Fibromyalgia Group Research Articles

Investigation of the Relationship of Sleep Disorder Occurring in Fibromyalgia with Central Nervous System and Pineal Gland Volume.

Mechanisms of sleep disorders in fibromyalgia (FM) patients, such as insomnia, early morning awakenings and poor quality sleep, have not yet been proven and no consistent and effective treatment is yet available. The aim of this study was to investigate the pineal gland volume and the relationship between total fiber count, total fiber volume and total fiber length of the spinoreticular tract involved in regulation of sleep and wakefulness in terms of the mechanism of sleep disturbance. This study included only female cases, 31 with fibromyalgia and 31 controls. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Tractography of targeted pathway from brain diffusion MR images was calculated in DSI Studio program and the volume of the pineal gland was calculated in ITK-SNAP program. The mean volume of the pineal gland was higher in control group (218.84±64.45 mm3) than in fibromyalgia group (174.77±48.65 mm3), which was statistically significant (p=0.004). However, there was no statistically significant difference between two groups in total spinoreticular tract (TSRT), total volume (TSRTV), TSRT FA, TSRT MD, TSRT AD and TSRT RD of spinoreticular tract, which is involved in the regulation of sleep and wakefulness (p>0.05). In conclusion, it is thought that the endocrine system may be more related to sleep disturbance in individuals with FM than central nervous system. Therefore, we believe that it may be more appropriate to work on the endocrine system rather than neural system in the treatment of sleep disturbance in patients with FM.

Uncovering the alterations in extrinsic foot muscle mechanical properties and foot posture in fibromyalgia: a case-control study.

The aim of the study was to evaluate foot posture and the mechanical properties of extrinsic foot muscles in fibromyalgia. Patients with fibromyalgia (n = 86) and age- and gender-matched controls (n = 41) were included in the study. Foot Posture Index (FPI), Beighton and Brighton criteria were used to evaluate static foot posture, joint hypermobility, and benign joint hypermobility syndrome (BJHS), respectively. Tonus, elasticity, and stiffness of the extrinsic foot muscles including gastrocnemius medialis, tibialis anterior, and peroneus longus were measured by the MyotonPRO® device. Foot function, quality of life, and physical activity level were assessed by the Foot Function Index (FFI), Short Form-36 (SF-36), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. The frequency of abnormal foot posture in the fibromyalgia and control groups was 68.6% versus 39%, respectively; and neutral foot posture was approximately twice as prevalent in the control group compared to the fibromyalgia group (p = 0.006). Pronated foot posture was the most common abnormality in fibromyalgia (61.6%) and observed in 85.5% of the patients with joint hypermobility and in 87.1% of those meeting BJHS criteria. The elasticity of peroneus longus at rest and the elasticity of tibialis anterior in the standing position were significantly different between the fibromyalgia group and the control group [1.08 (0.22) vs. 1.02 (0.25), p = 0.037 and 0.92 (0.29) vs. 0.87 (0.24), p = 0.011, respectively]. Regarding the fibromyalgia group, no difference was detected among foot posture groups in terms of myotonometric data. Pronation foot posture is common in fibromyalgia with a much higher frequency in fibromyalgia patients with hypermobility. In daily clinical practice for fibromyalgia, particular attention should be given to foot alignment.

Structural MRI findings in the brain related to pain distribution in chronic overlapping pain conditions: An explorative case-control study in females with fibromyalgia, temporomandibular disorder-related chronic pain and pain-free controls.

