Fibromyalgia - etiology, diagnosis and treatment including perioperative management in patients with fibromyalgia

Global research trends on fibromyalgia and exercise: a ten-year Web of Science-based bibliometric analysis

Fibromyalgia causes widespread pain, exhaustion, and cognitive deficits, lowering sufferers' quality of life. Exercise supports the management of fibromyalgia by reducing pain and improving mood. This study examines global fibromyalgia and exercise research trends using bibliometric analysis to identify major contributors, citation patterns, and prospective research areas. Data were obtained from the Web of Science (WoS) database utilizing the keywords "fibromyalgia exercise" for publications from 2014 to 2023. The inclusion criteria prioritized original articles and reviews published in the English language. Bibliometric characteristics were examined, including publication year, country, journal, and citation metrics. Statistics adjusted for population and gross domestic product (GDP) were computed to evaluate research productivity in relation to economic and demographic variables. A total of 497 publications satisfied the inclusion criteria. A significant increase trend in publication counts was noted (p = 0.003), with Spain (25.75%), the United States (15.09%), Brazil (13.88%), Türkiye (7.24%), and Sweden (5.23%) identified as the major contributors. Publications were produced by 37 countries, 19 of which were the main active countries. Spain displayed remarkable productivity, ranking first in population- and GDP-adjusted contributions. Based on publication type, 388 (78.06%) were original articles, and the rest were reviews. The median number of original article and review citations were 11 (min = 0; max = 289) and 14 (min = 0; max = 1092). Review citations outnumbered original articles (p = 0.013). The median number of citations for SCIE and/or SSCI and ESCI articles were 12 (min = 0; max = 1092) and 3 (min = 0; max = 92). SCIE and/or SSCI articles were significantly more cited than ESCI ones (p < 0.001). INT J ENV RES PUB HE (n = 18), RHEUMATOL INT (n = 17), ARCH PHYS MED REHAB (n = 15), J CLIN MED (n = 14) and DISABIL REHABIL (n = 13) were the top five journals in terms of article count. This bibliometric analysis evaluates and summarizes global scholarly output on fibromyalgia and exercise, underscoring the increasing research interest in the two. High-income countries, notably Spain, the United States, and Sweden, significantly contributed to the area, underscoring differences in research capacities.

Self-Reported Physical Activity Levels in Patients With Arthritis: A Retrospective Study

Introduction Arthritis affects a significant number of adults in the United States, leading to pain and limited mobility. This study explores the impact of physical activity on patients with arthritis, including rheumatoid arthritis, gout, lupus, and fibromyalgia. Using data from the Behavioral Risk Factor Surveillance System (BRFSS), it examines how exercise may improve symptoms and quality of life for these patients. Aim The aim of this study is to evaluate the prevalence of self-reported physical activity among US patients with arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia while considering demographic, socioeconomic, and healthcare access variables. Methodology A retrospective study was conducted using 2021 data from the BRFSS, analyzing responses from 434,985 participants. The focus was on arthritis diagnosis and physical activity, with variables including demographics, socioeconomic status, and healthcare access. Statistical analysis was performed using cross-tabulation, chi-square tests, and Fisher's exact test. Results In 2021, 434,985 individuals participated in the BRFSS study, with 32.69% reporting a diagnosis of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. Among these patients, 68% engaged in physical activity, compared to 79.3% of those without these conditions. Physical activity levels varied significantly across factors such as age, gender, race, education, employment, income, and recent medical checkups. Conclusions This study found that 68% of participants with arthritis-related conditions were physically active, with activity levels varying across demographic and socioeconomic factors. Younger individuals, males, White non-Hispanics, and those with higher education, income, and employment were more likely to be active. Additionally, regular medical checkups were associated with higher physical activity levels, underscoring the need for targeted interventions to improve activity in underserved groups.

Relationship of Pain, Depression, Fatigue, and Sleep Problems with Functional Capacity, Balance, and Fear of Falling in Women with Fibromyalgia: Cross-Sectional Study

(1) Background: Fibromyalgia (FM) is a syndrome marked by chronic widespread pain, fatigue, sleep issues, and other symptoms. Interventions like physical exercise can potentially enhance physical function in individuals with FM. This study aimed to assess physical function, perceived physical fitness, balance confidence, and fear of falling in women with FM based on their levels of pain, depression, fatigue, and sleep problems. (2) Methods: Participants underwent a series of tests and questionnaires to evaluate physical and perceptual aspects. These included the Time Up and Go, Four Step Square Test, 6-Minute Walking Test, Maximum Handgrip Strength, Back Scratch, International Fitness Scale, Activities-Specific Balance Confidence Scale, and Fall Efficacy Scale-International. Participants were categorised by the severity of their pain, depression, fatigue, and sleep problems (mild, moderate, severe). A Kruskal-Wallis test assessed intergroup differences, while Spearman's rho evaluated correlations between the study variables and symptom levels. (3) Results: Perceived physical condition varied significantly with symptom severity. Symptoms and sleep problems were notably linked to fear of falling, though no significant differences emerged in the physical tests. (4) Conclusions: In women with fibromyalgia, symptom severity was primarily related to perceptual and subjective aspects of physical condition and fall safety.

