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Galvez-Sánchez CM, Duschek S, Reyes del Paso GA. A Comparative Analysis of Cognitive Deficits in Rheumatoid Arthritis and Fibromyalgia: Impact of Symptoms Severity and Its Clinical Implications. Psychol Res Behav Manag 2024; 17:1399-1415. [PMID: 38566824 PMCID: PMC10985931 DOI: 10.2147/prbm.s446798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated. Patients and Methods A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons. Results Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients. Conclusion The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.
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Affiliation(s)
- Carmen M Galvez-Sánchez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Stefan Duschek
- Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
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Aslan Çİn NN, Açik M, Tertemİz OF, Aktan Ç, Akçali DT, Çakiroğlu FP, Özçelİk AÖ. Effect of prebiotic and probiotic supplementation on reduced pain in patients with fibromyalgia syndrome: a double-blind, placebo-controlled randomized clinical trial. PSYCHOL HEALTH MED 2024; 29:528-541. [PMID: 37224267 DOI: 10.1080/13548506.2023.2216464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
It has recently been observed that microorganisms in the gut can regulate brain processes through the gut microbiota-brain axis, affecting pain, depression, and sleep quality. Consequently, prebiotics and probiotics may potentially improve physical, psychological, and cognitive states in those with fibromyalgia syndrome (FMS) who have an altered microbiota balance. In a randomised, double-blind, placebo-controlled clinical trial to determine the effects of probiotic and prebiotic treatments on pain, sleep, quality of life, and psychological distress (depression and anxiety) in FMS, 53 female participants with FMS were randomised to receive either: 1) 4 × 1010 CFUs per day for the 18 patients in the probiotics group; 2) 10 g dose inulin per day for the 17 patients in the prebiotic group; or 3) a placebo for 8 weeks for the 18 patients in this group. The mean ages of the groups were similar and there was no significant difference between the groups. The impact of FMS on pain, sleep quality, quality of life, anxiety, and depressive symptoms were measured at baseline, 4 weeks, and 8 weeks post-intervention. Probiotic supplementation significantly decreased the Beck Depression Index (BDI), Beck Anxiety Index (BAI), and Pittsburgh Sleep Quality Index (PSQI) scores compared to baseline, while prebiotic supplementation only significantly decreased PSQI scores. Moreover, participants who received probiotic treatment presented a significantly reduced Visual Analogue Scale (VAS) score compared with those who received placebo treatment, after the interventions. Probiotic supplementation significantly improved sleep quality, depression, anxiety, and pain scores compared to those at baseline in FMS patients, while prebiotic supplementation significantly improved pain scores and sleep quality. The potential benefits of using probiotics for treatment management in FMS patients is supported by the results of the current study and might provide an important strategy to combat FMS-associated diseases.
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Affiliation(s)
- Nazlı Nur Aslan Çİn
- Department of Nutrition and Dietetics, Karadeniz Technical University Faculty of Health Sciences, Trabzon, TURKEY
| | - Murat Açik
- Department of Nutrition and Dietetics, Fırat University Faculty of Health Sciences, Elazığ, TURKEY
| | - Oktay Faysal Tertemİz
- Department of Algology, İzmir Health Sciences University Tepecik Education and Research Hospital, İzmir, TURKEY
| | - Çile Aktan
- Department of Algology, Gazi University Hospital, Ankara, TURKEY
| | | | - Funda Pınar Çakiroğlu
- Department of Nutrition and Dietetics, Ankara University Faculty of Health Sciences, Ankara, TURKEY
| | - Ayşe Özfer Özçelİk
- Department of Nutrition and Dietetics, Ankara University Faculty of Health Sciences, Ankara, TURKEY
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Ketenci S, Uzuner B, Durmuş D, Polat M. Frequency of idiopathic intracranial hypertension with ultrasound in patients with fibromyalgia: Relation with function, central sensitization, and neuropathic pain. Int J Rheum Dis 2024; 27:e15066. [PMID: 38334253 DOI: 10.1111/1756-185x.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The purpose of this study was to evaluate the prevalence of idiopathic intracranial hypertension (IIH) in fibromyalgia (FMS) patients by utilizing ultrasound to measure the optic nerve sheath diameter (ONSD), a marker of elevated intracranial pressure and also to investigate the relationship with function, fatigue, quality of life (QOL), central sensitization (CS) and neuropathic pain. METHODS The study encompassed 80 female FMS patients and 75 healthy controls. Ultrasound was employed to measure the average ONSD in both groups. Conditions potentially elevating intracranial pressure were ruled out following neurological assessments. Pain (via visual analog scale, VAS), function (revised Fibromyalgia Impact Questionnaire, r-FIQ), QOL (Short Form-36, SF-36), fatigue (fatigue severity scale, FACIT), CS (Central Sensitization Scale), and neuropathic pain (Douleur Neuropathique-4) were evaluated. RESULTS The average ONSD was significantly higher in the patient group than the control group. Patients with ONSD >5.5 mm consistent with IIH were categorized as Group 1 (n = 54, 67.5%), while those with a diameter of 5.5 mm and below-formed Group 2. VAS pain (p = .033) and FIQ-R scores (p = .033) were significantly higher in Group 1 than Group 2. Headache was found more common in Group 1. CONCLUSION This study unveils a substantial occurrence (67.5%) of IIH in FMS patients, suggesting shared pathophysiological mechanisms contributing to symptoms like fatigue, headache, and cognitive dysfunction. Additionally, these findings implicate heightened functional impairment, CS, headache, and fatigue in FMS patients with IIH.
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Affiliation(s)
- Sertaç Ketenci
- Department of Physical Medicine and Rehabilitation and Department of Rheumatology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Bora Uzuner
- Department of Physical Medicine and Rehabilitation and Department of Algology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Durmuş
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Murat Polat
- Department of Neurology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Wang S, Du SH, Wang XQ, Lu JY. Mechanisms of transcranial direct current stimulation (tDCS) for pain in patients with fibromyalgia syndrome. Front Mol Neurosci 2024; 17:1269636. [PMID: 38356687 PMCID: PMC10865494 DOI: 10.3389/fnmol.2024.1269636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Fibromyalgia syndrome (FMS) is a recurrent pain condition that can be challenging to treat. Transcranial direct current stimulation (tDCS) has become a promising non-invasive therapeutic option in alleviating FMS pain, but the mechanisms underlying its effectiveness are not yet fully understood. In this article, we discuss the most current research investigating the analgesic effects of tDCS on FMS and discuss the potential mechanisms. TDCS may exert its analgesic effects by influencing neuronal activity in the brain, altering cortical excitability, changing regional cerebral blood flow, modulating neurotransmission and neuroinflammation, and inducing neuroplasticity. Overall, evidence points to tDCS as a potentially safe and efficient pain relief choice for FMS by multiple underlying mechanisms. This article provides a thorough overview of our ongoing knowledge regarding the mechanisms underlying tDCS and emphasizes the possibility of further studies to improve the clinical utility of tDCS as a pain management tool.
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Affiliation(s)
- Shan Wang
- Department of Health School, Shanghai Normal University Tianhua College, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jun-Yan Lu
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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Topal İ, Tuman TC. The Impact of Type D Personality Traits on Quality of Life, Sleep, Anxiety, and Depression in Fibromyalgia Patients: A Comparative Study with Healthy Controls. Med Sci Monit 2024; 30:e942606. [PMID: 38238996 PMCID: PMC10804653 DOI: 10.12659/msm.942606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Type D personality has been associated with adverse clinical outcomes and poor quality of life in many diseases. This study aimed to evaluate the effects of type D personality on pain, anxiety and depression, sleep quality, and quality of life in 50 patients with fibromyalgia syndrome. MATERIAL AND METHODS Fifty patients with fibromyalgia and 50 healthy controls were included in the study. Baseline and post-treatment evaluations encompassed a comprehensive battery of assessment tools: socio-demographic questionnaire, visual analog scale for pain, Beck Anxiety Inventory, Beck Depression Inventory, Fibromyalgia Impact Questionnaire, SF-36 Short Form Questionnaire, and Pittsburgh Sleep Quality Index. The effects of type D personality traits on clinical parameters were determined by evaluating the participants with the D-Type Personality Scale (DS-14). RESULTS Twelve participants (24%) in the control group and 30 patients (60%) in the fibromyalgia group had type D personality traits, and the difference was significant (P<0.001). The Beck Anxiety Inventory and Beck Depression Inventory scores were significantly higher, and the SF-36 domains of vitality and mental health were significantly lower in fibromyalgia patients with type D personality (P=0.023, P=0.036, P=0.002, P>0.001). CONCLUSIONS This study draws attention to the high prevalence of type D personality in patients with fibromyalgia and demonstrates that this personality trait has a negative impact on patients' clinical parameters.
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Affiliation(s)
- İlknur Topal
- Department of Physical Medicine and Rehabilitation, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Taha Can Tuman
- Department of Psychiatry, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Arfuch VM, Aguilar Martín C, Berenguera A, Caballol Angelats R, Gonçalves AQ, Carrasco-Querol N, González Serra G, Sancho Sol MC, Fusté Anguera I, Friberg E, Pettersson E, Casajuana M. Cost-utility of a multicomponent intervention for fibromyalgia versus usual care: a pragmatic randomised controlled trial. J Rehabil Med 2023; 55:jrm12361. [PMID: 38111994 PMCID: PMC10753594 DOI: 10.2340/jrm.v55.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/06/2023] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVE To perform an economic evaluation on a multicomponent intervention programme for patients with fibromyalgia syndrome compared with usual clinical practice in primary care. DESIGN A cost-utility analysis was conducted alongside a pragmatic randomised controlled trial (ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/record/NCT04049006) from a societal perspective, a human capital approach, and a 1-year time horizon. PATIENTS Patients diagnosed with fibromyalgia syndrome from the public health system in south Catalonia, Spain. METHODS Crude and adjusted incremental cost- utility ratios were estimated to compare the treatment strategies based on cost estimations (direct medical costs and productivity losses) and quality-adjusted life years. One-way and 2-way deterministic sensitivity analyses were performed. RESULTS The final analysed sample comprised 297 individuals, 161 in the intervention group and 136 in the control group. A crude incremental cost-utility ratio of € 1,780.75 and an adjusted ratio of € 851.67 were obtained, indicating that the programme significantly improved patients' quality of life with a cost-increasing outcome that fell below the cost-effectiveness threshold. The sensitivity analysis confirmed these findings when varying large cost components, and showed dominance when increasing session attendance. CONCLUSION The proposed multicomponent intervention programme was cost-effective compared with usual care for fibromyalgia, which supports its addition to standard practice in the regional primary care service.