Few neuroimaging studies have investigated structural brain differences associated with variations in pain distribution. To explore structural differences of the brain in fibromyalgia (FM), temporomandibular disorder pain (TMD) and healthy pain-free controls (CON) using structural and diffusion MRI. A case-control exploratory study with three study groups with different pain distribution were recruited: FM (n = 16; mean age [standard deviation]: 44 [14] years), TMD (n = 17, 39 [14] years) and CON (n = 10, 37 [14] years). Participants were recruited at the University Dental Clinic in Malmö, Sweden. T1-weighted and diffusion MRIs were acquired, clinical and psychosocial measures were obtained. Main outcome measures were subcortical volume, cortical thickness, white matter microstructure and whole brain grey matter intensity. Patients with FM had smaller volume in the right thalamus than patients with TMD (p = .020) and CON (p = .030). The right thalamus volume was negatively correlated to pain intensity (r = -0.37, p = .022) and pain-related disability (r = -0.45, p = .004). The FM group had lower cortical thickness in the right anterior prefrontal cortex than CON (p = .005). Cortical thickness in this area was negatively correlated to pain intensity (r [37] = - 0.48, p = .002). This study suggests that thalamus grey matter alterations are associated with FM and TMD, and that anterior prefrontal cortex grey matter alterations are associated with FM but not TMD. Studies on chronic overlapping pain conditions are needed in relation to possible nociplastic pain mechanisms in the brain and central nervous system.

T Lymphocyte Interferon-gamma Response to Anaplasmataceae-related Major Surface Proteins and Ankyrin A in Fibromyalgia.

The aetiology of fibromyalgia is unknown; its symptoms may be related to a T-lymphocyte-mediated response to infectious organisms. First, to test the hypothesis that fibromyalgia is associated with increased interferon (IFN)-γ-secreting T-lymphocytes after stimulation with Anaplasmataceae-related major surface proteins (MSPs) and the macromolecular translocation type IV secretion system effector ankyrin repeat domain-containing protein A (AnkA). Second, to ascertain the relationship in fibromyalgia between (i) the IFN-γ-secreting T-lymphocyte response to stimulation with Anaplasmataceae-related MSPs and AnkA, and (ii) co-infection by Borrelia and Yersinia spp., and antinuclear antibodies. Using a case-control design, patients fulfilling the American College of Rheumatology revised criteria for fibromyalgia, and controls, underwent the following blinded assessments: (i) enzyme- linked immune absorbent spot (ELISpot) IFN-γ release assay of T-lymphocyte reactivity to Anaplasmataceae-related MSPs and AnkA; (ii) ELISpot IFN-γ release assays of T-lymphocyte reactivity to three Borrelia antigens, namely Borrelia burgdorferi full antigen (B31); peptide mix (from Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii); and Borrelia burgdorferi lymphocyte function-associated antigen-1; (iii) immunoglobulin (Ig) A assay by enzyme-linked immunosorbent assay (ELISA) of antibodies to Yersinia spp.; (iv) IgG (ELISA) antibodies to Yersinia spp.; (v) serum antinuclear antibodies (immunofluorescence). The groups were age- and sex-matched. The mean (standard error) value of IFN-γ release for the fibromyalgia group was 1.52 (0.26), compared with 1.00 (0.22) for the controls. Generalised linear modelling (p<0.001) of IFN-γ release in the fibromyalgia patients showed significant main effects of all three indices of Borrelia infection and of antinuclear antibodies. Anaplasmataceae may play an aetiological role in fibromyalgia.

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.

Human Herpesvirus-6B Infection and Alterations of Gut Microbiome in Patients with Fibromyalgia: A Pilot Study

Fibromyalgia (FM) is a chronic disorder characterized by widespread musculoskeletal pain often accompanied by fatigue, sleep disturbances, memory issues, and mood disorders. The exact cause of FM remains unknown, and diagnosis is typically based on a history of persistent widespread pain, as there are no objective biomarkers usable in diagnosis of this disorder available. The aim of this study was to identify measurable indicators specific to FM with potential as biomarkers. This study included 17 individuals diagnosed with FM and 24 apparently healthy persons. Using real-time polymerase chain reaction (qPCR), we detected the presence of human herpesvirus (HHV)-6A and B genomic sequences in DNA isolated from peripheral blood mononuclear cells (PBMCs) and buccal swabs. HHV-6-specific IgG and IgM class antibodies, along with proinflammatory cytokine levels, were measured using enzyme-linked immunosorbent assay (ELISA) and bead-based multiplex assays. Additionally, the gut microbiome was analyzed through next-generation sequencing. HHV-6B was more frequently detected in the PBMCs of FM patients. FM patients with a body mass index (BMI) of 30 or higher exhibited elevated cytokine levels compared to the control group with the same BMI range. Gut microbiome analysis revealed significant differences in both α-diversity and β-diversity between the FM and control groups, indicating a shift in species abundance in the FM group.