Population Pharmacokinetic-Pharmacodynamic Analysis of a Reserpine-Induced Myalgia Model in Rats

(1) Background: Fibromyalgia syndrome (FMS) is a chronic pain condition with widespread pain and multiple comorbidities, for which conventional therapies offer limited benefits. The reserpine-induced myalgia (RIM) model is an efficient animal model of FMS in rodents. This study aimed to develop a pharmacokinetic-pharmacodynamic (PK-PD) model of reserpine in rats, linking to its impact on monoamines (MAs). (2) Methods: Reserpine was administered daily for three consecutive days at dose levels of 0.1, 0.5, and 1 mg/kg. A total of 120 rats were included, and 120 PK and 828 PD observations were collected from 48 to 96 h after the first dose of reserpine. Non-linear mixed-effect data analysis was applied for structural PK-PD model definition, variability characterization, and covariate analysis. (3) Results: A one-compartment model best described reserpine in rats (V = 1.3 mL/kg and CL = 4.5 × 10-1 mL/h/kg). A precursor-pool PK-PD model (kin = 6.1 × 10-3 mg/h, kp = 8.6 × 10-4 h-1 and kout = 2.7 × 10-2 h-1) with a parallel transit chain (k0 = 1.9 × 10-1 h-1) characterized the longitudinal levels of MA in the prefrontal cortex, spinal cord, and amygdala in rats. Reserpine stimulates the degradation of MA from the pool compartment (Slope1 = 1.1 × 10-1 h) and the elimination of MA (Slope2 = 1.25 h) through the transit chain. Regarding the reference dose (1 mg/kg) of the RIM model, the administration of 4 mg/kg would lead to a mean reduction of 65% (Cmax), 80% (Cmin), and 70% (AUC) of MA across the brain regions tested. (4) Conclusions: Regional brain variations in neurotransmitter depletion were identified, particularly in the amygdala, offering insights for therapeutic strategies and biomarker identification in FMS research.

Unraveling the Complex Web of Fibromyalgia: A Narrative Review

Fibromyalgia is a complex and often misunderstood chronic pain disorder. It is characterized by widespread musculoskeletal pain, fatigue, and heightened sensitivity, and has evolved in diagnostic criteria and understanding over the years. Initially met with skepticism, fibromyalgia is now recognized as a global health concern affecting millions of people, with a prevalence transcending demographic boundaries. The clinical features and diagnosis of fibromyalgia encompass a range of symptoms beyond pain, including sleep disturbances and cognitive difficulties. This study emphasizes the importance of a comprehensive evaluation for accurate diagnosis, considering the shift from tender point reliance to a more holistic approach. Etiology and pathophysiology involve genetic predisposition, neurotransmitter dysregulation, central sensitization, and immune system involvement. Risk factors such as gender, age, family history, and comorbid conditions contribute to susceptibility. The impact on quality of life is profound, affecting physical and social aspects, often accompanied by mood disorders. Management approaches include pharmacological interventions, non-pharmacological therapies, lifestyle modifications, and alternative treatments. This study also delves into emerging research, exploring advances in neurobiological understanding, brain imaging, genetic markers, glutamate modulation, cannabinoids, gut microbiome, and digital health tools for fibromyalgia management. Overall, this study provides a nuanced and up-to-date overview of the complexities surrounding fibromyalgia, aiming to enhance understanding and support for individuals grappling with this challenging condition.

Preference for Hedonic Goals in Fibromyalgia; Is It Always an Avoidance Mechanism? Looking the Relationship with Pain Acceptance from a Positive Psychology Perspective

The aim of this study was to analyze the effect of openness to experience on pain acceptance through positive affect (PA) considering the moderating role of preference for mood management goals in women with fibromyalgia (FM). A cross-sectional study (n = 231) was carried out. A simple mediation model and a moderate mediation model were conducted by SPSS macro-PROCESS. Results showed that PA mediated positively the effect of openness to experience on acceptance (B = 0.46, SE = 0.80, t = 5,59; 95% CI = [0.3016, 0.6298], p < .001) and that the contribution of openness to experience to PA varied at different values of mood management goals (medium: - .04; ß = .40, p < .001; high: .95; ß = .61, p<.001). Findings may serve as a foundation for tailored interventions to promote activity through acceptance focusing on PA and mood management goals among women with medium to high level of hedonic goals.

Is fibromyalgia an autoimmune disorder?

Fibromyalgia (FM) is a multifactorial syndrome which includes not only widespread pain and stiffness, now recognized as major symptoms, but also numerous other somatic, emotional, and neuropsychic manifestation. The lack of specific validated biological and instrumental biomarkers has made FM a condition of unexplained medical significance, and its pathophysiology remains controversial and subject to debate. The current hypothesis regarding the pathogenesis of FM proposes that its development is influenced by various mechanism, including genetic predisposition, stressful life events, inflammatory processes, and cognitive-emotional factors. However, despite the extensive research conducted to date, the available data do not provide a clear understanding of the pathogenesis of FM. In this article, we report the opposing viewpoints of two leading experts who debate the question of whether FM is an autoimmune disease, based on scientific data regarding this condition. Both perspectives are discussed and the latest evidence on the pathophysiology of FM is reported to provide a comprehensive understanding of this complex syndrome.