Female Fibromyalgia Research Articles

Functional brain changes in Mexican women with fibromyalgia

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

Assessment of small fiber neuropathy and distal sensory neuropathy in female patients with fibromyalgia.

We investigated sudomotor dysfunction, small fiber neuropathy (SFN), and their clinical significance in female fibromyalgia patients. Fibromyalgia patients and healthy controls (HCs) were recruited. Clinical and laboratory data were measured. Electrochemical skin conductance (ESC) values of hands and feet were assessed by SUDOSCAN. Additionally, several other methods were employed, including nerve conduction study (NCS), electromyography (EMG), and questionnaires. Spearman correlation coefficient was calculated to identify factors associated with ESC values of SUDOSCAN. Twenty-two female fibromyalgia patients and 22 female HCs were recruited. The fibromyalgia group had lower EQ5D and higher Toronto Clinical Neuropathy scores than the HC group. Most of the EMG/NCS findings of motor and proximal sensory nerves were comparable between the fibromyalgia and HC groups, whereas sensory nerve action potential amplitudes of distal sensory nerves were significantly lower in the fibromyalgia group. Mean ESC values of hands and feet were significantly lower in the fibromyalgia group than in the HC group (57.6 ± 16.2 vs. 68.8 ± 10.3 μS, p = 0.010 for hands, 64.9 ± 11.5 vs. 72.0 ± 8.2 μS, p = 0.025 for feet, respectively). Moderate to severe SFN was more common in the fibromyalgia group (68.2%) than in the HC group (68.2 vs. 50%, p = 0.019). Fibromyalgia disease duration was significantly correlated with the ESC values of hands/feet, and tricyclic antidepressant (TCA) responders had higher ESC values than non-responders. SFN was commonly detected in fibromyalgia patients who had normal EMG/NCS findings and was more severe in fibromyalgia patients with longer disease duration. SUDOSCAN may predict response to TCA therapy.

A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study

IntroductionDespite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients. ObjectiveTo compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity. Materials and methodsPre-diagnosed female FM patients (n=7) and age-matched healthy females (n=19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity. ResultsThe mean holding time for trunk extensors (26.14±7.7s), right lateral flexors (20.14±8.3s), and left lateral flexors (20.86±5.3s) was significantly lower in the FM females than the healthy females (trunk extensors=55.21±17.1s; right lateral flexors=36.05±13.2s; left lateral flexors=35.11±13.8s). The endurance of trunk flexors was statistically similar in both groups (FM females=52.14±27.9s; healthy females=74.37±37.7s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (p>0.05). ConclusionThe results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.

Fibromyalgia, perfectionism, and interpersonal style. Further evidence for a person-centered approach

Objectives. We carried out a controlled, cross-sectional investigation in patients with Fibromyalgia (FM) to determine the presence of perfectionism and three interpersonal styles, namely ‘subjugation’, ‘approval-seeking’, and ‘self-sacrifice’. Method. Several validated self-report questionnaires were filled-in by 100 female FM patients and 36 women with rheumatoid arthritis as a control group. Results. We found significantly higher scores in the FM group for all perfectionism subscales, except for the subscale ‘organization’. Moreover, FM patients scored higher for the three interpersonal styles. Conclusions. Our results support our clinical observations suggesting that maladaptive perfectionism as well as excessive other-directed interpersonal styles may be highly prevalent in patients with FM. These results add to growing evidence that a personalized, biopsychosocially oriented approach taking these factors into account may be a useful addition to standard therapy. However, the effectiveness of additional psychotherapy for FM should be further investigated.