Behavioral Changes and Long-Term Cortical Thickness Alterations in Women with Fibromyalgia

ObjectivesThe purpose of this study was to examine long-term brain and behavioral changes in patients with fibromyalgia (FM) compared to healthy individuals. MethodsData from 33 female volunteers with FM and 33 healthy controls women paired by age and school degree were used to analyze the cortical thickness from high-resolution T1-weighted magnetic resonance imaging (MRI) obtained through a 3T-MRI scanner. Additionally, the Toronto Alexithymia Scale, the Positive and Negative Affect Scale, the emotion regulation questionnaire (ERQ), and the Hamilton Depression and Anxiety rating scales were used to evaluate the behavioral changes. ResultsThe findings indicate significant cortical structure differences in the right cerebral hemisphere between groups in the insular anterior cortex precentral and postcentral gyrus (P < .001). The FM group scored higher for alexithymia (P < .01), negative affect (P < .01), anxiety (P < .01), and depression (P < .01) symptoms, on the other hand, scored lower for positive affect (P < .01). No differences were found on the left cerebral hemisphere. Furthermore, there was a negative correlation between the right insular anterior cortex and Toronto Alexithymia Scale (P < .001). ConclusionThis study showed long-term brain and behavioral changes in patients with FM, suggesting notable neurophysiological alterations associated with this chronic pain condition. It provides new insights into how FM may affect brain health and potential biomarkers for the condition.

Autonomic Dysfunction in Fibromyalgia Patients: Electrophysiological Evidence from a Cross-sectional Study in Kochi, India

Background: Over the decades, studies from various populations have found fibromyalgia and dysautonomia to be linked. However, recent evidence from Indian populations contradicts these findings. Methods: This cross-sectional study, conducted in a quaternary care centre in South India, recruited 30 women with fibromyalgia (2016 ACR criteria) and 30 age and sex-matched controls. We assessed all participants using Composite Autonomic Symptom Score (COMPASS-31) questionnaires, Sympathetic Skin Response (SSR) for sympathetic dysfunction and Heart Rate Variability battery of tests for parasympathetic dysfunction. Results: Median age of the women was 40 years. Fibromyalgia group reported severe levels of pain and disease impact on life. Fourteen participants (46.7%) with fibromyalgia tested positive for either sympathetic or parasympathetic dysfunction or both, while none of the control participants tested positive for either (odds ratio [OR] = 53.6, 95% confidence interval [CI] = 3–957, p = 0.0068). Conclusion: Dysautonomia is strongly associated with fibromyalgia syndrome. Further research is needed to determine causality.

Is serum hornerin a potential biomarker in fibromyalgia? A pilot study

Abstract Objectives The study aims to investigate the relationship between serum hornerin levels and disease severity and pain scores and to evaluate hornerin’s potential as a biomarker and its role in understanding the etiopathogenesis of fibromyalgia (FM). Methods The study included 36 female patients diagnosed with FM and 36 healthy female volunteers, matched for age and body mass index (BMI). Disease functional status and pain intensity in FM were assessed using the Fibromyalgia Impact Questionnaire (FIQ) and Visual Analog Scale (VAS), respectively. Serum hornerin levels were measured using a commercial ELISA kit. Results The mean age and BMI were 47.08 ± 9.76 and 27.17 ± 4.19 in the patient group and 43.61 ± 12.40 and 25.43 ± 5.25 in the control group. Serum hornerin levels averaged 2.64 ± 0.50 ng/mL in the patient group and 2.33 ± 0.49 ng/mL in the control group, showing significantly higher levels in the FM group (p=0.009). The median VAS score for FM patients was 8.0 (6.25–10) cm, and the mean FIQ score was 61.64 ± 15.09. The cutoff value for hornerin was determined to be 2.44 ng/mL (with 63.9 % sensitivity and 61.1 % specificity). A positive correlation was found between serum hornerin levels and BMI values. Conclusions Elevated hornerin levels were observed in FM cases. Hornerin has the potential to be explored as a biomarker for diagnosing FM.