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Affiliation(s)
- Victoria Mailen Arfuch
- Terres de l'Ebre Research Support Unit, Jordi Gol I Gurina Primary Health Research Institute Foundation (IDIAPJGol), Tortosa, Spain; Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Autonomous University of Barcelona, Bellaterra, Spain; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Carina Aguilar Martín
- Terres de l'Ebre Research Support Unit, Jordi Gol I Gurina Primary Health Research Institute Foundation (IDIAPJGol), Tortosa, Spain; Evaluation Unit, Directorate of Primary Care Terres de l'Ebre, Territorial Management of Terres de l'Ebre, Catalan Institute of Health (ICS), Tortosa, Spain
| | - Anna Berenguera
- Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Autonomous University of Barcelona, Bellaterra, Spain; Central Research Unit, Jordi Gol I Gurina Primary Health Research Institute Foundation (IDIAPJGol), Barcelona, Spain; Department of Nursing, University of Girona, Plaça de Sant Domènec, Girona, Spain
| | - Rosa Caballol Angelats
- Primary Care Center (CAP) El Temple, Territorial Management of Terres de l'Ebre, Catalan Health Institute (ICS), Tortosa, Spain; Unit of Expertise in Central Sensitization Syndromes Terres de l'Ebre, Territorial Management of Terres de l'Ebre, Catalan Institute of Health (ICS), Tortosa, Spain
| | - Alessandra Queiroga Gonçalves
- Terres de l'Ebre Research Support Unit, Jordi Gol I Gurina Primary Health Research Institute Foundation (IDIAPJGol), Tortosa, Spain; Tortosa, Spain, 9Family and Community Medicine Teaching Unit Tortosa-Terres de L'Ebre, Catalan Institute of Health (ICS), Tortosa, Spain
| | - Noèlia Carrasco-Querol
- Terres de l'Ebre Research Support Unit, Jordi Gol I Gurina Primary Health Research Institute Foundation (IDIAPJGol), Tortosa, Spain
| | - Gemma González Serra
- Rehabilitation and Physical Medicine Service, Tortosa Verge de la Cinta Hospital, Territorial Management of Terres de l'Ebre, Catalan Health Institute (ICS), Tortosa, Spain
| | - Maria Cinta Sancho Sol
- Unit of Expertise in Central Sensitization Syndromes Terres de l'Ebre, Territorial Management of Terres de l'Ebre, Catalan Institute of Health (ICS), Tortosa, Spain; Adult Mental Health Center (CSMA) of Fundació Pere Mata Terres de l'Ebre, Tortosa, Spain
| | - Immaculada Fusté Anguera
- Primary Care Center (CAP) El Temple, Territorial Management of Terres de l'Ebre, Catalan Health Institute (ICS), Tortosa, Spain; Unit of Expertise in Central Sensitization Syndromes Terres de l'Ebre, Territorial Management of Terres de l'Ebre, Catalan Institute of Health (ICS), Tortosa, Spain
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Emma Pettersson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marc Casajuana
- Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Autonomous University of Barcelona, Bellaterra, Spain; Central Research Unit, Jordi Gol I Gurina Primary Health Research Institute Foundation (IDIAPJGol), Barcelona, Spain
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Du M, Hou X, Lu S, Kang T, Li Y, Wang R. Effectiveness of traditional Chinese exercise in patients with fibromyalgia syndrome: A systematic review and meta-analysis of randomized clinical trials. Int J Rheum Dis 2023; 26:2380-2389. [PMID: 37813823 DOI: 10.1111/1756-185x.14924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 06/27/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Fibromyalgia syndrome (FMS) is a common disorder characterized by heterogeneous symptoms that leads to decreased functioning, work productivity, and quality of life. Exercise has been recommended for fibromyalgia treatment. Traditional Chinese exercise (TCE), including Taichi, Qigong, Badunjin, Wuqinxi, etc., as a kind of mind-body exercise, plays an important role in alleviating symptoms of FMS. The objective of this study is to summarize the available evidence, through meta-analysis, on the pain relief, quality of life, sleep improvement, and emotion regulation of FMS in TCE. METHODS Databases of PubMed, EMBASE, Cochrane library, Google scholar, CNKI, WANFANG DATA, VIP, etc. were used to search eligible studies that were published from the time of their inception to February 11, 2022, in English and Chinese. The included studies were divided into two groups: TCE group (experimental group) and control group. The Cochrane collaboration's tool was used to assess the risk of bias, and Revman5.4.1 software was used to synthesize and analyze the data. RESULTS A total of 12 literatures were included in this study, which contained 781 patients, and 448 of them were included in the treatment group, 333 of others in control group. TCE significantly alleviated pain [SMD = -0.83, 95% CI (-1.15, -0.51), p < .00001], improved quality of life [SMD = -0.53, 95% CI (-0.86, -0.19), p = .002] and improved qualities of sleep [SMD = -0.41, 95% CI (-0.57, -0.24), p < .00001] and relieved depression [SMD = -0.40, 95% CI (-0.69, -0.10), p < .008]. CONCLUSION TCE may be a way to reduce pain, improve the quality of life and sleep, and relieve depression for FMS, and it could be part of the FMS treatment.
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Affiliation(s)
- Mengmeng Du
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiujuan Hou
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Siyi Lu
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Tianlun Kang
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Li
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Ruoyi Wang
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
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Mollà-Casanova S, Muñoz-Gómez E, Sempere-Rubio N, Inglés M, Aguilar-Rodríguez M, Moreno-Cervera N, Serra-Añó P. Fibromyalgia syndrome is associated with sexual dysfunction regardless of physical activity status: a cross-sectional study. J Sex Med 2023; 20:1285-1291. [PMID: 37740987 DOI: 10.1093/jsxmed/qdad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/17/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a rheumatic disorder that has been observed to affect self-perception of sexuality. AIM The study aims to assess sexual dysfunction (SD), establish possible associations with SD levels, and evaluate the impact of physical activity (PA) levels on SD in Spanish women with FMS as compared with healthy control women. METHODS The study was cross-sectional. A total of 170 women voluntarily agreed to participate between September 2019 and February 2020: 88 in the FMS group and 82 in the control group. OUTCOMES The main outcome measures were SD, as assessed through the Female Sexual Function Index (FSFI), and PA levels, as assessed with a structured interview. RESULTS There were significant differences in every domain and total SD score between the FMS and control groups (P < .05). In addition, we obtained a moderate significant direct association (χ2[1] = 37.071, P < .05, phi = 0.467) when exploring the associations between FMS and risk of SD. Results showed statistically significant differences between the FMS group and the control group when PA levels were not reached in the desire, pain, and total scores of the FSFI (P < .05). When the PA levels were reached, between-group differences were found in all domains, as well as in the total score of the FSFI (P < .05). CLINICAL IMPLICATIONS Sexual function should be evaluated in women with FMS, while future treatments should address this clinical area with the aim of managing SD in this population. STRENGTHS AND LIMITATIONS The main limitation is that the outcome measures were self-reported. CONCLUSION We found a high prevalence of SD in Spanish women with FMS, with an impact on aspects such as desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. In addition, there is a moderate direct association between FMS and SD. Ultimately, the results showed that, irrespective of PA, women with FMS reported increased SD.
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Affiliation(s)
- Sara Mollà-Casanova
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Elena Muñoz-Gómez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Núria Sempere-Rubio
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Marta Inglés
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Marta Aguilar-Rodríguez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Noelia Moreno-Cervera
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Pilar Serra-Añó
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
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9
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Granero-Molina J, Jiménez-Lasserrotte MDM, Dobarrio-Sanz I, Correa-Casado M, Ramos-Rodríguez C, Romero-Alcalá P. Sexuality in Women with Fibromyalgia Syndrome: A Metasynthesis of Qualitative Studies. Healthcare (Basel) 2023; 11:2762. [PMID: 37893837 PMCID: PMC10606292 DOI: 10.3390/healthcare11202762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a nonarticular rheumatic syndrome which presents as chronic musculoskeletal pain, stiffness and body aches. FMS affects approximately 2.5% of the population, mostly women. FMS causes physical and psychological problems and reduces quality of life. The objective of this study is to identify qualitative evidence about experiences of women diagnosed with FMS about their sexuality. METHODS Metasynthesis of qualitative studies. The search included articles published between 2000 and June 2023 on the PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. RESULTS 450 articles were found through the initial search, of which, only nine fulfilled the criteria and were included in the thematic synthesis. From this analysis, three main themes emerged: (1) "I want to, but I can't": FMS causes a shift in feminine sexuality. (2) Resetting sex life and intimacy. (3) Taking charge of a "new sexuality." CONCLUSIONS Women with FMS suffer from limitations of their sexuality that affect their partner. Pain, stiffness and a loss of desire make sexual encounters difficult. Becoming aware of this and striving not to lose their sexuality is key to coping with this problem. Women and their sexual partners can change roles and encourage communication, games, foreplay or touching. The use of lubricants, physical exercise and complementary therapies, along with social, professional and partner support, are key to coping with FMS.
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Affiliation(s)
- José Granero-Molina
- Nursing, Physiotheraphy and Medicine Department, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.D.-S.); (M.C.-C.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | | | - Iria Dobarrio-Sanz
- Nursing, Physiotheraphy and Medicine Department, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.D.-S.); (M.C.-C.)
| | - Matías Correa-Casado
- Nursing, Physiotheraphy and Medicine Department, University of Almería, 04120 Almería, Spain; (J.G.-M.); (I.D.-S.); (M.C.-C.)
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Pathak A, Rai J, Rai NK, Singh R, Bhatt GC. Effectiveness of rehabilitation strategies in primary fibromyalgia syndrome: A systematic review and meta-analysis. Br J Pain 2023; 17:375-399. [PMID: 37538942 PMCID: PMC10395393 DOI: 10.1177/20494637231168021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Objectives The aim of this review was to (1) summarize evidence on the effectiveness of rehabilitation strategies in fibromyalgia syndrome (FMS) and (2) determine the most effective rehabilitation strategy for reducing pain and depression in people with FMS. Data Sources PubMed, Ovid (Sp), and Cochrane search engines were used for identifying relevant studies done up to 1st of July 2022. Study Selection Randomized control trials (RCTs) that have a passive control group and an active control group were included in this review for primary and secondary aim, respectively. The primary outcome measures were pain and depression. Secondary outcome was one from the sleep or fatigue or healthy related quality of life (HRQOL). Data Extraction Two researchers independently selected the studies and extracted the key information. Data Synthesis A total of 25 RCTs were included. Studies with passive control group showed moderate to large positive effects on pain (standard mean difference -0.65, 95% confidence interval -0.93 to -0.38; I2 = 72%) and HRQOL (MD -5.40, 95% CI -10.17 to -0.62; I2 = 74%) but were not statistically significant for sleep, fatigue, and depression. Furthermore, on subgroup analysis studies with a short term protocol showed significant effects on pain only, whereas studies with long term protocols showed positive effects on pain and HRQOL only, but no statistical significance at the time of post-trial follow-up. Studies with active control groups gave non-significant results except where there was mixed exercises, which showed a positive effect (mean difference -4.78, 95% CI -7.98 to -1.57; I2 = 0%) for HRQOL. Conclusion All rehabilitation strategies were effective for pain and HRQOL, and had a marginal effect on depression, sleep, and fatigue but efficacy was not maintained at the time of post-trial follow-up. However, in this review, we could not differentiate any rehabilitation strategies for the best among those used in the included studies.
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Affiliation(s)
- Akash Pathak
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Jyotsana Rai
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Nirendra K. Rai
- Department of Neurology, All India Institute of Medical Sciences, Bhopal, India
| | - Ruchi Singh
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Girish C. Bhatt
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India
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Neelapala YVR, Mercuri D, Macedo L, Hanna S, Kobsar D, Carlesso L. Mechanisms hypothesized for pain-relieving effects of exercise in fibromyalgia: a scoping review. Ther Adv Musculoskelet Dis 2023; 15:1759720X231182894. [PMID: 37484924 PMCID: PMC10356998 DOI: 10.1177/1759720x231182894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/31/2023] [Indexed: 07/25/2023] Open
Abstract
Background Exercise is one of the most recommended management strategies by treatment guidelines for fibromyalgia (FM); however, the mechanism through which exercise improves pain in FM is still unknown. Objective We aimed to summarize the hypothesized theoretical mechanisms for the pain-relieving effects of exercise in people with FM. Eligibility Criteria Randomized controlled trials (RCTs) in English reporting mechanisms for pain-relieving effects of exercise in the 'Introduction' and 'Discussion' sections and significant within- group or between-group effects of exercise interventions were included. Sources of Evidence We searched the databases Ovid MEDLINE(R), EMBASE, CINAHL, COCHRANE, Sports Discuss, and AMED with the keywords: exercise and fibromyalgia until December 2021. Charting Methods Two authors independently performed title/abstract, full-text review, and data abstraction using a data abstraction form. The hypothesized mechanisms from individual studies were grouped into three categories. Results The literature search resulted in 2147 studies, out of which 220 studies were considered for full-text review. A total of 50 RCTs proposing 29 unique mechanisms for the pain-relieving effects of exercise were included. These mechanisms were divided into three categories: physical, neuro-physiological, and psychological. The neuro-physiological category was further subdivided into exercise-induced hypoalgesia (EIH), pain sensitization, the autonomic system, the immune system, the endocrine system, and miscellaneous categories. The most frequently hypothesized mechanisms were EIH (n = 15), autonomic modulation (n = 7), improved sleep (n = 6), muscle oxygenation (n = 6), self-efficacy (n = 5), mental health (n = 4), and benefits of the aquatic environment (n = 12). While all exercise interventions involved FM patients, most of the supporting evidence for these mechanisms was cited from previous studies conducted on healthy samples. No studies performed analyses to demonstrate causal associations between the mechanisms and outcomes. Conclusion Multiple mechanisms were hypothesized for the positive influence of exercise in people with FM. Future studies using causal analyses, such as mediation analysis, are recommended to validate these mechanisms.