The Effects of Employment Status and Daily Routines on Fibromyalgia

Abstract Introduction Fibromyalgia (FM) is a complex and debilitating condition characterised by chronic pain, fatigue, sleep and mood disturbances. This study aimed to investigate the impact of employment status and daily routines on FM symptoms. Methods This cross-sectional study included female FM patients meeting the diagnostic criteria of the American College of Rheumatology. Participants’ employment status, daily routines, FM symptoms, and psychological well-being were assessed using various scales. The relationship between the variables was also examined. Results Of the 74 female FM patients included, those who were employed exhibited better health outcomes, including reduced symptom severity and improved functionality. Engaging in exercise and reading books were associated with less severe FM symptoms. The frequency of going out during lockdown was positively correlated with FM symptom severity. House cleaning was linked to improved emotional well-being, while social media use, watching TV, and household size had no significant impact on the FM burden. Conclusion This study highlights the positive effects of employment, exercise, and reading on FM symptoms and emphasises the importance of a multi-modal approach to FM management. The findings also suggest that external stressors such as the frequency of going out during a pandemic may influence the course of FM. These insights may inform strategies to enhance the quality of life for individuals living with FM.

Psychological Pain, Hopelessness and Suicide Ideation in Female Patients with Fibromyalgia.

Objective: The aim of this study was to investigate if psychache and hopelessness may serve as reliable predictors of suicidal ideation among female fibromyalgia (FM) patients. This was a cross-sectional study of 50 women with FM, examining the relationship between psychological pain, hopelessness, depressive symptoms, and suicidal ideation. FM diagnosis was confirmed by the American College of Rheumatology (ACR) criteria. Demographic data, the Mini International Neuropsychiatric Interview (MINI 7.0.2), the Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), the Pittsburgh Sleep Quality Index (PSQI) and the Psychache Scale were utilized to assess these relationships and their predictive value for suicidality. The mean age of the participants was 50.2 years (±8.7). Thirty-two (64%) patients had current major depression, 11 (22%) had bipolar disorder, 20 (40%) presented passive suicidal ideation and 14 (28%) presented active suicidal ideation. Psychological pain correlated with both depressive symptoms (p<0.01; r= 0.648) and hopelessness (p=0.029; r=0.312) but did not predict suicidal ideation. Logistic regression analyses revealed depressive symptom severity as a predictor of passive suicidal ideation (odds ratio = 1.486; 95% CI: 1.017 - 2.170), while hopelessness predicted active suicidal ideation (odd ratio = 1.356; 95% CI, 1.049 - 1.753). FM female patients showed increased prevalence of suicidal ideation. Hopelessness predicts active suicidal ideation but psychological pain did not serve as predictive factor for suicide ideation among female FM patients.

How to Promote Walking in Women with Fibromyalgia: A Look at Catastrophizing, Goal Conflict, and Avoidance from a Self-Emotional Regulatory Perspective.

The aim of this study was twofold: to explore the concordance between two measures of physical activity (accelerometer and IPAQ) among female fibromyalgia (FM) patients, as well as to examine the impact of psychosocial variables (catastrophism, activity avoidance) on walking among these patients. Helplessness, activity avoidance, and commitment to physical activity were evaluated in 132 FM women. After the first assessment, an accelerometer was placed by a psychologist on each participant for seven consecutive days. Eight days later, accelerometers were collected, and participants were evaluated again using the IPAQ. Two models were tested to analyze mediation and a moderated mediation effect. The mediating role of activity avoidance between helplessness and minutes walked was corroborated regarding the objective measure of walking. The effect of helplessness on minutes walked during a week was mediated by activity avoidance and assessed by accelerometers. Cognitive variables played a contextual role when trying to promote exercise. Activity avoidance must be understood as a key variable in physical activity promotion, specifically in the promotion of walking with the aim to do exercise in individuals with FM.