Cardiac autonomic regulation during submaximal exercise in women with fibromyalgia.

Fibromyalgia (FM) patients present impaired cardiac autonomic regulation during maximal exercise; however, it is unknown whether these alterations also manifest during submaximal exercise. The aim of this study was to compare the on-transient heart rate (HR) response and HR variability during a constant-load submaximal cycling exercise between FM and control (CON) women. Ten women with FM (age: 45.2±9.3 years) and 10 age-matched CON women (age: 48.4±6.1 years) performed a 15-min cycling exercise, with the work rate fixed at 50% of the individual peak power output attained in a maximal graded exercise test. The time intervals between consecutive heartbeats were recorded regularly during the exercise for subsequent analysis of on-transient HR response and HR variability indices. The on-transient HR time constant was similar (P=0.83) between the FM (41.0±14.1 sec) and CON (42.2±10.4 sec). During the 5-10 and 10-15 min of exercise, HR variability indices indicating sympathetic and parasympathetic activities were similar (P>0.05) between FM and CON groups. In conclusion, women with FM presented a normal cardiac autonomic response to submaximal cycling exercise. These findings have clinical relevance, as submaximal exercises are commonly prescribed for FM patients.

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.

Comparison of the symptom networks of long-COVID and chronic fatigue syndrome: From modularity to connectionism.

The objective was to compare the symptom networks of long-COVID and chronic fatigue syndrome (CFS) in conjunction with other theoretically relevant diagnoses in order to provide insight into the etiology of medically unexplained symptoms (MUS). This was a cross-sectional comparison of questionnaire items between six groups identified by clinical diagnosis. All participants completed a 65-item psychological and somatic symptom questionnaire (GSQ065). Diagnostically labelled groups were long-COVID (N = 107), CFS (N = 254), irritable bowel syndrome (IBS, N = 369), fibromyalgia (N = 1,127), severe asthma (N = 100) and healthy group (N = 207). The 22 symptoms that best discriminated between the six groups were selected for network analysis. Connectivity, fragmentation and number of symptom clusters (statistically related symptoms) were assessed. Compared to long-COVID, the symptom networks of CFS, IBS and fibromyalgia had significantly lower connectivity, greater fragmentation and more symptom clusters. The number of clusters varied between 9 for CFS and 3 for severe asthma, and the content of clusters varied across all groups. Of the 33 symptom clusters identified over the six groups 30 clusters were unique. Although the symptom networks of long-COVID and CFS differ, the variation of cluster content across the six groups is inconsistent with a modular causal structure but consistent with a connectionist (network, parallel distributed processing) biological basis of MUS. A connectionist structure would explain why symptoms overlap and merge between different functional somatic syndromes, the failure to discover a biological diagnostic test and how psychological and behavioral interventions are therapeutic.

Impact of migraine and fibromyalgia on temporomandibular disorder: A retrospective study on pain, psychological factors and quality of life.

This study assessed the impact of migraine and fibromyalgia (FM) in TMD patients, focusing on pain, anxiety, depression, and quality of life (QoL). Additionally, we investigated how these variables relate to the total number of comorbidities to gain insights into their interactions. A retrospective data collection was conducted during January 2016 to December 2022, involving 409 adult TMD patients. TMD patients were categorised into four groups: those without comorbidity (TMD-only) and those with comorbid migraine and/or fibromyalgia (TMD + MG, TMD + FM and TMD + MG + FM). Quantitative variables were compared among them. Linear regression was used to analyse the associations between these variables. Most of study population were women (79%) with a mean age of 44.43 years. TMD + MG patients reported longer pain duration, higher pain scores and greater pain interference compared with TMD-only patients. Similarly, TMD + FM patients had higher pain intensity than patients with TMD only. Both the TMD + MG and TMD + FM groups had higher levels of anxiety, depression, and health impairment compared with patients with TMD only. Patients with all three pain conditions (TMD + MG + FM) experienced the longest pain duration, highest pain intensity, psychological distress, and impaired QoL. The result showed positive associations between pain outcomes, psychological measures, pain's impact on QoL, and the number of comorbidities and a negative association between overall health states and the number of comorbidities. These findings underscore the importance of considering the presence of comorbidities and addressing physical and psychological aspects in the management of TMD patients.

