Revised Fibromyalgia Impact Questionnaire Research Articles

The impact of metabolic health on fibromyalgia: insights from insulin resistance and related indexes

ABSTRACT Objectives To assess the association between fibromyalgia (FM) and insulin resistance (IR) using multiple IR indices in FM patients and to investigate how these indices vary with the severity of FM. Methods This cross-sectional study included 70 female patients diagnosed with FM and 70 age-matched female healthy controls. The data collected included demographics, clinical characteristics, and laboratory parameters. FM severity was evaluated using the Fibromyalgia Impact Questionnaire-Revised (FIQR). The metabolic indices calculated were the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), triglyceride – glucose index (TyG), triglyceride to HDL cholesterol ratio (TG/HDL-C), and Metabolic Score for Insulin Resistance (METS-IR). Results FM patients exhibited significantly higher HOMA-IR values (p = 0.002), and lower QUICKI values (p = 0.000) than controls. METS-IR also showed significant differences between FM patients and controls (p = 0.026). HOMA-IR and METS-IR values increased with FM severity, whereas QUICKI values decreased (p < 0.05). Duration of FM showed a moderately positive correlation with HOMA-IR (r = 0.249, p = 0.027). For TG/HDL-C and METS-IR, the correlations were weaker, but still positive (r = 0.094, p = 0.378, and r = 0.184, p = 0.056, respectively). Conclusion This study observed a significant association between FM and IR, as evidenced by metabolic indices in FM patients compared to controls. IR levels tended to increase with FM severity and duration. These findings suggest that IR could play a role in FM pathogenesis. Non-invasive and practical methods, such as METS-IR, may provide advantages for metabolic screening in FM patients; however, further studies are needed to establish their clinical utility.

Effects of Myofascial Release on the Pain and Quality of Life in Patients with Fibromyalgia

Objectives: To investigate the effects of myofascial release technique on pain and quality of life (QoL) in patients with fibromyalgia (FM). Methods: A quasi-experimental study was conducted to investigate the effects of myofascial release technique on patients with FM in Shalamar Hospital Lahore, Pakistan. After initial screening, 28 patients aged 25 to 45 years of both genders meeting the predetermined inclusion criteria were selected using convenience sampling. They were divided into two groups. Group A was treated with myofascial release therapy and passive stretching, while group B was treated with passive stretching alone. The McGill pain questionnaire (MPQ) was used to assess the pain, and the revised FM impact questionnaire (FIQR) was used to evaluate QoL. Results: Out of 28 participants, 11(39.3%) were male and 17(60.7%) were females. Pre- and post-treatment mean scores of pain rating index on MPQ were 46.76±10.47 and 23.79±7.43 for the experimental group and 43.36±12.7 and 30.0±9.89 for the control group, respectively (P&gt;0.05). Mean pre- and post-treatment FIQR scores were 52.9±13.6 and 33.02±13.75 for the experimental group and 57.77±23.04 and 46.59±19.37 for the control group, respectively. The difference in the means of post-treatment scores of the two groups for FIQR was significant (P=0.042). Discussion: Compared with passive stretching alone, the myofascial release method for FM did not demonstrate significant improvement in alleviating pain among such patients. However, it is remarkable that myofascial release therapy unveiled a positive impact by improving the overall QoL for FM patients.

Proinflammatory Diet is Associated with Higher Pain, Disease Severity and Biochemical Parameters Associated with Inflammation in Fibromyalgia.

Fibromyalgia, which is becoming increasingly common today, affects the quality of life of those affected. The aim of this study was to investigate the relationship between diet and pain, disease severity and biochemical parameters in fibromyalgia. Cross-sectional design using validated questionnaires. Fibroyalgia patients with Traditional and Complementary Medicine clinics. 84 patients with Fibromyalgia (FM), which was diagnosed by a rheumatologist. The cross-sectional study was conducted with 84 fibromyalgia patients in Turkey. The Dietary Inflammatory Index (DII) was calculated by a 24-hour diet recall. Self-reported pain levels and disease severity were evaluated by the Visual Analog Scale (VAS) and a Revised Fibromyalgia Impact Questionnaire (FIQR), respectively. Antropometric measures and biochemical parameters associated with inflammation were also evaluated. Linear regression analysis revealed that the VAS pain score [β (%95CI)=1,72 (0,90-2,55), p < 0,001], FIQ-R [β (%95CI)=5,62 (0,14-11,09), p < 0,001] and uric acid/creatinine ratio [β (%95CI)=0,21 (-0,10-0,52), p < 0,001] were positively associated with the DII after adjustments for BMI, body fat, fat free mass, cholesterol, fiber, caroten, iron, magnesium, vitamine C reported by the patients with FM. A pro-inflammatory diet was associated with higher pain, disease severity and uric acid/creatinine ratio in patients with FM.

Fibromyalgia Concomitant With Rheumatic Diseases in the Eastern Province of Saudi Arabia: A Cross-Sectional Study.