Comparative proteomics analysis of female fibromyalgia and osteoarthritis using data‐independent acquisition sequential window acquisition of all theoretical mass spectra‐based mass spectrometry

AbstractFibromyalgia (FM) is a widespread muscle pain disorder that primarily affects females. Osteoarthritis (OA) is another common chronic condition. This study utilized sequential window acquisition of all theoretical mass spectra (SWATH)‐based proteomic analysis on the urine of patients with FM and OA. The study identified 54 differentially expressed proteins (DEPs) in the FM group compared to the healthy control (HC) group; 17 DEPs in the OA group compared to the HC group; and 47 DEPs in the FM group compared to the OA group, with a p‐value &lt;0.05 and a fold change &gt;1.5 or &lt;0.67. The DEPs in both FM and OA groups were primarily involved in pathways related to coagulation and the complement system, as well as serotonin, dopamine, glutamate pathways, and acute phase reactions. The study suggests that FM and OA induce inflammatory reactions, significantly altering the expression of acute phase proteins and notably decreasing the expression of GNB2. This distinction between health and disease, and the differentiation between FM and OA, is facilitated through the coagulation and complement systems, with SERPING1 and EPCR being key markers. Through these pathways, a better understanding of the impact of FM and OA on the human proteome is achieved.

Comparative efficacy of neuromodulation and structured exercise program on pain and muscle oxygenation in fibromyalgia patients: a randomized crossover study.

Introduction: This study investigates the comparative efficacy of neuromodulation therapy using the EXOPULSE Mollii Suit and a structured exercise program in pain modulation and muscle oxygenation in Fibromyalgia patients. Methods: A randomized, crossover, longitudinal, and experimental study design was employed, involving 10 female Fibromyalgia patients. Participants were subjected to two distinct treatment modalities: neuromodulation therapy with the EXOPULSE Mollii Suit and a strength-based High-Intensity Interval Training (HIIT) exercise program, each conducted over 16 sessions. Outcome measures included pain severity, assessed using the Numeric Rating Scale (NRS), and muscle oxygenation variables measured via Near-Infrared Spectroscopy (NIRS). Results: Both interventions demonstrated significant reductions in NRS scores and improvements in muscle oxygenation. However, the exercise program yielded more pronounced long term basal adaptations in muscle oxygenation compared to the neuromodulation therapy. Discussion: The findings underscore the potential of integrating non-pharmacological treatments, particularly structured exercise programs, in managing Fibromyalgia. While neuromodulation therapy presents a viable alternative, the exercise regimen's capacity to induce basal muscle oxygenation adaptations suggests its superiority in addressing the complex symptoms of Fibromyalgia. Furthermore, these therapeutic approaches may enhance patients' vocational values and employability opportunities by improving their functional capabilities and overall quality of life.

Investigating the Effectiveness of a Carb-Free Oloproteic Diet in Fibromyalgia Treatment.

Fibromyalgia (FM), a chronic disease with a high incidence in women, poses a significant challenge for diagnosis and treatment, especially due to the absence of specific biomarkers and the multifaceted nature of its symptoms, which range from neuromuscular pain to mood disorders and intestinal dysbiosis. While diagnosis currently relies on rheumatological clinical evaluations and treatment options mainly focus on symptom management, FM seems to have possible links with systemic metabolic dysfunctions with a common inflammatory root. In this context, a new therapeutic avenue emerges: could a therapeutic nutritional approach be the missing piece of the puzzle? Indeed, diet therapies employed particularly for metabolic syndromes proved recently to be efficacious for correcting systemic dysmetabolism and a high number of chronic inflammation conditions. In particular, the very-low-calorie ketogenic diet (VLCKD) demonstrated therapeutic benefits in many disorders. In the present study, we aimed to investigate the specific effects of two dietary interventions, namely the oloproteic VLCKD and the low-glycemic insulinemic (LOGI) diet, on two groups of female FM patients (FM1 and FM2) over a 45-day period. Utilizing clinical and laboratory tests, as well as non-invasive NMR metabolomic analysis of serum, urine, and saliva samples, we sought to uncover how these dietary regimens impact the metabolic dysfunctions associated with FM.