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Affiliation(s)
| | - Domenico Mercuri
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Luciana Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Steven Hanna
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Dylan Kobsar
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Erden E, Turk AC, Erden E. Can the monocyte-to-HDL ratio be used as an inflammation marker in patients with fibromyalgia syndrome? Niger J Clin Pract 2023; 26:998-1004. [PMID: 37635586 DOI: 10.4103/njcp.njcp_875_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background and Aim The monocyte-to-high-density lipoprotein (HDL) ratio (MHR) may be used as a marker of inflammation and oxidative stress. This study aimed to evaluate the use of MHR and platelet markers in patients with fibromyalgia syndrome (FMS) and demonstrate MHR's relationship with inflammation, the Fibromyalgia Impact Questionnaire (FIQ), and quality of life. Materials and Methods Ninety FMS patients and 90 healthy controls, whose clinical and laboratory evaluations were performed simultaneously, were included in the study. The monocyte, platelet, HDL, MHR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), mean platelet volume (MPV), and platelet distribution width (PDW) values of all patients were evaluated. The quality of life of the participants was assessed using the FIQ and their general health using the health assessment questionnaire (HAQ). Results Age, body mass index (BMI), and marital status distribution were similar in both groups. The FMS patients had a mean disease duration of 11.29 ± 2.62 months. The median monocyte, platelet, MPV, visual analog scale (VAS), FIQ, and HAQ values and the mean MHR of the FMS patients were significantly higher than the control group, while the mean HDL level was significantly lower (P < 0.05). There was a weak negative correlation between the MPV and HAQ score and the PDW and HAQ score (rs = -0.225, P = 0.042 and rs = -0.249, P = 0.024, respectively), whereas no correlation was detected between the MHR and the FIQ and HAQ scores in FMS patients. According to the receiver operating characteristic curve analysis, MHR had prediction of FMS (P = 0.002; sensitivity = 0.63, specificity = 0.50, cut-off point ≥8.4). Conclusions Our results suggest that the monocyte, platelet, HDL, MHR, and MPV parameters can be used in the evaluation of inflammation in FMS patients.
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Affiliation(s)
- E Erden
- Department of Physical Medicine and Rehabilitation, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - A C Turk
- Department of Physical Medicine and Rehabilitation, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - E Erden
- Department of Physical Medicine and Rehabilitation, Hitit University Erol Olçok Education and Research Hospital Çorum, Turkey
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Zure M, Menekşeoğlu AK, Ketenci A. Validation of the Turkish Chronic Pain Acceptance Questionnaire-8. Turk J Phys Med Rehabil 2023; 69:216-221. [PMID: 37671382 PMCID: PMC10475906 DOI: 10.5606/tftrd.2023.10857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/11/2022] [Indexed: 09/07/2023] Open
Abstract
Objectives The aim of this study was to test the validity of the Turkish version of the Chronic Pain Acceptance Questionnaire (CPAQ)-8. Patients and methods This methodological and cross-sectional study was conducted with 80 female patients (mean age: 49.5±10 years; range, 28 to 75 years) diagnosed with fibromyalgia syndrome between January 2020 and December 2021. Participants completed the Turkish version of the CPAQ-8, as well as the Fibromyalgia Impact Questionnaire, Brief Pain Inventory, Hospital Anxiety and Depression Scale, and Tampa Kinesiophobia Scale. Internal consistency, confirmatory factor analysis, and construct validity were examined in the statistical analysis of the data obtained. Results The two-factor model created by exploratory factor analysis provided a better fit than the global factor model. Cronbach's alphas of both subscales of the CPAQ-8 were found to be 0.76 and 0.80; therefore, they provided internal consistency. The CPAQ-8 was found to be significantly correlated with all other scales compared. Conclusion The Turkish version of the CPAQ-8 is an assessment tool with sufficient validity in assessing pain acceptance levels in fibromyalgia patients experiencing chronic pain. Future studies are needed to evaluate the validity and reliability of the questionnaire in different chronic pain models.
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Affiliation(s)
- Mert Zure
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye
| | - Ahmet Kıvanç Menekşeoğlu
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye
| | - Ayşegül Ketenci
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye
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Beyrek B, Naz İ, Emuk Y, Köprülüoğlu M, Felekoğlu E, Uzun E, Nas K. Investigation of the dual-task performance and affecting factors in female patients with fibromyalgia syndrome. Women Health 2023; 63:277-284. [PMID: 36872852 DOI: 10.1080/03630242.2023.2185748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Recent studies report that dual-task (DT) performance might be affected in patients with fibromyalgia syndrome (FMS). This cross-sectional study aims to compare the DT performance in female patients with FMS and healthy controls, and to investigate the DT-related factors in these patients. This study was conducted at a university hospital between November 2021 and April 2022. Forty females aged 30-65, diagnosed with FMS, and 40 aged-matched pain-free healthy controls were included. All participants performed the Timed Up and Go Test under a single task (ST) and a cognitive DT condition, and the DT cost was calculated. The following evaluations were applied; The six-minute walk test, Baecke Habitual Physical Activity Questionnaire, Multidimensional Fatigue Inventory-20, Toronto Alexithymia Scale, Trail Making Test, and the Revised Fibromyalgia Impact Questionnaire. As a result of the study, the patient group showed lower performance than controls in both, ST and DT conditions (p < .05). Disease duration, pain and fatigue severity, functional capacity, leisure time and physical activity total scores, alexithymia scores, health status, and cognitive variables were correlated with DT performance in the patient group (p < .05). According to our results, we consider that the rehabilitation approach for females with FMS should take into account DT and related characteristics.
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Affiliation(s)
- Beyza Beyrek
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
| | - İlknur Naz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
| | - Yusuf Emuk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
| | - Melissa Köprülüoğlu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
| | - Elvan Felekoğlu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
| | - Emre Uzun
- Division of Rheumatology and Immunology, Department of Physical Medicine and Rehabilitation, School of Medicine, Sakarya University, Sakarya, Turkey
| | - Kemal Nas
- Division of Rheumatology and Immunology, Department of Physical Medicine and Rehabilitation, School of Medicine, Sakarya University, Sakarya, Turkey
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15
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Maddox EK, Massoni SC, Hoffart CM, Takata Y. Dietary Effects on Pain Symptoms in Patients with Fibromyalgia Syndrome: Systematic Review and Future Directions. Nutrients 2023; 15:nu15030716. [PMID: 36771421 PMCID: PMC9921865 DOI: 10.3390/nu15030716] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is recognized for its difficulty to diagnose and its subjective symptomatology. There is neither a known cure nor a recommended therapeutic diet to aid in the multidisciplinary treatment. We conducted a systematic review to investigate if diets can improve pain symptoms of fibromyalgia. Through the PubMed search in March 2022, 126 abstracts were identified. We included both intervention and observational studies of diets and pain symptoms among patients with FMS. After screening titles, abstracts, and full-texts, 12 studies, including 11 intervention and one observational study, were selected. These studies included 546 participants and investigated plant-based diets (n = 3), anti-inflammatory diets (n = 1), gluten-free diets (n = 2), and elimination/restrictive diets (n = 6). These studies assessed pain symptoms through visual analogue scale for pain, fibromyalgia impact questionnaire/revised fibromyalgia impact questionnaire, tender point count, pain pressure threshold, and/or total myalgic score. Nine studies, including all three plant-based diet studies, reported statistically significant beneficial effects of their respective diets on pain symptom measurements. Given the small sample size and short intervention duration of the included studies, limited evidence currently exists to recommend any specific diet to patients with FMS. Further research is warranted to clarify specific diets to recommend and explore their potential mechanisms.
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Affiliation(s)
- Emma K. Maddox
- BioHealth Science Program, College of Science, Oregon State University, Corvallis, OR 97331, USA
| | - Shawn C. Massoni
- Department of Microbiology, College of Science, Oregon State University, Corvallis, OR 97331, USA
| | - Cara M. Hoffart
- Department of Pediatrics, Division of Rheumatology, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Yumie Takata
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
- Correspondence: ; Tel.: +1-541-737-1606
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Yu G, Chen L, Huang H, Nie B, Gu J. Research Trends of Acupuncture Therapy on Fibromyalgia from 2000 to 2021: A Bibliometric Analysis. J Pain Res 2022; 15:3941-3958. [PMID: 36545405 PMCID: PMC9762411 DOI: 10.2147/jpr.s382847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Fibromyalgia Syndrome causes great physical and mental discomfort and incurs high costs. Acupuncture has been regarded as the mainstay of treatment for Fibromyalgia Syndrome while the bibliometric analysis of this field has not been summarized properly. Thus, the purpose of this study is to analyze the hotspot of acupuncture for Fibromyalgia Syndrome. Methods The core collection database of Web of Science were searched for relevant publications from 2000 to 2021, and countries, institutions, authors, keywords, and literature were analyzed and visualized by bibliometric software CiteSpace V software and Vosviewer software, to explore the scientific achievements, research collaboration networks, research hot spots, and research trends. Results 868 publications were included in this study. The publications have increased steadily over time, and the type published the most is Article. Pain is the most cited journal. The most prolific country is the USA while the most prolific institution is Univ Michigan. The most prolific and influential authors were Yiwen Lin and Wolfe F respectively. The analysis of keywords and literature showed that long-term efficacy, animal studies, alternative medicine, and electroacupuncture will be the scientific hotspots in acupuncture for fibromyalgia. Conclusion This study shows that the number of research studies, researchers, and research institutions on acupuncture for fibromyalgia is increasing from year to year. Future research hotspots will focus on the long-term efficacy of acupuncture in the treatment of fibromyalgia, experimental animal studies, and the development of other alternative medical therapies. In addition, electroacupuncture is receiving more and more attention as a new application of traditional acupuncture therapy.
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Affiliation(s)
- Guangbin Yu
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Li Chen
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Hao Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
| | - Bin Nie
- Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China,Correspondence: Bin Nie, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou City, People’s Republic of China, Tel +86 13826067459, Email
| | - Jianhao Gu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou City, People’s Republic of China
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Zhang KD, Wang LY, Zhang ZH, Zhang DX, Lin XW, Meng T, Qi F. Effect of Exercise Interventions on Health-Related Quality of Life in Patients with Fibromyalgia Syndrome: A Systematic Review and Network Meta-Analysis. J Pain Res 2022; 15:3639-3656. [PMID: 36444171 PMCID: PMC9700437 DOI: 10.2147/jpr.s384215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/12/2022] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE Several guidelines highlight the beneficial impact of exercise on the management of symptoms and health-related quality of life (HRQOL) in patients with fibromyalgia syndrome (FMS). However, few analyses have compared different types of exercise. We, therefore, intent to compare the effects of different exercise types on improving the overall HRQOL and typical symptoms in patients with FMS. METHODS Medline, Embase, the Cochrane Register of Clinical Trials, and NIH ClinicalTrials.gov were searched from inception to April 21, 2022. Randomized clinical trials (RCTs) were included to assess the impact of exercise intervention on health parameters in adult FMS patients. Data were extracted independently and a frequentist network meta-analyses (NMA) was performed to rank the effects of interventions according to P-scores. The NMA evidence certainty was assessed using the method recommended by Grading of Recommendations Assessment, Development, and Evaluation Working Group. RESULTS A total of 57 RCTs were identified, including 3319 participants, involving 9 interventions (7 types of exercise, 2 controls). Of all treatments compared with usual care in efficacy outcomes, Mind-body exercise was associated with the best HRQOL (SMD, -12.12; 95% CI, -15.79 to -8.45). On the other characteristic symptom dimensions, based on moderate quality evidence, sensorimotor training was associated with minimal pain scores compared with usual care (SMD, -1.81; 95% CI, -2.81 to -0.82), whole body vibration therapy was most promising for improving sleep quality (SMD, -6.95; 95% CI, -10.03 to -3.87), pool-based aerobic exercise was most likely to ease anxiety (SMD, -4.83; 95% CI, -7.47 to -2.19), and whole body vibration was most likely to improve depression (SMD, -10.44; 95% CI, -22.00 to 1.12). CONCLUSION Mind-body exercise seems to be the most effective exercise to improve the overall HRQOL of patients with FMS. But at the same time, clinicians still need to develop individualized exercise plans for patients according to their symptoms and accessibility.