The polymorphism Val158Met in the COMT gene: disrupted dopamine system in fibromyalgia patients?

The single-nucleotide polymorphism (SNP) rs4680 in the catechol-O-methyltransferase gene ( COMT ) is a missense variant (Val158Met) associated with altered activity of the COMT enzyme and suggested as a predictive feature for developing some chronic pain conditions. However, there are controversial results on its role in fibromyalgia (FM). Here, the SNP Val158Met was analyzed in 294 FM patients (without comorbidities) and 209 healthy controls (without chronic pain). The concurrent impact of Val158Met genotypes and FM comorbid disorders (depression and sleep impairment) on FM risk were tested. In addition, the genotypic distribution of FM patients in relation to pain intensity was evaluated. The G allele (Val) resulted in being more represented in the FM group (57.8%) compared with the control group (48.8%; P = 0.037). Logistic regression highlighted that having the G/G (Val/Val) homozygous genotype was associated with 2 times higher risk of having FM compared with the A/A (Met/Met) carriers ( P = 0.038), whereas depression and sleep impairment increased FM risk by 12 and 8 times, respectively ( P < 0.001). However, considering only the FM patient group, the A/A homozygous genotype was significantly associated with severe pain intensity ( P = 0.007). This study highlighted associations between the SNP Val158Met and both FM and pain intensity, suggesting a link between dopaminergic dysfunction and vulnerability to chronic pain. Further studies should explore this SNP in FM patients in conjunction with COMT enzymatic activity and other symptoms connected with the dopaminergic system such as depression or sleep impairment.

Effect of fibromyalgia on demographic, biochemical, metabolic and inflammatory profiles: a single-centre retrospective study.

The objective of this study is to ascertain the disparities in demographic features and biochemical profiles between individuals diagnosed with fibromyalgia (FM) and a control group of healthy individuals. This retrospective, cross-sectional study compared the demographic, biochemical, metabolic, and inflammatory indexes and rates of 174 FM patients diagnosed using the American College of Rheumatology 2016 diagnostic criteria between January 2023 and January 2024, and 186 healthy control groups. There was no difference between the FM and control groups in terms of alcohol consumption, marital status, or diabetes mellitus. The smoking rate is higher, and the educational level was found to be lower for FM versus the control. There was no significant difference between FM and controls regarding waist-height ratio, triglyceride-glucose index, plasma atherogenic index, vitamin B12, and folate levels. Monocyte HDL ratio, cardiometabolic index, magnesium, HbA1c, and ferritin levels were significantly higher in the control than in FM (p<0.001, p=0.039, p=0.007, p<0.001, p<0.001, respectively). C-reactive protein, erythrocyte sedimentation rate, systemic immune-inflammatory index, neutrophil-lymphocyte rate, platelet lymphocyte rate, and vitamin D levels were found to be higher in FM compared to control (p=0.001, p=0.032, p=0.003, p=0.030, p=0.003, p<0.001, respectively). A weak positive correlation was observed between the fibromyalgia impact questionnaire (FIQ) score and disease duration, as well as between pain degree and ESR, and pain degree and CRP. The study revealed a weak inverse relationship between Widespread Pain Index (WPI) and waist circumference. This study highlights fthe association f ibromyalgia with elevated inflammatory markers, altered metabolic parameters, and specific demographic characteristics.

Caffeine Attenuates Exacerbated Central Fatigue during Moderate-Intensity Cycling Exercise in Women with Fibromyalgia.