Resilience and Sense of Coherence among Female Fibromyalgia Patients Living in a Conflict Zone Who Underwent Fibrotherapy Intervention

Objective: This study sought to examine whether the sense of coherence (SoC) and resilience among female fibromyalgia (FM) patients increased after participation in a fibrotherapy intervention program (FTI) and whether SoC and resilience increased among female FM patients (FFMPs) exposed to security threats who changed their coping strategies to problem-oriented coping. Methods: Ninety-six FFMPs aged 19–75 enrolled in the FTI program led by Rabbi Firer in Sderot, Israel. The intervention program is divided into three stages, each comprising a distinct weekly treatment plan. The treatment plans encompass the following modalities: physiotherapy adapted to FM conditions, group therapy, hydrotherapy, horticultural therapy/cooking therapy, Pilates, pottery therapy, and kundalini yoga. Each stage spans a duration of 10 weeks, culminating in a total program duration of 30 weeks. Results: The findings show that after participating in FTI, the problem-orientation level of coping and health indicators, including functional ability and physiological scores (pre- and post-exertion), increased while psychological distress levels decreased. Overall, all the physiological scales measured before and after the FTI showed a significant improvement among the entire sample. FFMPs with problem-oriented strategies reported higher levels of SoC and resilience after participating in the FTI program. Conclusions: The FTI provided FFMPs with tools to understand the meaning of their disease and its management, whereas before they were preoccupied with the presence of the disease and its negative impact on their lives. The participation of FFMPs in the FTI leads to a perceptual change, the adoption of problem-oriented coping strategies, and the increased utilization of coping resources, namely, SoC and resilience. Problem-oriented coping combined with high SoC and resilience led FFMPs to adopt health strategies such as physical activity and other empowering activities that raised their physical and mental health indicators.

A comparison of core muscle endurance of females with fibromyalgia versus healthy females: An observational study

IntroductionDespite the numerous benefits of core muscle strengthening in improving symptoms of fibromyalgia (FM), limited studies have quantified core muscle function in FM patients. ObjectiveTo compare the core muscle endurance of FM females with age-matched healthy females and determine whether a correlation exists between core muscle endurance and FM severity. Materials and methodsPre-diagnosed female FM patients (n=7) and age-matched healthy females (n=19) were assessed using McGill's core endurance tests in four positions – flexion, extension, and bilateral side-bridge. The longest contraction holding time (in seconds) in each position was noted and compared in both groups. Additionally, patient-reported Fibromyalgia Impact Questionnaire (FIQ) scores were obtained to determine disease severity. ResultsThe mean holding time for trunk extensors (26.14±7.7s), right lateral flexors (20.14±8.3s), and left lateral flexors (20.86±5.3s) was significantly lower in the FM females than the healthy females (trunk extensors=55.21±17.1s; right lateral flexors=36.05±13.2s; left lateral flexors=35.11±13.8s). The endurance of trunk flexors was statistically similar in both groups (FM females=52.14±27.9s; healthy females=74.37±37.7s). Lastly, core muscle endurance was not correlated with the FIQ scores in FM patients (p>0.05). ConclusionThe results of this preliminary study revealed that core extensor and lateral flexor endurance in FM females was lower than their healthy female counterparts. Larger sample studies are needed to further substantiate our findings.

Psychological characteristics associated with the brain volume of patients with fibromyalgia

Fibromyalgia (FM) is a disease characterized by chronic widespread pain concomitant with psychiatric symptoms such as anxiety and depression. It has been reported that FM patients engage in pain catastrophizing. In this study, we investigated characteristics of the brain volume of female FM patients and the association between psychological indices and brain volume. Thirty-nine female FM patients and 25 female healthy controls (HCs) were recruited for the study, and five FM patients were excluded due to white matter lesions. The following analyses were performed: (1) T1-weighted MRI were acquired for 34 FM patients (age 41.6 ± 7.4) and 25 HCs (age 39.5 ± 7.4). SPM12 was used to compare their gray and white matter volumes. (2) Data from anxiety and depression questionnaires (State-Trait Anxiety Inventory and Hospital Anxiety and Depression Scale), the Pain Catastrophizing Scale (subscales rumination, helplessness, magnification), and MRI were acquired for 34 FM patients (age 41.6 ± 7.4). Correlation analysis was done of the psychological indices and brain volume. We found that (1) The white matter volume of the temporal pole was larger in the FM patient group than in the HC group. (2) Correlation analysis of the psychological indices and gray matter volume showed a negative correlation between trait anxiety and the amygdala. For the white matter volume, positive correlations were found between depression and the brainstem and between magnification and the postcentral gyrus. Changes in the brain volume of female FM patients may be related to anxiety, depression, and pain catastrophizing.