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Affiliation(s)
- Kang-Da Zhang
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Lin-Yu Wang
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Zhi-Hua Zhang
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Dan-Xu Zhang
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Xiao-Wen Lin
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Tao Meng
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Feng Qi
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
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Abstract
Fibromyalgia syndrome (FMS) is a common widespread primary pain condition, with a worldwide prevalence of 2%-4%. Recent research has revealed important evidence for changes in central and peripheral nervous system functions and immunological activity. The diagnosis of FMS can be challenging with no known clinical laboratory investigations to confirm or refute its presence. Symptoms are commonly multiple, fluctuant and may not easily align with established medical diagnostic categories. It can be difficult for patients to articulate their array of symptoms, and for both patients and healthcare professionals to fully make sense of the complexities of the condition. As such, patients may be diagnosed inaccurately with alternative conditions, delaying diagnosis by years. The recent publication of the Royal College of Physicians' guidance aims to support clinicians in the diagnosis of FMS. Its purpose is to provide succinct, relevant information for patients and clinicians about FMS and its diagnosis.
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Affiliation(s)
- Richard Berwick
- Walton Centre NHS Foundation Trust, Liverpool, UK, and PhD student, Liverpool University, Liverpool, UK.
| | | | - Andreas Goebel
- Walton Centre NHS Foundation Trust, Liverpool, UK, and reader in pain medicine, Liverpool University, Liverpool, UK
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Arfuch VM, Caballol Angelats R, Aguilar Martín C, Gonçalves AQ, Carrasco-Querol N, González Serra G, Sancho Sol MC, Fusté Anguera I, Friberg E, Berenguera A. Patients' Lived Experience in a Multicomponent Intervention for Fibromyalgia Syndrome in Primary Care: A Qualitative Interview Study. Int J Environ Res Public Health 2022; 19:13322. [PMID: 36293900 PMCID: PMC9603341 DOI: 10.3390/ijerph192013322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Fibromyalgia syndrome (FMS) disrupts patients' biopsychosocial spheres. A multicomponent intervention (MCI) program, which combined health education, cognitive behavioral therapy, and physical activity, was conducted in South Catalonia's primary care centers with the aim of improving symptom self-management and quality of life. A qualitative interview study was carried out to understand patients' lived experiences during the intervention program. Sampled purposively, 10 patients were interviewed via phone calls and face-to-face. The encounters were audio-recorded, verbatim transcribed, and analyzed through thematic analysis. As a result, four themes emerged: legitimizing fibromyalgia through the MCI, the MCI as a socializing experience, learning how to live with FMS through the MCI, and room for improving the MCI. Participants agreed on the program being an insightful experience that promoted illness knowledge and acceptance and that improved their coping skills and symptom self-management. The inclusion of additional psychological guidance, expressive psychological group therapy, and providing relatives with information were proposed for enhancing the program. Our findings have contributed to gaining insight into the subjective impact of the MCI and identifying new therapeutic targets to tailor the program to patients' needs, which will hopefully increase its effectiveness and improve their quality of life.
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Affiliation(s)
- Victoria Mailen Arfuch
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 3 Berzelius väg Street, 6 Floor, 171 77 Stockholm, Sweden
| | - Rosa Caballol Angelats
- Centre d’Atenció Primària (CAP) El Temple, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), Plaça Carrilet sn., 43500 Tortosa, Spain
- Unitat d’Expertesa en Sindromes de Sensibilització Central Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Unitat d’Avaluació, Direcció d’Atenció Primària Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de L‘Ebre, Institut Català de la Salut (ICS), 44-58 Esplanetes Street, 43500 Tortosa, Spain
| | - Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Gemma González Serra
- Servei de Rehabilitació i Medicina Física, Hospital de Tortosa Verge de la Cinta, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 44-58 Esplanetes Street, 43500 Tortosa, Spain
| | - Maria Cinta Sancho Sol
- Unitat d’Expertesa en Sindromes de Sensibilització Central Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
- Centre de Salut Mental d’Adults (CSMA) de Fundació Pere Mata Terres de l’Ebre, 50 Rambla de Pompeu Fabra, 43500 Tortosa, Spain
| | - Immaculada Fusté Anguera
- Centre d’Atenció Primària (CAP) El Temple, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), Plaça Carrilet sn., 43500 Tortosa, Spain
- Unitat d’Expertesa en Sindromes de Sensibilització Central Terres de l’Ebre, Gerència Territorial de Terres de l’Ebre, Institut Català de la Salut (ICS), 20 Cristòfol Colom Avenue, 43500 Tortosa, Spain
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 3 Berzelius väg Street, 6 Floor, 171 77 Stockholm, Sweden
| | - Anna Berenguera
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Central Research Unit, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Department of Nursing, Universitat de Girona, Plaça de Sant Domènec, 3, 17004 Girona, Spain
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Xiang T, Li JH, Su HY, Bai KH, Wang S, Traub RJ, Cao DY. Spinal CCK1 Receptors Contribute to Somatic Pain Hypersensitivity Induced by Malocclusion via a Reciprocal Neuron-Glial Signaling Cascade. J Pain 2022; 23:1629-1645. [PMID: 35691467 PMCID: PMC9560966 DOI: 10.1016/j.jpain.2022.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/05/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Recent studies have shown that the incidence of chronic primary pain including temporomandibular disorders (TMD) and fibromyalgia syndrome (FMS) often exhibit comorbidities. We recently reported that central sensitization and descending facilitation system contributed to the development of somatic pain hypersensitivity induced by orofacial inflammation combined with stress. The purpose of this study was to explore whether TMD caused by unilateral anterior crossbite (UAC) can induce somatic pain hypersensitivity, and whether the cholecystokinin (CCK) receptor-mediated descending facilitation system promotes hypersensitivity through neuron-glia cell signaling cascade. UAC evoked thermal and mechanical pain hypersensitivity of the hind paws from day 5 to 70 that peaked at week 4 post UAC. The expression levels of CCK1 receptors, interleukin-18 (IL-18) and IL-18 receptors (IL-18R) were significantly up-regulated in the L4 to L5 spinal dorsal horn at 4 weeks post UAC. Intrathecal injection of CCK1 and IL-18 receptor antagonists blocked somatic pain hypersensitivity. IL-18 mainly co-localized with microglia, while IL-18R mainly co-localized with astrocytes and to a lesser extent with neurons. These findings indicate that the signaling transduction between neurons and glia at the spinal cord level contributes to the descending pain facilitation through CCK1 receptors during the development of the comorbidity of TMD and FMS. PERSPECTIVE: CCK1 receptor-dependent descending facilitation may mediate central mechanisms underlying the development of widespread somatic pain via a reciprocal neuron-glial signaling cascade, providing novel therapeutic targets for the clinical treatment of TMD and FMS comorbidities.
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Affiliation(s)
- Ting Xiang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China; Department of Orthodontics, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Jia-Heng Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Han-Yu Su
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Kun-Hong Bai
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Shuang Wang
- Department of Orthodontics, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Richard J Traub
- Department of Neural and Pain Sciences, School of Dentistry; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, Maryland.
| | - Dong-Yuan Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China.
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Miró J, Lleixà-Daga M, de la Vega R, Llorens-Vernet P, Jensen MP. A Mobile Application to Help Self-Manage Pain Severity, Anxiety, and Depressive Symptoms in Patients with Fibromyalgia Syndrome: A Pilot Study. Int J Environ Res Public Health 2022; 19:12026. [PMID: 36231327 PMCID: PMC9566351 DOI: 10.3390/ijerph191912026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Treatment for individuals with fibromyalgia syndrome (FMS) is complex and is not always accessible to those who could benefit. The aim of this study was to conduct a preliminary evaluation of a mobile-app-delivered, cognitive behavioral treatment (CBT)-based intervention in helping adults self-manage fibromyalgia symptoms. A total of 100 adults with FMS (M [SD] age = 49.81, [9.99] years; 94% women) were given access to the digital treatment program and downloaded the app. Pain severity, anxiety symptoms, depression symptoms, fatigue, and sleep quality were assessed at pre-treatment, post-treatment, and 3-month follow-up. Fifty-three of the potential participants completed the 47-day treatment. Data showed significant improvements in pain severity (p = 0.007, d = 0.43), anxiety (p = 0.011, d = 0.40) and depressive symptoms (p = 0.001, d = 0.50) from pre-treatment to post-treatment. The effect sizes associated with app use are consistent with improvements seen in previously published clinical trials of CBT for FMS. Improvements were generally maintained, although there was some decrease in the outcomes from post-treatment to the 3-month follow-up. Most participants reported that they were very satisfied with the app. The use of the app was associated with similar levels of improvements found with in-person CBT treatment for FMS. Research to evaluate the effectiveness of the app in a controlled trial is warranted.
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Affiliation(s)
- Jordi Miró
- Universitat Rovira i Virgili, Carretera de Valls, 43007 Tarragona, Spain
- Unit for the Study and Treatment of Pain—ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Institut d’Investigació Sanitària Pere Virgili, 43007 Tarragona, Spain
| | - Meritxell Lleixà-Daga
- Universitat Rovira i Virgili, Carretera de Valls, 43007 Tarragona, Spain
- Unit for the Study and Treatment of Pain—ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Institut d’Investigació Sanitària Pere Virgili, 43007 Tarragona, Spain
| | - Rocío de la Vega
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, 29071 Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA), Avda. Jorge Luis Borges n°15, Bl.3 Pl.3, 29010 Málaga, Spain
| | - Pere Llorens-Vernet
- Universitat Rovira i Virgili, Carretera de Valls, 43007 Tarragona, Spain
- Unit for the Study and Treatment of Pain—ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Institut d’Investigació Sanitària Pere Virgili, 43007 Tarragona, Spain
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
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Cigarán-Méndez MI, Pellicer-Valero OJ, Martín-Guerrero JD, Varol U, Fernández-de-Las-Peñas C, Navarro-Pardo E, Valera-Calero JA. Bayesian Linear Regressions Applied to Fibromyalgia Syndrome for Understanding the Complexity of This Disorder. Int J Environ Res Public Health 2022; 19:4682. [PMID: 35457550 DOI: 10.3390/ijerph19084682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023]
Abstract
A better understanding of the connection between factors associated with pain sensitivity and related disability in people with fibromyalgia syndrome may assist therapists in optimizing therapeutic programs. The current study applied mathematical modeling to analyze relationships between pain-related, psychological, psychophysical, health-related, and cognitive variables with sensitization symptom and related disability by using Bayesian Linear Regressions (BLR) in women with fibromyalgia syndrome (FMS). The novelty of the present work was to transfer a mathematical background to a complex pain condition with widespread symptoms. Demographic, clinical, psychological, psychophysical, health-related, cognitive, sensory-related, and related-disability variables were collected in 126 women with FMS. The first BLR model revealed that age, pain intensity at rest (mean-worst pain), years with pain (history of pain), and anxiety levels have significant correlations with the presence of sensitization-associated symptoms. The second BLR showed that lower health-related quality of life and higher pain intensity at rest (mean-worst pain) and pain intensity with daily activities were significantly correlated with related disability. These results support an application of mathematical modeling for identifying different interactions between a sensory (i.e., Central Sensitization Score) and a functional (i.e., Fibromyalgia Impact Questionnaire) aspect in women with FMS.
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Wu J, Chen Z, Zheng K, Huang W, Liu F, Lin J, Ren Z. Benefits of exergame training for female patients with fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil 2022; 103:1192-1200.e2. [PMID: 35033538 DOI: 10.1016/j.apmr.2021.10.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the effects of exergame training on female patients with fibromyalgia syndrome (FMS), and outcome measurements mainly include overall functioning, pain perception, quality of life, exercise capacity, health perception, kinesiophobia and fatigue severity. DATA SOURCES Five electronic databases (PubMed, Web of Science, PsycInfo, Scopus, and Cochrane Library) were searched from inception until June 24, 2021. In addition to search reviewing the reference lists of relevant papers by hand. Cochrane Collaboration's tool for assessing risk of bias was used to evaluate the risk of bias in the included studies. STUDY SELECTION Articles were collected with the following study inclusion criteria: (1) randomized controlled trials (RCTs) design. (2) participants were female patients with FMS aged > 18 years. (3) participants from experiments groups received exergame training using any modality. And (4) outcome measures include overall functioning, quality of life, exercise capacity, health perception, kinesiophobia and fatigue severity. DATA SYNTHESIS Nine randomized controlled trials, including 466 female patients with FMS, were included in the analysis. Exergame training had significant positive effects on overall functioning (standardized mean difference [SMD] = -0.52; 95% confidence interval [CI] = -0.77 to 0.27; p < .0001), pain perception (SMD = -0.49; 95% CI = -0.97 to -0.02; p = .04), quality of life (SMD = 0.77; 95% CI = 0.44 to1.10; p < .00001), exercise capacity (SMD = 0.58; 95% CI = 0.32 to 0.84; p < .0001), health perception (SMD = 0.69; 95% CI: 0.38 to 1.01; p < .0001), and fatigue severity (SMD = -0.97; 95% CI = -1.55 to -0.38; p = .001). However, exergame training did not have significant effects on kinesiophobia (SMD = -1.13; 95% CI = -2.88 to 0.62; p = .21) . CONCLUSIONS Exergame training has beneficial effects on the overall functioning, pain perception, quality of life, exercise capacity, health perception and fatigue severity of female patients with FMS. Exergame training is a potential non-drug therapy for the treatment of patients with FMS.
