyalgia, a condition characterized by chronic pain, is frequently accompanied by emotional disturbances. Here we aimed to study brain activation and functional connectivity (FC) during processing of emotional stimuli in fibromyalgia. Thirty female patients with fibromyalgia and 31 female healthy controls (HC) were included. Psychometric tests were administered to measure alexithymia, affective state, and severity of depressive and anxiety symptoms. Next, participants performed an emotion processing and regulation task during functional magnetic resonance imaging (fMRI). We performed a 2 × 2 ANCOVA to analyze main effects and interactions of the stimuli valence (positive or negative) and group (fibromyalgia or HC) on brain activation. Generalized psychophysiological interaction analysis was used to assess task-dependent FC of brain regions previously associated with emotion processing and fibromyalgia (i.e., hippocampus, amygdala, anterior insula, and pregenual anterior cingulate cortex [pACC]). The left superior lateral occipital cortex showed more activation in fibromyalgia during emotion processing than in HC, irrespective of valence. Moreover, we found an interaction effect (valence x group) in the FC between the left pACC and the precentral and postcentral cortex, and central operculum, and premotor cortex. These results suggest abnormal brain activation and connectivity underlying emotion processing in fibromyalgia, which could help explain the high prevalence of psychopathological symptoms in this condition.

A scoping review of the landscape of health-related open datasets in Latin America

Artificial intelligence (AI) algorithms have the potential to revolutionize healthcare, but their successful translation into clinical practice has been limited. One crucial factor is the data used to train these algorithms, which must be representative of the population. However, most healthcare databases are derived from high-income countries, leading to non-representative models and potentially exacerbating health inequities. This review focuses on the landscape of health-related open datasets in Latin America, aiming to identify existing datasets, examine data-sharing frameworks, techniques, platforms, and formats, and identify best practices in Latin America. The review found 61 datasets from 23 countries, with the DATASUS dataset from Brazil contributing to the majority of articles. The analysis revealed a dearth of datasets created by the authors themselves, indicating a reliance on existing open datasets. The findings underscore the importance of promoting open data in Latin America. We provide recommendations for enhancing data sharing in the region.

Identifiability in Functional Connectivity May Unintentionally Inflate Prediction Results

Functional magnetic resonance (fMRI) is an invaluable tool in studying cognitive processes in vivo. Many recent studies use functional connectivity (FC), partial correlation connectivity (PC), or fMRI-derived brain networks to predict phenotypes with results that sometimes cannot be replicated. At the same time, FC can be used to identify the same subject from different scans with great accuracy. In this paper, we show a method by which one can unknowingly inflate classification results from 61% accuracy to 86% accuracy by treating longitudinal or contemporaneous scans of the same subject as independent data points. Using the UK Biobank dataset, we find one can achieve the same level of variance explained with 50 training subjects by exploiting identifiability as with 10,000 training subjects without double-dipping. We replicate this effect in four different datasets: the UK Biobank (UKB), the Philadelphia Neurodevelopmental Cohort (PNC), the Bipolar and Schizophrenia Network for Intermediate Phenotypes (BSNIP), and an OpenNeuro Fibromyalgia dataset (Fibro). The unintentional improvement ranges between 7% and 25% in the four datasets. Additionally, we find that by using dynamic functional connectivity (dFC), one can apply this method even when one is limited to a single scan per subject. One major problem is that features such as ROIs or connectivities that are reported alongside inflated results may confuse future work. This article hopes to shed light on how even minor pipeline anomalies may lead to unexpectedly superb results.

Artificial Intelligence for Automatic Pain Assessment: Research Methods and Perspectives

Although proper pain evaluation is mandatory for establishing the appropriate therapy, self-reported pain level assessment has several limitations. Data-driven artificial intelligence (AI) methods can be employed for research on automatic pain assessment (APA). The goal is the development of objective, standardized, and generalizable instruments useful for pain assessment in different clinical contexts. The purpose of this article is to discuss the state of the art of research and perspectives on APA applications in both research and clinical scenarios. Principles of AI functioning will be addressed. For narrative purposes, AI-based methods are grouped into behavioral-based approaches and neurophysiology-based pain detection methods. Since pain is generally accompanied by spontaneous facial behaviors, several approaches for APA are based on image classification and feature extraction. Language features through natural language strategies, body postures, and respiratory-derived elements are other investigated behavioral-based approaches. Neurophysiology-based pain detection is obtained through electroencephalography, electromyography, electrodermal activity, and other biosignals. Recent approaches involve multimode strategies by combining behaviors with neurophysiological findings. Concerning methods, early studies were conducted by machine learning algorithms such as support vector machine, decision tree, and random forest classifiers. More recently, artificial neural networks such as convolutional and recurrent neural network algorithms are implemented, even in combination. Collaboration programs involving clinicians and computer scientists must be aimed at structuring and processing robust datasets that can be used in various settings, from acute to different chronic pain conditions. Finally, it is crucial to apply the concepts of explainability and ethics when examining AI applications for pain research and management.