Strong and aversive cold processing and pain facilitation in fibromyalgia patients relates to augmented thermal grill illusion

The thermal grill illusion (TGI) is assumed to result from crosstalk between the thermoreceptive and nociceptive pathways. To elucidate this further, we compared 40 female fibromyalgia patients to 20 healthy women in an exploratory cross-sectional study. Sensations (cold, warm/heat, unpleasantness, pain and burning) evoked by 20 °C, 40 °C and alternating 20 °C/40 °C (TGI) and somatosensory profiles according to standardized quantitative sensory testing (QST) were assessed on the palm of the dominant hand. Compared to healthy controls, fibromyalgia patients reported stronger thermal grill-evoked cold, warm, unpleasantness and pain as well as stronger and more aversive 20 °C- and 40 °C-evoked sensations. They showed a loss in warm, mechanical and vibration detection, a gain in thermal pain thresholds and higher temporal summation (TS). Among QST parameters higher TS in fibromyalgia patients was most consistently associated with an augmented TGI. Independently, an increased TGI was linked to cold (20 °C) but less to warm (40 °C) perception. In fibromyalgia patients all thermal grill-evoked sensations were positively related to a higher 20 °C-evoked cold sensation and/or 20 °C-evoked unpleasantness. In conclusion, the TGI appears to be driven mainly by the cold-input. Aversive cold processing and central pain facilitation in fibromyalgia patients seem to independently augment the activation of the pain pathway.

Association between cardiac atrioventricular conduction and antibodies to Chlamydia pneumoniae in fibromyalgia patients.

Fibromyalgia patients may complain of cardiovascular symptoms, including chest pain and palpitations. It has been proposed that infection by Chlamydia pneumoniae might be common in fibromyalgia. Chlamydia pneumoniae infection has also been hypothesized to be a causative factor in cardiac disease. This study aims to test the hypothesis that there is an association between atrioventricular conduction and antibodies to Chlamydia pneumoniae in fibromyalgia. Thirteen female fibromyalgia patients underwent serum Chlamydia pneumoniae IgG assays and 12-lead electrocardiography in a cross-sectional study. None of the patients was taking medication which might affect atrioventricular conduction, and none suffered from hypothyroidism, renal disease, hepatic disease, or carotid hypersensitivity. There was a significant positive correlation between the PR interval duration and the serum Chlamydia pneumoniae IgG level (r = 0.650; P = 0.016). This study supports the hypothesis of an association between atrioventricular conduction and antibodies to Chlamydia pneumoniae in fibromyalgia patients. It suggests that the higher the level of such antibodies, the greater the electrocardiographic PR interval, and therefore the slower the atrioventricular conduction. Potential pathophysiological mechanisms include a chronic inflammatory response to Chlamydia pneumoniae and the action of the bacterial lipopolysaccharide. The latter may involve stimulators of interferon genes, activation of the cardiac NOD-like receptor protein 3 inflammasomes, and downregulation of fibroblast growth factor 5 in the heart.