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Affiliation(s)
- Jinlong Wu
- College of Physical Education, Shenzhen University, Shenzhen, China; Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong
| | - Ziyan Chen
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Kangyong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Weiwei Huang
- College of Physical Education, Guangzhou Sport University, Gaungzhou, China
| | - Fang Liu
- Shenzhen Fuyong Middle School, Shenzhen, China
| | - Jian Lin
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- College of Physical Education, Shenzhen University, Shenzhen, China.
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Abstract
Oxytocin (OT) is recognized as a critical neuropeptide in pain-related disorders. Chronic pain caused by the comorbidity of temporomandibular disorder (TMD) and fibromyalgia syndrome (FMS) is common, but whether OT plays an analgesic role in the comorbidity of TMD and FMS is unknown. Female rats with masseter muscle inflammation combined with 3-day forced swim (FS) stress developed somatic hypersensitivity, which modeled the comorbidity of TMD and FMS. Using this model, the effects of spinal OT administration on mechanical allodynia and thermal hyperalgesia in hindpaws were examined. Furthermore, the protein levels of OT receptors and 5-HT2A receptors in the L4-L5 spinal dorsal horn were analyzed by Western blot. The OT receptor antagonist atosiban and 5-HT2A receptor antagonist ritanserin were intrathecally injected prior to OT injection in the separate groups. Intrathecal injection of 0.125 μg and 0.5 μg OT attenuated the hindpaw hyperalgesia. The expression of OT receptors and 5-HT2A receptors in the L4-L5 spinal dorsal horn significantly increased following intrathecal injection of 0.5 μg OT. Intrathecal administration of either the OT receptor antagonist atosiban or 5-HT2A receptor antagonist ritanserin blocked the analgesic effect of OT. These results suggest that OT may inhibit hindpaw hyperalgesia evoked by orofacial inflammation combined with stress through OT receptors and/or 5-HT2A receptors, thus providing a therapeutic prospect for drugs targeting the OT system and for patients with comorbidity of TMD and FMS.
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Affiliation(s)
- Yue-Xin Li
- Key Laboratory of Shaanxi Province
for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi’an Jiaotong University College of
Stomatology, China
- Department of Special Dental Care, Xi’an Jiaotong University College of
Stomatology, China
| | - Jia-Heng Li
- Key Laboratory of Shaanxi Province
for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi’an Jiaotong University College of
Stomatology, China
| | - Yi Guo
- Key Laboratory of Shaanxi Province
for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi’an Jiaotong University College of
Stomatology, China
| | - Zhuo-Ying Tao
- Key Laboratory of Shaanxi Province
for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi’an Jiaotong University College of
Stomatology, China
| | - Shi-Hao Qin
- Key Laboratory of Shaanxi Province
for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi’an Jiaotong University College of
Stomatology, China
- Department of Special Dental Care, Xi’an Jiaotong University College of
Stomatology, China
| | - Richard J Traub
- Department of Neural and Pain
Sciences, School of Dentistry, Center to Advance Chronic Pain Research, University of Maryland
Baltimore, Baltimore, MD, USA
| | - Hong An
- Department of Special Dental Care, Xi’an Jiaotong University College of
Stomatology, China
| | - Dong-Yuan Cao
- Key Laboratory of Shaanxi Province
for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi’an Jiaotong University College of
Stomatology, China
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25
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Brown N. The Social Course of Fibromyalgia: Resisting Processes of Marginalisation. Int J Environ Res Public Health 2021; 19:333. [PMID: 35010593 PMCID: PMC8751202 DOI: 10.3390/ijerph19010333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
This sociological article reports an empirical study into the lived experience of fibromyalgia. It includes 28 participants (26 women, 2 men) with a formal diagnosis of fibromyalgia. Data collection consisted of the completion of an identity box project and subsequent interviews. Data analysis followed the principles of iterative, inductive, semantic thematic analysis, and led to the identification of four major themes: the role of the social in making sense of the experience, the process of redefining lifegoals, the refusal to accept fibromyalgia as a diagnosis, and the consideration of identifying as a patient. These themes in turn demonstrate four forms of resistance against processes of marginalisation amongst those who have been diagnosed with fibromyalgia: (1) the incorporation of societal expectations and norms into their life-stories; (2) the re-making the lifeworld at a cerebral level through redefining reality and creating a new, socially acceptable reality; (3) the active rejection of the fibromyalgia diagnosis; and (4) the employment of active and pro-active countermeasures to assuming the sick role.
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Affiliation(s)
- Nicole Brown
- UCL Institute of Education, College London, London WC1H 0AL, UK
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Kvæl LAH, Løchting I, Molin M. Use of Dietary Supplements and Perceived Knowledge among Adults Living with Fibromyalgia in Norway: A Cross-Sectional Study. Nutrients 2021; 14:5. [PMID: 35010882 DOI: 10.3390/nu14010005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 01/13/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a complex medical condition characterized by widespread musculoskeletal pain. To date, no gold standard treatment has been developed, and persons with FMS often seek alternative methods to control their symptoms, such as dietary supplements (DS). This study aimed to describe the use of DS in persons living with FMS and examine the associations between the use of DS and its potential predictors. We recruited a convenience sample of 504 participants (≥18 years) living with FMS. The main outcome variables included estimated expenditure on DS in the last 12 months in Norwegian kroner (NOK) and the differences between the groups of users and non-users of DS. Of the 504 participants, 430 reported having used DS, and the mean amount of money spent in the previous year was determined to be NOK 2300. The most common DS reported were vitamin D, magnesium, and omega-3 fatty acids. The predictors of being a DS user were high education, high self-reported knowledge of DS but low overall knowledge of health claims. Users of DS marketed for muscles/joints appear to spend more money on DS. The increasing availability of DS and aggressive advertising in the media through health claims stipulate the need for interventions that lead to informed decisions about DS.
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Montesó-Curto P, Cubí-Guillen MT, Llàdser Navarro AN, Puig Llobet M, Toussaint L. Family perceptions and experiences of living with patients with fibromyalgia syndrome. Disabil Rehabil 2021; 44:5855-5862. [PMID: 34232795 DOI: 10.1080/09638288.2021.1948620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To explore the perception of the illness and the experience of the illness for relatives of fibromyalgia syndrome (FMS) patients. MATERIALS AND METHODS This qualitative interpretative study adopted a grounded theory research methodology with a purposive sample. We conducted a focus group with 11 family members of FMS patients. There were six men and five women, five were spouses and six were children (four husbands and one wife, and five daughters and one son). RESULTS Three categories of family perceptions of FMS emerged: (1) manifestations of FMS; (2) FMS is regarded as a psychological problem; (3) FMS interferes with traditional gender roles. Three categories of family members' experience of living with FMS patients were identified: (1) emotional concerns and exhaustion; (2) overprotective family members; and (3) escape coping. CONCLUSIONS Family members feel emotionally burdened, can be overprotective and over-involved and find it difficult to set limits ultimately succumbing to a vicious cycle of caregiving and emotional exhaustion from which they find it difficult to escape. As the perceptions and experiences of family members of FMS patients are not commonly studied, the present findings offer new insights for families and elucidate important points of intervention.Implications for rehabilitationBecause family members tend to dismiss fibromyalgia as a psychological problem for which ignoring or distracting the patient is the best approach to coping, rehabilitation programs should give family members education and training to develop the ability to better understand fibromyalgia and reduce stereotypes about the condition.Rehabilitation programs should work to identify and manage marital and family systems dysfunction that may be interfering with fibromyalgia patients' adjustment and quality of life.Family members often engage in maladaptive escape coping to manage the demands of living with patients with fibromyalgia, and rehabilitation professionals should be ready to engage and refer to allied specialists to assist family members in finding alternatives for more effective coping approaches that improve patient and family mental health and social relations.Rehabilitation programs for fibromyalgia patients should use a gender perspective and emphasize patient and spouse equality in activities of daily living as many patients and family members feel uncomfortable about not fulfilling traditional gender roles.
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Marino C, Grimaldi M, Sabatini P, Amato P, Pallavicino A, Ricciardelli C, D’Ursi AM. Fibromyalgia and Depression in Women: An 1H-NMR Metabolomic Study. Metabolites 2021; 11:429. [PMID: 34209136 PMCID: PMC8304744 DOI: 10.3390/metabo11070429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/18/2022] Open
Abstract
Fibromyalgia is a chronic and systemic syndrome characterized by muscle, bone, and joint pain. It is a gender-specific condition with a 9:1 incidence ratio between women and men. Fibromyalgia is frequently associated with psychic disorders affecting the cognitive and emotional spheres. In the reported work, we compared 31 female fibromyalgia patients to 31 female healthy controls. They were analyzed for biochemical clinical parameters, for autoimmune markers, and were subjected to 1H-NMR metabolomics analysis. To identify a correlation between the metabolomic profile and the psychic condition, a subset of 19 fibromyalgia patients was subjected to HAM-A and HAM-D Hamilton depression tests. Multivariate statistical analysis showed the dysmetabolism of several metabolites involved in energy balance that are associated with systemic inflammatory conditions. The severity of depression worsens dysmetabolic conditions; conversely, glycine and glutamate, known for their critical role as neuromodulators, appear to be potential biomarkers of fibromyalgia and are associated with different severity depression conditions.
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Affiliation(s)
- Carmen Marino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Manuela Grimaldi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Paola Sabatini
- U.O.C. Clinical Pathology D.E.A. III Umberto I, Viale S. Francesco D’Assisi, 84014 Nocera Inferiore, Italy;
| | - Patrizia Amato
- ASL Ser. T Cava de’ Tirreni, Piazza Matteo Galdi 1/3, 84013 Pregiato, Italy;
| | - Arianna Pallavicino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Carmen Ricciardelli
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Anna Maria D’Ursi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
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Galvez-Sánchez CM, Montoro CI, Moreno-Padilla M, Reyes del Paso GA, de la Coba P. Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review. J Clin Med 2021; 10:2706. [PMID: 34205244 PMCID: PMC8235706 DOI: 10.3390/jcm10122706] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). METHODS This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. RESULTS The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., "waiting list") conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. CONCLUSIONS There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.
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Affiliation(s)
- Carmen M. Galvez-Sánchez
- Department of Psychology, University of Jaén, 23071 Jaén, Spain; (C.I.M.); (M.M.-P.); (G.A.R.d.P.); (P.d.l.C.)
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Şen ÇakiroĞlu G, Hİzmetlİ S, SİlİĞ Y, KaradaĞ A, Hayta E, Özaltin B, TaŞ A, Zontul C. Comparison of Beta-2 Adrenergic Receptor Gene Polymorphisms Between Patients with Fibromyalgia Syndrome and Healthy Controls. Arch Rheumatol 2021; 35:328-334. [PMID: 33458655 PMCID: PMC7788641 DOI: 10.46497/archrheumatol.2020.7602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/05/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to compare the beta-2 adrenergic receptor (ADRB2) gene polymorphisms of patients with fibromyalgia syndrome (FMS) with those of healthy control subjects, and to investigate the possible relationship between symptoms of FMS and polymorphisms of the ADRB2 gene. Patients and methods The study included 170 females (mean age 47.8±10.3 years; range, 21 to 75 years) diagnosed with FMS according to the 2010 American College of Rheumatology criteria and 170 healthy females (mean age 47.2±8.8 years; range, 20 to 72 years) as the control group. Several clinical symptoms of the participants related to FMS were questioned and recorded. The visual analog scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scores of the fibromyalgia group were recorded. In both groups, the ADRB2 (rs1042717) single-nucleotide polymorphism was detected by way of a real-time polymerase chain reaction. The wild-type (Guanine/Guanine), the mutant type (Adenine/Adenine) and heterozygous type (Adenine/Guanine) were detected. The sample power was calculated considering the minor allele frequency. Results The comparison of the ADRB2 gene polymorphism between patients with FMS and the control subjects showed that the groups were similar in terms of ADBR2 gene polymorphism and genotype (p>0.05). There was no significant difference in terms of genotype when the ADRB2 gene polymorphisms in patients with FMS were compared in terms of clinical symptoms, VAS and FIQ scores (p>0.05). Conclusion Beta-2 adrenergic receptor (rs1042717) gene polymorphisms and genotype distribution are no different between patients with FMS and healthy individuals. ADRB2 gene polymorphisms in patients with FMS have no effect on clinical symptoms and VAS and FIQ scores. The results of the present study will light the way for future research into ADRB2 gene polymorphisms in the pathogenesis of FMS.