To compare the development of fatigability during a moderate-intensity cycling exercise between women with fibromyalgia (FM) and control women (CON) after acute ingestion of caffeine and placebo. Ten FM and 10 CON women performed a 30-min moderate-intensity cycling exercise 1 h after the ingestion of a capsule containing either caffeine or a placebo. Fatigability and its central and peripheral determinants were determined via changes from pre- to post-15 and post-30 min of exercise in maximal voluntary isometric contractions, voluntary activation (VA), and quadriceps potentiated twitch torque ( Qtw-pot ), respectively. Heart rate, muscle oxygen saturation, perceptive responses, mood state, localized and widespread pain, and sleepiness were also monitored during and after exercise. There was a time versus group interaction for maximal voluntary isometric contraction and VA ( P < 0.001) but not for Qtw-pot ( P = 0.363), indicating a greater rate of fatigability development, mainly caused by central mechanisms, in the FM than in the CON group. There was also a main effect of condition for VA ( P = 0.011), indicating that caffeine attenuates central mechanisms of fatigability in both groups. Caffeine ingestion also increased muscle oxygenation, perceived vigor, and energy, and decreased leg muscle pain, sleepiness, and perceived fatigue in both groups. However, caffeine improved perceived pleasure/displeasure and exercise adherence likelihood only in the FM group. Compared with CON, women with FM present a greater rate of fatigability during exercise, mainly of central origin. Caffeine seems to be a promising bioactive to counteract the central mechanisms of fatigability and improve the exercise experience among FM women.

Predictability and Complexity of Fine and Gross Motor Skills in Fibromyalgia Patients: A Pilot Study.

Fine and gross motor tasks are usually used to evaluate behavioral dysfunctions and can be applied to diseases of the central nervous system, such as fibromyalgia (FM). Non-linear measures have allowed for deeper motor control analysis, focusing on the process and on the quality of movement. Therefore, to assess uncertainty, irregularity, and structural richness of a time series, different algorithms of entropy can be computed. The aim of this study was to (i) verify the single-scale and multiscale entropy values in fine and gross motor movements and (ii) to verify whether fine and gross motor tasks are sensitive to characterizing FM patients. The sample consisted of 20 females (46.2 ± 12.8 years) divided in two groups, an experimental group with 10 FM subjects and a control group with 10 subjects without FM. Inertial sensors were used to collect the finger tapping test (FTT), walking, and sit-and-stand task data. Regarding fine motor skills, patients with FM showed a loss of structural richness (complexity), but they had information processing with greater control in the FTT, probably to simplify task execution and for correction of the movement. On the other hand, people without FM seemed to have more automatic control of the movement when performed with the preferred hand and exhibited similar difficulties to the FM group when performed with the non-preferred hand. Gross motor tasks showed similar entropy values for both groups. The results show that FM patients have movement controls primarily at the level of the motor cortex, whereas people without FM perform movement at the medullary level, especially in fine motor tasks, indicating that the FTT is sensitive to the presence of FM, especially when performed with the preferred hand.

The relationship between fibromyalgia syndrome and inflammation parameters in hemodialysis patients

Objectives: Diagnosing fibromyalgia, a condition characterized by widespread body pain of unknown origin accompanied by various additional symptoms, poses a challenge in hemodialysis patients, who frequently experience musculoskeletal disorders. To investigate the relationship between fibromyalgia syndrome and inflammation parameters in hemodialysis patients. Methods: The study enrolled 311 hemodialysis patients undergoing treatment for over three months. Demographic characteristics, complete blood count, and biochemical values were documented as part of the study. To assess fibromyalgia, the researchers recorded the patients scores on the Generalized Pain Scale and Symptom Severity Scale based on data provided by the American College of Rheumatology. The patients were then divided into two groups: those with fibromyalgia and those without fibromyalgia, and their laboratory values and rates were compared. Inflammatory parameters such as erythrocyte sedimentation rate, c reactive protein, monocyte-to-lymphocyte ratio, lymphocyte-to-c reactive protein ratio, and c reactive protein to albumin ratio were recorded. Results: The study included 311 patients on hemodialysis for more than three months. Among the study participants, 48.9% of the patients and 62.9% of those with fibromyalgia were women. The mean age was 54±26 years and was significantly higher in patients with fibromyalgia (P&amp;lt;0.001). Monocyte (P&amp;lt;0.03), C-reactive protein (P&amp;lt;0.01), erythrocyte sedimentation rate (P&amp;lt;0.02), Monocyte to lymphocyte ratio (P=0.028), c reactive protein to albumin ratio (P&amp;lt;0.005) were significantly higher, lymphocyte to c reactive protein ratio (P&amp;lt;0.004) and albumin (P=0.018) were significantly lower in the fibromyalgia group. Conclusions: Fibromyalgia should be considered in the presence of high inflammation parameters in hemodialysis patients with diffuse musculoskeletal pain.