Medication use and factors associated with opiate use among patients with diagnosed fibromyalgia from two ethnic sectors in southern Israel

BackgroundOur aims were to compare fibromyalgia (FM) rate, drug treatment and factors associated with the use of opiates in two ethnic sectors.MethodsA retrospective cross-sectional study in southern district of Israel was performed on diagnosed FM patients in 2019–2020 [7686 members (1.50%)]. Descriptive analyses were conducted and multivariable models for the use of opiates were developed.ResultsThere were significant differences between the two ethnic groups in FM prevalence at 1.63% and 0.91% in the Jewish and Arab groups, respectively. Only 32% of the patients used recommended medications and about 44% purchased opiates. Age, BMI, psychiatric co-morbidity, and treatment with a recommended drug were similarly associated with an increased risk for opiate use in both ethnic groups. However, male gender was associated with × 2 times reduced risk to use opiates only among the Bedouins (aOR = 0.552, 95%CI = 0.333–0.911). In addition, while in both of ethnic groups the existence of another localized pain syndrome was associated with an increased risk for opiates use, this risk was 4 times higher in the Bedouin group (aOR = 8.500, 95%CI = 2.023–59.293 and aOR = 2.079, 95%CI = 1.556–2.814).ConclusionsThe study showed underdiagnosis of FM in the minority Arab ethnicity. Female Arab FM patients in low or high, compared to middle socio-economic status, were a risk group for excess opiate use. Increased use of opiates and very low rate of purchase of recommended drugs point to a lack of effectiveness of these drugs. Future research should assess whether the treatment of treatable factors can reduce the dangerous use of opiates.

MicroRNA-Related Polymorphism and Their Association with Fibromyalgia.

MicroRNAs are tissue-specific expressed short RNAs that serve post-transcriptional gene regulation. A specific microRNA can bind to mRNAs of different genes and thereby suppress their protein production. In the context of the complex phenotype of fibromyalgia, we used the Axiom miRNA Target Site Genotyping Array to search genome-wide for DNA variations in microRNA genes, their regulatory regions, and in the 3'UTR of protein-coding genes. To identify disease-relevant DNA polymorphisms, a cohort of 176 female fibromyalgia patients was studied in comparison to a cohort of 162 healthy women. The association between 48,329 markers and fibromyalgia was investigated using logistic regression adjusted for population stratification. Results show that 29 markers had p-values < 1 × 10-3, and the strongest association was observed for rs758459 (p-value of 0.0001), located in the Neurogenin 1 gene which is targeted by hsa-miR-130a-3p. Furthermore, variant rs2295963 is predicted to affect binding of hsa-miR-1-3p. Both microRNAs were previously reported to be differentially expressed in fibromyalgia patients. Despite its limited statistical power, this study reports two microRNA-related polymorphisms which may play a functional role in the pathogenesis of fibromyalgia. For a better understanding of the disease pattern, further functional analyses on the biological significance of microRNAs and microRNA-related polymorphisms are required.

The Relationship Between Eating Behaviors and Functional Status in Female Patients Diagnosed with Fibromyalgia

Aim. To evaluate whether eating behaviors of female patients with fibromyalgia syndrome differ from those of the healthy population, what factors affect these behaviors, and whether eating behaviors are effective on patients’ life quality and functional status.&#x0D; Materials and Methods. This cross-sectional and observational study included 55 female fibromyalgia patients and 55 healthy female volunteers. All participants were assessed using demographic data, body mass index (BMI), and the Three-Factor Eating Questionnaire (TFEQ) (Uncontrolled Eating, Cognitive Restraint, Emotional Eating, and Hunger Susceptibility). Fibromyalgia patients were assessed using the Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ).&#x0D; Results. BMI, Uncontrolled Eating, and Hunger Susceptibility scores differed significantly between fibromyalgia patients and healthy volunteers (p &lt; 0.05). In fibromyalgia patients, the TFEQ subscores were not correlated with the FIQ (p &gt; 0.05). There was a positive correlation between the Cognitive Restraint score and age, rest and night pain scores in fibromyalgia patients (p&lt; 0.05). Increasing age was an independent predictor of Cognitive Restraint in fibromyalgia patients (p=0.003).&#x0D; Conclusions. The proportion of overweight/obese patients, BMI, Uncontrolled Eating, and Hunger Susceptibility were significantly higher among fibromyalgia patients. Fibromyalgia patients’ eating behaviors were not associated with their quality of life and functional status. Increasing age appeared to be a predictor of Cognitive Restraint degree.