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Affiliation(s)
- Gözde Şen ÇakiroĞlu
- Department of Physical Medicine and Rehabilitation, Niğde State Hospital, Niğde, Turkey
| | - Sami Hİzmetlİ
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Yavuz SİlİĞ
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ahmet KaradaĞ
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Emrullah Hayta
- Department of Physical Medicine and Rehabilitation, Acıbadem Hospital, İstanbul, Turkey
| | - Burcu Özaltin
- Department of Physical Medicine and Rehabilitation, Anamur State Hospital, Mersin, Turkey
| | - Ayça TaŞ
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Cemile Zontul
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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Mülkoğlu C, Ayhan FF. The impact of coexisting fibromyalgia syndrome on disease activity in patients with psoriatic arthritis and rheumatoid arthritis: A cross-sectional study. Mod Rheumatol 2020; 31:827-833. [PMID: 32924689 DOI: 10.1080/14397595.2020.1823069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND/OBJECTIVE This study aims to assess the coexistence of fibromyalgia syndrome (FMS) and impact of possible FMS on disease activity in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA). METHODS A total of 126 patients, aged 18-65 years old, who were being followed up with PsA (n = 64) and RA (n = 62) diagnoses were included. The Fibromyalgia Rapid Screening Tool (FiRST) was administered for screening FMS. Patients were divided according to the presence of FMS; PsA patients with FMS, patients with PsA without FMS, patients with both RA and FMS and patients with RA without FMS. Disease Activity Score 28 (DAS28) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were recorded. RESULTS FMS was detected in 26.5% of the patients with PsA and 17.7% of the patients with RA (p = .04). A statistically significant higher DAS28 and BASDAI scores were found in patients with FMS (p < .05). There was statistically significant correlation between FiRST with DAS28 and BASDAI scores (p < .001, p = .03, respectively) in PsA patients. No significant correlation was found between FiRST score with age, disease duration, CRP and DAS28 in patients with RA (p > .05). CONCLUSION The patients with concomitant FMS had higher disease activity parameters (DAS28 and BASDAI) than those without FMS.
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Affiliation(s)
- Cevriye Mülkoğlu
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - F Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Medicana International Ankara, Ankara, Turkey
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Velasco-Furlong L, Gutiérrez-Hermoso L, Mateos-Pintado B, Castro DG, Blanco-Rico S, Sanromán-Canelada L, López-Roig S, Pastor-Mira MÁ, Peñacoba-Puente C. The 4 U's Rule of Fibromyalgia: A Proposed Model for Fatigue in a Sample of Women with Fibromyalgia: A Qualitative Study. Int J Environ Res Public Health 2020; 17:E6224. [PMID: 32867186 DOI: 10.3390/ijerph17176224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023]
Abstract
Although fatigue usually goes unnoticed, it is a symptom that poses great challenges to patients with fibromyalgia and is a strong limitation. The aim of this study is to identify and describe the variables involved in fatigue in nine different situations of the Goal Pursuit Questionnaire (GPQ) that may occur in the daily lives of women with fibromyalgia, according to an ABC (Antecedents–Behaviors–Consequences) model. This study followed a qualitative descriptive research method and a deductive–inductive hybrid approach based on a phenomenological paradigm. Twenty-six women with fibromyalgia participated in focus group discussions between February and March of 2018. Thematic content analysis was carried out from transcribed verbatim interviews. We identified nine major themes that emerged from the participants’ conversations: self-imposed duties, muscle fatigue, overwhelming feeling of tiredness, difficulty thinking, difficulty concentrating, negative emotions, lifestyle changes, affected everyday activities, and lack of motivation for daily activities and social interactions. We conclude that the ABC model allowed certain elements to emerge regarding the fatigue experience, highlighting its importance as a symptom in fibromyalgia. This additional analysis of the ABC model showed that fatigue can be described through the 4 U’s Rule, which is integrated by these four adjectives: (1) Unpredictable, (2) Uncontrollable, (3) Unseen, and (4) Unintelligible. Identifying these characteristics can contribute to a better understanding of fibromyalgia in addition to better treatment for these patients.
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Bilgici B, Akyol Y, Ulus Y, Ürkmez SS, Kuru Ö. Is there any association between low level of serum nesfatin-1 and fibromyalgia syndrome? Arch Rheumatol 2020; 36:38-46. [PMID: 34046567 PMCID: PMC8140860 DOI: 10.46497/archrheumatol.2021.7736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/13/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to investigate the relationship between serum level of nesfatin-1 and fibromyalgia syndrome (FMS) clinical parameters such as pain severity, disease activity, fatigue, emotional state, and sleep quality. Patients and methods Forty-six female patients with FMS (median age 40 years; range, 18 to 53 years) and 46 healthy female controls (median age 36 years; range, 19 to 52 years) were included in the study. Severity of pain, disease activity, fatigue, sleep quality, and emotional status were evaluated by visual analog scale, Fibromyalgia Impact Questionnaire, Multidimensional Assessment of Fatigue (MAF), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI), respectively. Serum nesfatin-1 concentrations (pg/mL) were measured by enzyme-linked immunosorbent assay method. Results There was no significant difference with respect to demographic characteristics between the FMS patients and healthy controls. When clinical parameters were compared, MAF, BDI, BAI, and PSQI scores were significantly higher in FMS patients than controls (p<0.05). Serum nesfatin-1 concentration was significantly lower in patients with FMS (p<0.05). When compared to the FMS patients without anxiety, serum nesfatin-1 concentration was significantly increased in FMS patients with anxiety (p<0.05). Serum nesfatin-1 concentration was positively correlated with BAI scores in patients with FMS (p<0.05). Conclusion Low nesfatin-1 serum levels may contribute to pathological changes in FMS. In addition, nesfatin-1 may also be involved in the mediation of anxiety-related responses in FMS.
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Affiliation(s)
- Birşen Bilgici
- Department of Biochemistry, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Yeşim Akyol
- Department of Physical Therapy and Rehabilitation, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Yasemin Ulus
- Department of Physical Therapy and Rehabilitation, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Sebati Sinan Ürkmez
- Department of Biochemistry, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Ömer Kuru
- Department of Physical Therapy and Rehabilitation, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
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Aksu E, Berk E, Sökmen A, Sökmen G, Çelik E. Subclinical cardiac structural and electrical abnormalities in fibromyalgia syndrome. Turk J Med Sci 2020; 50:885-893. [PMID: 32283905 PMCID: PMC7379451 DOI: 10.3906/sag-1912-228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/11/2020] [Indexed: 12/19/2022] Open
Abstract
Background/aim In the literature, there is a paucity of data about the effects of fibromyalgia syndrome (FMS) on myocardial function and electrophysiological properties of atrium and ventricles. In this study, we investigated cardiac functions and noninvasive predictors of arrhythmias in patients with FMS. Materials and methods The study included 43 female patients diagnosed with FMS and 30 age- and sex-matched healthy subjects. The presence of fragmented QRS (fQRS) morphology, P dispersion, QT dispersion, inter- and intraatrial electromechanical delay was evaluated in the groups with 12-lead ECG and standard and tissue Doppler echocardiography. Results Among electrocardiographic parameters, P dispersion, QT dispersion, and the ratio of presence of fQRS morphology were found to be significantly higher in the study group as compared to the control group. In lateral and septal, the ratio of the early transmitral flow velocity to the early diastolic tissue velocity (E/Em) was significantly higher in the study group. Additionally, intra- and interatrial electromechanical delay was found significantly prolonged in the study group. Conclusion FMS is found to be associated with significant cardiac electrical alterations that may indicate the increased risk of atrial and ventricular arrhythmias in this group of patients.
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Affiliation(s)
- Ekrem Aksu
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ejder Berk
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Abdullah Sökmen
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Gülizar Sökmen
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Enes Çelik
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Üçeyler N, Buchholz HG, Kewenig S, Ament SJ, Birklein F, Schreckenberger M, Sommer C. Cortical Binding Potential of Opioid Receptors in Patients With Fibromyalgia Syndrome and Reduced Systemic Interleukin-4 Levels - A Pilot Study. Front Neurosci 2020; 14:512. [PMID: 32508586 PMCID: PMC7248364 DOI: 10.3389/fnins.2020.00512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/24/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: We investigated cerebral opioid receptor binding potential in patients with fibromyalgia syndrome (FMS) using positron-emission-tomography (PET) and correlated our results with patients’ systemic interleukin-4 (IL-4) gene expression. Methods: In this pilot study, seven FMS patients (1 man, 6 women) agreed to participate in experimental PET scans. All patients underwent neurological examination, were investigated with questionnaires for pain, depression, and FMS symptoms. Additionally, blood for IL-4 gene expression analysis was withdrawn at two time points with a median latency of 1.3 years. Patients were investigated in a PET scanner using the opioid receptor ligand F-18-fluoro-ethyl-diprenorphine ([18F]FEDPN) and results were compared with laboratory normative values. Results: Neurological examination was normal in all FMS patients. Reduced opioid receptor binding was found in mid cingulate cortex compared to healthy controls (p < 0.005). Interestingly, three patients with high systemic IL-4 gene expression had increased opioid receptor binding in the fronto-basal cortex compared to those with low IL-4 gene expression (p < 0.005). Conclusion: Our data give further evidence for a reduction in cortical opioid receptor availability in FMS patients as another potential central nervous system contributor to pain in FMS.
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Affiliation(s)
- Nurcan Üçeyler
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | | | - Susanne Kewenig
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | | | - Frank Birklein
- Department of Neurology, University of Mainz, Mainz, Germany
| | | | - Claudia Sommer
- Department of Neurology, University of Würzburg, Würzburg, Germany
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Écija C, Luque-Reca O, Suso-Ribera C, Catala P, Peñacoba C. Associations of Cognitive Fusion and Pain Catastrophizing with Fibromyalgia Impact through Fatigue, Pain Severity, and Depression: An Exploratory Study Using Structural Equation Modeling. J Clin Med 2020; 9:jcm9061763. [PMID: 32517175 PMCID: PMC7356993 DOI: 10.3390/jcm9061763] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 01/09/2023] Open
Abstract
Differences in fibromyalgia impact on functioning exist and appear to be influenced by numerous factors, including symptomatology severity, as well as the cognitive profile of the individual. The contribution of these elements, however, tends to be explored in a fragmented manner. To address this issue, we tested a comprehensive structural equation model in which associations of cognitive fusion and pain catastrophizing with function limitations are investigated through fibromyalgia symptomatology (i.e., fatigue, pain severity, and depression) in 231 women with fibromyalgia. In the model, cognitive fusion and two catastrophizing components (magnification and helplessness) were associated with poorer functioning indirectly through fibromyalgia symptomatology. Only the rumination component of catastrophizing had a direct association with functional limitations. All fibromyalgia symptoms were linked to increased functional limitations. A parsimonious model with significant associations only obtained an excellent fit (S-B χ2 = 774.191, df = 543, p < 0.001; CFI = 0.943; RMSEA = 0.043; CAIC = −2724.04) and accounted for 50% of the variance of functional limitations. These results suggest that the relationship between psychological cognitive processes, fibromyalgia symptomatology, and functional limitations is complex and support the need for comprehensive models such as the present. The findings are discussed in the context of personalized psychological treatments (i.e., the need to address certain cognitive processes according to the problematic symptomatology or outcome).
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Affiliation(s)
- Carmen Écija
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Madrid, Spain; (C.E.); (O.L.-R.); (P.C.)
| | - Octavio Luque-Reca
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Madrid, Spain; (C.E.); (O.L.-R.); (P.C.)