Fibromyalgia is linked to increased subjective sensory sensitivity across multiple senses.

Changes in subjective sensory sensitivity - reporting sensory stimuli as being atypically intense or weak - are a transdiagnostic symptom of several disorders. The present study documents for the first time the sensory sensitivity profile of fibromyalgia, taking a questionnaire measure that asks about different sensory modalities and both hyper- and hyposensitivity (the Glasgow Sensory Questionnaire, GSQ). The fibromyalgia group had higher overall scores on this measure. This was linked more strongly to sensory hypersensitivity and was pervasive across all senses that were surveyed. Although differences in hyposensitivity were found, these were sporadic (perhaps linked to the symptoms of fibromyalgia itself) and did not resemble the pattern documented for autism (e.g., self-stimulating and repetitive behaviours were not a feature of fibromyalgia). We suggest that individual differences in subjective sensory hypersensitivity may be a multisensory dispositional trait linked to fibromyalgia which ultimately becomes most pronounced for pain.

Assessment of the Efficacy and Safety of Hyperbaric Oxygen Therapy on Pain in Patients with Fibromyalgia: A Systematic Review and Meta-analysis of Randomised Controlled Studies

Abstract Hyperbaric oxygen therapy (HBOT) is an adjunctive treatment for chronic pain. The current study aimed to perform a systematic evaluation and meta-analysis of randomised controlled trials (RCTs) to assess the clinical efficacy and safety of HBOT for pain reduction in fibromyalgia (FM) patients compared to conventional therapy. A systematic search of medical subject headings and keywords associated with HBOT for FM patients was conducted using electronic databases: MEDLINE/ PubMed, Web of Science, Cochrane Library Central Register of Controlled Trials, and Scopus. Google Scholar was also combed to detect likely non-indexed available studies. We also searched manually through reference lists of identified original articles or reviews for relevant articles. The http://www.clinicaltrial.gov was examined for all research protocols being conducted/ planned. The Cochrane Collaboration tool and Higgins and Thompson’s I2 method determined the risk of bias and heterogeneity. The primary outcome was the effect of HBOT on pain; secondary outcomes included adverse effects of HBOT, assessment of the quality of life, functional impairment, psychological symptoms, and sleep quality. The overall quality of evidence was assessed with the GRADE approach. Cochrane RevMan software (version 5.4) was used for data analysis. Results were synthesised through a general summary of the characteristics and findings of each study. We also analysed different HBOT protocols and their outcomes across the studies. Five RCTs enrolling 91 and 89 patients in FM and control groups were included in the present study. HBOT results in decreased tender points (-6.23 (95 % CI: -7.76, -4.71) P &lt; 0.0001), increased pain threshold (0.57 (95% CI: 0.3, 0.83) P &lt; 0.00001) and a decreased Visual Analog scale (VAS) score for pain (-5.31(95 % CI: -8.17, -2.45)). Quality of life, sleep, functional impairment, etc., also improved after HBOT. HBOT is effective in pain and other associated outcomes in FM patients. In FM patients, high-quality evidence in favour of HBOT to improve pain, fatigue, quality of life, sleep, psychological outcomes, etc., is required.