Association of serum vitamin D status with serum pro-inflammatory cytokine levels and clinical severity of fibromyalgia patients

The role of vitamin D deficiency in fibromyalgia (FM) pathogenesis is not clearly understood. In this study, we evaluated the association of serum vitamin D status of FM patients with laboratory indices of inflammation, as well as clinical indices of FM. Ninety-two female FM patients with a mean age of 42.4±7.4 years were included in this cross-sectional study. Serum vitamin D, serum IL-6, and serum IL-8 levels were evaluated using an enzyme-linked immunosorbent assay. Serum vitamin D levels were categorized as deficient (<20ng/ml), insufficient (20-30ng/ml), and sufficient (30-100ng/ml). The clinical severity of the disease was assessed by the fibromyalgia impact questionnaire (FIQ) and widespread pain index (WPI). The mean serum IL-6 level was significantly higher in vitamin D-deficient patients in comparison with vitamin D-sufficient patients (P=0.039). The mean serum IL-8 level was also significantly higher in vitamin D-deficient patients in comparison with vitamin D-sufficient patients (P<0.001). A significant positive correlation was found between the serum IL-8 level and FIQ scores (r=0.389, p=0.001) and the WPI of the patients (0.401, p<0.001). Serum IL-6 level was significantly correlated with the WPI of the patients (r=0.295, p=0.004), but not with FIQ scores (r=0.134, p=0.066). Serum vitamin D status was not associated with either FIQ scores or WPI. In FM patients, serum vitamin D deficiency is associated with higher levels of serum pro-inflammatory cytokines, and higher levels of serum pro-inflammatory cytokines are associated with greater FM impact.

Evaluation of carotid intima-media thickness of female fibromyalgia patients and determination of their relationship with disease activity, severity of fibromyalgia, anxiety and depression levels

Aim: Carotid artery intima-media thickness is thought strong predictor of cardiovascular diseases. To evaluate the common carotid artery intima-media thickness (CCIMT) in female patients with fibromiyalgia (FM) and determine its relationship with disease activity, severity of fibromyalgia, anxiety and depression levels.Material and Method: Thirty nine patients who had fibromyalgia syndrome according to 2016 American College of Rheumatology (ACR) classification criteria and 41 healthy controls were included. Pain level and disease activities were assessed with Numerical Rating Scale (NRS) and Fibromyalgia Impact Questionnairre (FIQ) respectively. According to ACR 2016 classification criteria, Widespread Pain Index (WPI), Symptom Severity Score and Hospital Anxiety and Depression Scale (HADS) were performed. The LDL , HDL and Triglyceride levels were evaluated. Bilateral common carotid artery intima-media thicknesses (CCIMT) were performed by a blind radiologist to the groups of participants. Results: Age, weight and height were similar between groups (p&amp;gt;0.05). Triglyceride level was significant higher in patients with FM (p=0.001). HDL and LDL levels were similar between groups (p=0.297, p=0.061). Bilateral CCIMT was significantly higher in patients with FM (p&amp;lt;0.001). Bilateral CCIMT were found positively correlated with age in FM group (r=0.390, p=0.014, r=0.404, p=0.011 respectively). There were found no correlations between bilateral CCIMT, height, weight, triglyseride level, LDL level, FIQ, NRS, WPI, Symptom Severity Score, HADS scores. . Conclusion: In FM patients, bilateral CCIMTs were found increased compared to healthy controls. No associations were found between CCIMT, LDL, triglyceride levels, disease activity and pain level, anxiety and depression level in patients with FM.