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, 12071 Castelló de la Plana, Castelló, Spain;
| | - Patricia Catala
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Madrid, Spain; (C.E.); (O.L.-R.); (P.C.)
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, 28922 Alcorcón, Madrid, Spain; (C.E.); (O.L.-R.); (P.C.)
- Correspondence:
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Akar N, Sayıner Çaglar N, Aytekin E, Akar A, Aksu Ö, Öz N. Low levels of serum vitamin D3 are associated with fibromyalgia syndrome in pre-menopausal women: A pilot study. Turk J Phys Med Rehabil 2020; 66:67-72. [PMID: 32318677 DOI: 10.5606/tftrd.2020.2928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 11/05/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the prevalence of fibromyalgia syndrome (FMS) among patients with low and adequate vitamin D levels in premenopausal women. Patients and methods Between October 2012 and April 2013, a total of 80 premenopausal patients (mean age 38.1±7.1 years; range, 18 to 50 years) with non-specific musculoskeletal symptoms were included in the study. The determination of 25-hydroxyvitamin D3 (25(OH)D3) deficiency was based on a reference value of 25 ng/mL. Patients with deficient serum 25(OH)D3 levels (<25 ng/mL, n=40) comprised the patient group, while those with adequate serum 25(OH)D3 levels (≥25 ng/mL, n=40) comprised the control group. Data including demographic characteristics, laboratory parameters (i.e., calcium, phosphorus, alkaline phosphatase [ALP], and parathyroid hormone [PTH]), and clinical findings (i.e., proximal muscle weakness [PMW] and periarticular sensitivity [PAS]) were recorded and compared between the groups. Pain severity was evaluated using the visual analog scale (VAS), psychological status was evaluated using the Beck Depression Inventory (BDI), and quality of life (QoL) was evaluated using the Short Form 36 (SF-36). The diagnosis of FMS was made based on the 2010 criteria of the American College of Rheumatology. Results Although there were no statistically significant differences in the demographic characteristics between the groups, ALP and PTH levels were higher in the patient group (p<0.05). The VAS, frequency of FMS, PMW, and PAS were also significantly higher in the patient group (p<0.05). Depression and the mental and physical component scores of the SF-36 did not significantly differ between the two groups (p<0.05). Conclusion Our study results suggest that patients with low 25(OH)D3 levels may more frequently experience FMS and pain than healthy individuals.
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Samanci R, Ataoglu S, Ozsahin M, Ankarali H, Admis O. An investigation of serum irisin levels and inflammatory markers in fibromyalgia syndrome. North Clin Istanb 2019; 6:341-7. [PMID: 31909378 DOI: 10.14744/nci.2019.95676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 02/19/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: In the present study, we aimed to compare serum irisin levels in patients with fibromyalgia syndrome (FMS) and healthy control subjects and also investigate the relationship between irisin, disease activity and inflammation markers in patients. METHODS: A total of 84 women, including 48 patients who were diagnosed with FMS and 36 healthy controls, were included in this study. The demographic characteristics of the patients and control group were recorded. VAS for pain and the Fibromyalgia Impact Questionnaire for the assessment of the physical function of the patients, SF36 was used for quality of life, and accompanying Beck Depression Inventory to assess depression was used. Blood samples were taken for analysis that irisin, and inflammatory markers of the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP) and neutrophil/lymphocyte ratio (NLO). Serum irisin levels were determined using the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULTS: Serum irisin level of the patients with FMS had no significant differences compared with the healthy control group. When we compared the values of ESR, CRP, hsCRP, NLO with FMS patients and healthy controls, there was no significant difference found between them (p>0.05). There was no significant correlation between inflammatory markers and level of serum irisin (p>0.05). In patients, there was no significant correlation between inflammatory markers and level of serum irisin (p>0.05). CONCLUSION: Irisin, which is a myokine, was determined to have no significant role in the pathogenesis of FMS. Irisin had no association with disease activity and inflammatory markers. Also, the inflammation hypothesis was not supported, which suggested in FMS.
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Klitsch A, Evdokimov D, Frank J, Thomas D, Saffer N, Meyer Zu Altenschildesche C, Sisignano M, Kampik D, Malik RA, Sommer C, Üçeyler N. Reduced association between dendritic cells and corneal sub-basal nerve fibers in patients with fibromyalgia syndrome. J Peripher Nerv Syst 2020; 25:9-18. [PMID: 31846167 DOI: 10.1111/jns.12360] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/09/2019] [Accepted: 12/12/2019] [Indexed: 02/06/2023]
Abstract
In our study, we aimed at investigating corneal langerhans cells (LC) in patients with fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) as potential contributors to corneal small fiber pathology. We enrolled women with FMS (n = 134) and SFN (n = 41) who underwent neurological examination, neurophysiology, prostaglandin analysis in tear fluid, and corneal confocal microscopy (CCM). Data were compared with those of 60 age-matched female controls. After screening for dry eye disease, corneal LC were counted and sub-classified as dendritic (dLC) and non-dendritic (ndLC) cells with or without nerve fiber association. We further analyzed corneal nerve fiber density (CNFD), length (CNFL), and branch density (CNBD). Neurological examination indicated deficits of small fiber function in patients with SFN. Nerve conduction studies were normal in all participants. Dry eye disease was more prevalent in FMS (17%) and SFN (28%) patients than in controls (5%). Tear fluid prostaglandin levels did not differ between FMS patients and controls. While corneal LC density in FMS and SFN patients was not different from controls, there were fewer dLC in association with nerve fibers in FMS and SFN patients than in controls (P < .01 each). Compared to controls, CNFL was lower in FMS and SFN patients (P < .05 each), CNFD was lower only in FMS patients (P < .05), and CNBD was lower only in SFN patients (P < .001). There was no difference in any CCM parameter between patients with and without dry eyes. Our data indicate changes in corneal innervation and LC distribution in FMS and SFN, potentially based on altered LC signaling.
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Affiliation(s)
| | | | - Johanna Frank
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Dominique Thomas
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital, Goethe-University, Frankfurt am Main, Germany
| | - Nadine Saffer
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | | | - Marco Sisignano
- Institute of Clinical Pharmacology, pharmazentrum frankfurt/ZAFES, University Hospital, Goethe-University, Frankfurt am Main, Germany
| | - Daniel Kampik
- Department of Ophthalmology, University of Würzburg, Würzburg, Germany
| | - Rayaz A Malik
- Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Claudia Sommer
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Nurcan Üçeyler
- Department of Neurology, University of Würzburg, Würzburg, Germany
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Abstract
Fibromyalgia Syndrome (FMS) is a disorder of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cognitive dysfunction. There is no definitive pathogenesis except for altered central pain pathways. We previously reported increased serum levels of the neuropeptides substance P (SP) and its structural analogue hemokinin-1 (HK-1) together with the pro-inflammatory cytokines IL-6 and TNF in FMS patients as compared to sedentary controls. We hypothesize that thalamic mast cells contribute to inflammation and pain, by releasing neuro-sensitizing molecules that include histamine, IL-1β, IL-6 and TNF, as well as calcitonin-gene related peptide (CGRP), HK-1 and SP. These molecules could either stimulate thalamic nociceptive neurons directly, or via stimulation of microglia in the diencephalon. As a result, inhibiting mast cell stimulation could be used as a novel approach for reducing pain and the symptoms of FMS.
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Affiliation(s)
- Theoharis C Theoharides
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston, MA, United States.,Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, United States.,Department of Internal Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Psychiatry, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Irene Tsilioni
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston, MA, United States
| | - Mona Bawazeer
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston, MA, United States.,Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, United States.,Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Wylezinski LS, Gray JD, Polk JB, Harmata AJ, Spurlock CF. Illuminating an Invisible Epidemic: A Systemic Review of the Clinical and Economic Benefits of Early Diagnosis and Treatment in Inflammatory Disease and Related Syndromes. J Clin Med 2019; 8:E493. [PMID: 30979036 PMCID: PMC6518102 DOI: 10.3390/jcm8040493] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/06/2019] [Accepted: 04/08/2019] [Indexed: 12/12/2022] Open
Abstract
Healthcare expenditures in the United States are growing at an alarming level with the Centers for Medicare and Medicaid Services (CMS) projecting that they will reach $5.7 trillion per year by 2026. Inflammatory diseases and related syndromes are growing in prevalence among Western societies. This growing population that affects close to 60 million people in the U.S. places a significant burden on the healthcare system. Characterized by relatively slow development, these diseases and syndromes prove challenging to diagnose, leading to delayed treatment against the backdrop of inevitable disability progression. Patients require healthcare attention but are initially hidden from clinician's view by the seemingly generalized, non-specific symptoms. It is imperative to identify and manage these underlying conditions to slow disease progression and reduce the likelihood that costly comorbidities will develop. Enhanced diagnostic criteria coupled with additional technological innovation to identify inflammatory conditions earlier is necessary and in the best interest of all healthcare stakeholders. The current total cost to the U.S. healthcare system is at least $90B dollars annually. Through unique analysis of financial cost drivers, this review identifies opportunities to improve clinical outcomes and help control these disease-related costs by 20% or more.
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Affiliation(s)
- Lukasz S Wylezinski
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
- IQuity, Inc., Nashville, TN 37203, USA.
| | | | | | | | - Charles F Spurlock
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
- IQuity, Inc., Nashville, TN 37203, USA.
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Abd Elghany SE, Al Ashkar DS, El-Barbary AM, El Khouly RM, Aboelhawa MA, Nada DW, Darwish NF, Hussein MS, Rageh ES, Abo-Zaid MH, Eldesoky IF, Afifi S. Regenerative injection therapy and repetitive transcranial magnetic stimulation in primary fibromyalgia treatment: A comparative study. J Back Musculoskelet Rehabil 2019; 32:55-62. [PMID: 30149440 DOI: 10.3233/bmr-181127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study compared the effectiveness of regenerative injection therapy (RIT), i.e. prolotherapy, and repetitive transcranial magnetic stimulation (rTMS) in the treatment of fibromyalgia syndrome. PATIENTS AND METHODS This study included 120 female, age-matched fibromyalgia patients. All patients underwent a clinical examination, pain assessment by VAS, assessment of tender points, psychiatric and functional assessment using the Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire Revised (RFIQ), and measurement of cortical auditory evoked potentials CAEPs elicited at 1000 Hz. Patients were divided into two equal groups; Group 1 received prolotherapy three times, two weeks apart, and Group 2 received rTMS sessions every other day for one month. Assessment was performed before treatment, immediately after treatment, and one month later. RESULTS A significant improvement of pain measured by the mean score of VAS was remarked in Group 1 compared to Group 2 immediately after treatment and one month later. There was statistically significant difference of mean scores for the number of tender points in Group 1 compared to Group 2 after treatment and one month later. The patients improved functionally, with a statistically significant difference in mean score of RFIQ, in Group 1 compared to Group 2 one month after treatment. However, there was a significant difference in mean score of BDI in Group 2 compared to Group 1 after treatment and one month later. Further, CAEPs showed better improvement, with a significant difference in Group 2, one month after treatment. CONCLUSION RIT had the advantage in clinical and functional improvement in fibromyalgia patients, while rTMS had better results regarding depression and the cortical component of AEPs. These results might draw attention to the evaluability of a combination of both techniques for a better therapeutic response.
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Affiliation(s)
| | - Doaa S Al Ashkar
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Amal M El-Barbary
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Radwa M El Khouly
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Marwa A Aboelhawa
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Doaa W Nada
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Nivine F Darwish
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Manal S Hussein
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - El Sayed Rageh
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Mohamed H Abo-Zaid
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Islam F Eldesoky
- Neurology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samah Afifi
- Neurology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Elboğa G, Akaltun MS, Altındağ Ö, Altındağ A, Aydeniz A, Gürsoy S, Gür A. Alexithymia and attention deficit and their relationship with disease severity in fibromyalgia syndrome. Turk J Phys Med Rehabil 2020; 66:134-9. [PMID: 32760889 DOI: 10.5606/tftrd.2020.2926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 01/18/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives The aim of this study was to investigate the frequency of alexithymia and attention deficit and to evaluate their relationship with the severity of disease in patients with fibromyalgia syndrome (FMS). Patients and methods A total of 101 patients (6 males, 95 females; mean age 45.0 years; range, 33 to 56 years) who were admitted to Gaziantep University, Medical Faculty, Physical Medicine and Rehabilitation Department between January 2013 and December 2013 and were diagnosed with FMS and 40 healthy volunteers (4 males, 36 females; mean age 41.5 years; range, 31 to 51 years) were enrolled in this study. The Fibromyalgia Impact Questionnaire (FIQ), Hamilton Depression Scale (HAM-D), Toronto Alexithymia Scale-26 (TAS-26), and Jasper-Goldberg Attention Deficit Test (ADT) were applied. Results The rate of alexithymia and possible alexithymia was 56.4% and 20.8% in the patients with FMS and 2.5% and 5% in the control group, respectively. The mean TAS-26 score was 60.1±11.7 in the patients with FMS. According to the HAM-D, depressive symptoms were seen in 72.0% and 2.5% of the patients with FMS and healthy controls, respectively. Conclusion Our study results confirm the presence of psychiatric comorbidities in patients with FMS and clearly suggest that depression, alexithymia, and attention deficit are high and mutually correlated in FMS patients. Therefore, all patients should be meticulously evaluated for these conditions at the treatment stage.
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Gündüz N, Erzincan E, Polat A. The Relationship of Intimate Partner Violence With Psychiatric Disorders and Severity of Pain Among Female Patients With Fibromyalgia. Arch Rheumatol 2019; 34:245-52. [PMID: 31598588 DOI: 10.5606/ArchRheumatol.2019.7090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 08/27/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to compare the prevalence of intimate partner violence and comorbid psychiatric disorders among patients with fibromyalgia syndrome (FMS) and healthy controls and also to investigate the relationship of intimate partner violence with psychiatric disorders and severity of pain in FMS patients. Patients and methods The study group consisted of 136 females including 68 patients with FMS (mean age 43±10.4 years; range, 25 to 70 years) and 68 FMS-free healthy females (mean age 38.5±11.3 years; range, 22 to 70 years). Following a Structured Clinical Interview for Diagnostic and Statistical Manual-IV Axis I Disorders by a psychiatrist experienced in psychological trauma, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Visual Analog Scale (VAS) for the severity of pain and Domestic Violence Against Women Scale (DVAWS) were applied. Results In FMS group, 85% of the patients were diagnosed with mood or anxiety disorder. Almost half of these patients had major depressive disorder. The total scores of DVAWS and all subscales were significantly higher in the FMS group than in the control group (p<0.01). The severity of domestic violence were related to the presence of any psychiatric disorder only in FMS patients (p<0.01). Almost half of the FMS patients with high DVAWS score had comorbid mood and anxiety disorders. There was a significant positive correlation between the total scores of DVAWS, HDRS, HARS, and VAS (p<0.01). Conclusion Although the etiology of FMS is still uncertain, psychosocial factors may play role as risk factors. Therefore, a multidisciplinary approach to the treatment should be considered.
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Racine M, Jensen MP, Harth M, Morley-Forster P, Nielson WR. Operant Learning Versus Energy Conservation Activity Pacing Treatments in a Sample of Patients With Fibromyalgia Syndrome: A Pilot Randomized Controlled Trial. J Pain 2019; 20:420-39. [PMID: 30326271 DOI: 10.1016/j.jpain.2018.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 07/23/2018] [Accepted: 09/07/2018] [Indexed: 12/26/2022]
Abstract
This study's aim was to assess the efficacy of 2 forms of activity pacing in patients with fibromyalgia syndrome (FMS). Treatment-related changes in activity management patterns were also examined. Patients with FMS (n = 178) were randomly assigned to an operant learning (OL; delayed [n = 36] or immediate [n = 54] groups) or an energy conservation (EC; delayed [n = 35] or immediate [n = 53] groups) treatment condition. Of these, 32 OL and 37 EC patients completed treatment. Forty-three patients were allocated to the delayed treatment condition (control group). Repeated measures analyses of variance were used to examine the effects of OL and EC treatments on primary (average pain and usual fatigue), secondary (pain and fatigue interference, physical and psychological function, sleep quality, depressive symptoms, and anxiety symptoms), and tertiary (pain-related activity patterns) outcomes. Neither treatment was effective in reducing average pain or usual fatigue symptoms. Relative to EC, OL patients showed greater improvements in depressive symptoms, whereas nonsignificant trends (P values ranging between .05 and .06) were observed for pain interference, fatigue interference, and psychological function. Both treatments were associated with improvements in sleep quality and physical function, increases in pacing, and decreases in overdoing activity patterns. Reductions in activity avoidance were only found in OL. These findings suggest that OL may be more beneficial than EC and that it could potentially be viewed as an effective stand-alone activity pacing treatment for patients with FMS. Research to determine the extent to which these preliminary findings replicate is warranted. PERSPECTIVE: This article examines the efficacy of 2 forms of activity pacing in patients with fibromyalgia syndrome. The results suggest the possibility that operant learning may be more beneficial than energy conservation and could potentially be viewed as an effective stand-alone activity pacing treatment for patients with fibromyalgia syndrome.
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Robin F, Cébron T, Letellier M, Nizard J. The effects of emotional content on source monitoring in fibromyalgia patients. J Gen Psychol 2018; 145:392-414. [PMID: 30235106 DOI: 10.1080/00221309.2018.1494536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Source confusion refers to a person's failure to distinguish whether an event has been actually seen or simply imagined. Nevertheless, prior research has demonstrated a reduction of source confusion for negative arousing information. According to the emotional-congruence effect, this emotional benefit is likely observed in patients suffering from chronic pain. This hypothesis was tested on 15 patients suffering of fibromyalgia syndrome (FMS) and 15 healthy women. In a source-monitoring task, participants had to decide whether positive, negative, and neutral words were imagined or seen with a picture. The results showed recognition deficits and more source confusion for FMS patients compared to controls. Contrary to the hypothesis of negativity bias in fibromyalgia, patients exhibited enhanced recognition for both positive and negative words. Moreover, they showed better source memory for the imagined items than for those seen with a picture. Overall, these results indicate that FMS affects episodic memory.
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Sayilir S, Ergün G, Ekiz T. Evaluation of Ventricular Diastolic Function in Patients With Fibromyalgia Syndrome. Arch Rheumatol 2018; 33:150-3. [PMID: 30207569 DOI: 10.5606/ArchRheumatol.2018.6541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/09/2017] [Indexed: 01/08/2023] Open
Abstract
Objectives This study aims to compare the diastolic functions between fibromyalgia (FM) patients and control subjects by using transthoracic echocardiography. Patients and methods This case-control and cross-sectional study included 34 female FM patients (mean age 43.6±8.2 years; range 28 to 57 years), who were diagnosed by The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia and defined as the FM group. A control group was defined consisting of 30 healthy females (mean age 41.2±9.1 years; range 22 to 54 years). Echocardiography findings of the groups were compared. Results The body mass index and mean disease duration of the FM group were 25.37±2.71 kg/m2 and 12.24 months, respectively. The body mass index of the control group was 25.58±1.49 kg/m2. There was no significant difference between the groups in terms of age and body mass index. Isovolumetric relaxation time and mitral E-wave deceleration time values were significantly higher in the FM group than in the control group (p=0.047, p=0.003, respectively). Conclusion Isovolumetric relaxation time and mitral valve deceleration time are significantly prolonged in FM patients compared with healthy subjects. Female patients with FM seem to be under risk of impaired relaxation and diastolic function of the left ventricle.
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Gündüz N, Üşen A, Aydin Atar E. The Impact of Perceived Social Support on Anxiety, Depression and Severity of Pain and Burnout Among Turkish Females With Fibromyalgia. Arch Rheumatol 2019; 34:186-95. [PMID: 31497765 DOI: 10.5606/ArchRheumatol.2019.7018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/28/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to assess the impact of perceived social support on burnout, severity of pain and comorbid anxiety and depression among Turkish females with fibromyalgia syndrome (FMS). Patients and methods A total of 117 females including 65 patients with FMS (mean age 33.5±8.1 years; range 20 to 60 years) and 52 healthy controls (mean age 33.6±7.3 years; range 23 to 48 years) were included between January 2017 and May 2017. Following a semi-structured psychiatric interview by a psychiatrist, Sociodemographic Data Form, Mood and Anxiety Disorders Modules of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition Axis I Disorders (SCID-I), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Visual Analog Scale (VAS), Maslach Burnout Inventory (MBI) and Multidimensional Scale of Perceived Social Support (MSPSS) were applied to participants. Results As a result of the semi-structured clinical interview conducted by a psychiatrist, the prevalence of any mood or anxiety disorder was found to be significantly more common in the FMS group. The proportion of patients diagnosed with any mood or anxiety disorder using SCID-I was significantly different among FMS (n=50, 76.92%) and healthy control (n=14, 33.33%) groups (p<0.001). Correlations between these variables were examined within the FMS group. There was a significant negative correlation between VAS and MSPSS. There were significant negative correlations between MSPSS and HDRS, HARS, all subscales of MBI. There were significant positive correlations between VAS and HDRS, HARS, all subscales of MBI. Conclusion In conclusion, perceived social support was found to be strongly associated with depression, anxiety, burnout and severity of pain in patients with FMS. Our study provided support to emphasize the importance of perceived social support among females with FMS. Considering that FMS is associated with many physical and cognitive complaints in addition to pain, it can be considered as a multi-systemic disease requiring a multidisciplinary approach.
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Amutio A, Franco C, Sánchez-Sánchez LC, Pérez-Fuentes MDC, Gázquez-Linares JJ, Van Gordon W, Molero-Jurado MDM. Effects of Mindfulness Training on Sleep Problems in Patients With Fibromyalgia. Front Psychol 2018; 9:1365. [PMID: 30147666 PMCID: PMC6096902 DOI: 10.3389/fpsyg.2018.01365] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a complex psychosomatic pain condition. In addition to generalized pain and various cognitive difficulties, new FMS diagnostic criteria acknowledge fatigue and sleep problems as core aspects of this condition. Indeed, poor sleep quality has been found to be a significant predictor of pain, fatigue, and maladaptive social functioning in this patient group. While there is promising evidence supporting the role of mindfulness as a treatment for FMS, to date, mindfulness intervention studies have principally focused on dimensions of pain as the primary outcome with sleep problems either not being assessed or included as a secondary consideration. Given the role of sleep problems in the pathogenesis of FMS, and given that mindfulness has been shown to improve sleep problems in other clinical conditions, the present study explored the effects of a mindfulness-based intervention known as Flow Meditation (Meditación-Fluir) on a range of sleep-related outcomes (subjective insomnia, sleep quality, sleepiness, and sleep impairment) in individuals with FMS. Adult women with FMS (n = 39) were randomly assigned to the 7 weeks mindfulness treatment or a waiting list control group. Results showed that compared to the control group, individuals in the mindfulness group demonstrated significant improvements across all outcome measures and that the intervention effects were maintained at a 3 month follow-up assessment. The Meditación-Fluir program shows promise for alleviating sleep problems relating to FMS and may thus have a role in the treatment of FMS as well as other pain disorders in which sleep impairment is a central feature of the condition.
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Affiliation(s)
- Alberto Amutio
- Department of Social Psychology and Methodology of the Behavioral Sciences, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Clemente Franco
- Department of Psychology, University of Almería, Almería, Spain
| | | | | | | | - William Van Gordon
- Centre for Psychological Research, University of Derby, Derbyshire, United Kingdom
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Lattanzio SM, Imbesi F. Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary Strategy. Front Med (Lausanne) 2018; 5:94. [PMID: 29761101 PMCID: PMC5936760 DOI: 10.3389/fmed.2018.00094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/23/2018] [Indexed: 12/27/2022] Open
Abstract
A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol. Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months. Depression, widespread chronic pain, chronic fatigue, non-restorative sleep, morning stiffness, and the majority of the comorbidities remitted. Energy and vitality were recovered by the patient as prior to the onset of the disease, reverting the occupational and social disabilities. The patient episodically challenged herself breaking the dietary protocol leading to its negative test and to the evaluation of its benefit. These breaks correlated with the recurrence of the symptoms, supporting the correctness of the biochemical hypothesis underlying the diet design toward remission of symptoms, but not as a final cure. We propose this as a low risk and accessible therapeutic protocol for the symptomatic remission in FMS with virtually no costs other than those related to vitamin and mineral salt supplements in case of deficiencies. A pilot study is required to further ground this metabolic approach, and to finally evaluate its inclusion in the guidelines for clinical management of FMS.
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Affiliation(s)
| | - Francesca Imbesi
- Neurological Department, Ospedale Niguarda Ca' Granda, Milan, Italy
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