Fibromyalgia (FM) is a complex disorder involving pain dysregulation that can occur independently or alongside other rheumatological illnesses, complicating symptom interpretation. Consequently, this study aimed to evaluate the prevalence of secondary FM in patients with rheumatological diseases and its impact using the Revised Fibromyalgia Impact Questionnaire. This cross-sectional descriptive study was conducted at the RheumatologyOutpatientDepartment of King Fahad Military Medical Complex, Dhahran, from August 2023 to October 2023. Patients with primary rheumatological diseases other than FM were recruited. Secondary FM was diagnosed based on the 2016 revisions of the 2010/2011 FM diagnostic criteria. Data on the demographics of patients were collected through self-reported questionnaires. Overall, 158 women (76%) and 50 men (24%) with a mean age of 45.7 (12.8) years participated in the study.Systemic lupus erythematosus was the primary diagnosis for most patients. Fisher's exact test (p=0.007) indicated a significant but weak association between osteoarthritis and FM. A family history of comorbidity was significantly associated with an FM diagnosis(p<0.043). Having a major life event, such as the death of a kin, was significantly associated with FM (p<0.032). A personal history of functional disorders was significantly linked to a diagnosis of concomitant FM. Concomitant FM is frequently undetected in patients with rheumatic diseases. Raising awareness of FM through educational programs may facilitate earlier diagnosis and more effective treatment.

Geographical disparities in fibromyalgia severity: An Italian study.

Geographic origin may represent a variable capable of influencing health status. This study aims to investigate the presence of differences of disease severity in Italian patients with fibromyalgia from different macro-regions. This retrospective, cross-sectional study involved patients included in the Italian Fibromyalgia Registry. Three geographical macro-regions were identified, comprising patients from Northern Italy, Central Italy and Southern Italy. Clinical differences (evaluated through PolySymptomatic Distress Scale [PSD], revised Fibromyalgia Impact Questionnaire [FIQR] and modified Fibromyalgia Assessment Status [FASmod]) among the geographical macro-regions were studied using one-way analysis of variance (ANOVA) and the Scheffé's test. A total of 6095 patients (5719 females and 376 males) were included, with 1957 from Northern Italy, 2979 from Central Italy and 1159 from Southern Italy. All studied clinical indices showed a trend indicative of greater disease severity in Southern Italy, followed by Northern Italy and then Central Italy (mean values for PSD: 19.97 ± 6.20 in Northern Italy, 18.61 ± 7.12 in Central Italy, 23.01 ± 5.66 in Souther Italy). These differences were statistically significant for the overall scores of all studied indices, evaluated with ANOVA (all p < 0.001) and in the head to head comparisons, evaluted with Scheffé's test. Geographic background is significantly associated with variations in the severity of fibromyalgia in Italian patients. This is the first study to demonstrate geographical origin-dependent intra-national differences in the severity of fibromyalgia. The results confirm the necessity of considering fibromyalgia within the context of the biopsychosocial model and of implementing healthcare policies targeted towards the most underserved regions.

Fibromyalgia symptoms before and after septoplasty: A cross-sectional study.

This study aimed to investigate the impact of septoplasty on fibromyalgia symptoms in patients with septum deviation. Patients who were over 18 years of age, had been diagnosed with nasal septum deviation, and indicated for septoplasty were selected consecutively and included in the study. Patients were evaluated twice, at baseline and after septoplasty at 3 months. The patients' widespread pain and symptom severity scores were calculated according to the American College of Rheumatology 2016 Revised Fibromyalgia Diagnostic Criteria. A Revised Fibromyalgia Impact Questionnaire was filled out to evaluate the patients' fibromyalgia symptoms. The Pittsburgh Sleep Quality Index was used to assess the sleep quality of patients. Thirty-five patients, 21 (60.0%) male and 14 (40.0%) female, were accepted to the study. Nine (25.9%) patients had fibromyalgia at the beginning, and none of the patients met the fibromyalgia criteria after the surgery. After septoplasty, a statistically significant decrease was detected in the patients' widespread pain index, symptom severity scale, total score, and Pittsburgh Sleep Quality Index and Revised Fibromyalgia Impact Questionnaire scores (P = .006, P = .004, P = .028, P = .014, and P < .001, respectively). As a result of the study, it was observed that fibromyalgia symptoms of patients with septum deviation improved after surgical correction of the deviation.

Salivary Gland Sonography in Patients with Primary Fibromyalgia-A Pilot Study.

Primary Sjogren's syndrome (pSS) is often concomitant with fibromyalgia (FM). Salivary gland sonography aids in the diagnosis of pSS. We aimed to discover, in primary FM patients, the presence of pSS in undiagnosed patients through salivary gland sonography. We prospectively recruited 42 primary FM patients. FM symptoms were evaluated based on the revised Fibromyalgia Impact Questionnaire (FIQR). Salivary gland sonography was performed. Patients with positive findings underwent salivary gland biopsy. Comparisons were undertaken using the Mann-Whitney U tests and Chi-squared test. In primary FM patients, the prevalence of dry eye was 83%, and dry mouth was 90%. The salivary gland sonographic score did not differ between patients with and without dry eye/mouth. One patient with a positive finding at salivary gland sonography had a positive result of salivary gland biopsy. In the other four patients who received salivary gland biopsy, despite negative findings in salivary gland sonography, only one had a positive result of salivary gland biopsy. To be noted, scores evaluated by salivary gland sonography were negatively associated with levels of pain (rho = -0.360, p= 0.023) and levels of sleep quality (rho = -0.447, p = 0.004). Our pilot study demonstrated the potential of salivary gland biopsy in detecting undiagnosed pSS in primary FM patients.

Do Disease Parameters Related to Primary Sjögren's Syndrome have an Impact on the Severity of Co-Existing Fibromyalgia Syndrome or Vice Versa?

Abstract Objectives We aimed to examine whether primary Sjögren's syndrome (pSS)-related parameters may affect the severity of co-existing fibromyalgia syndrome (FMS) in pSS patients or vice versa; co-existing FMS might have an influence on the severity of sicca symptoms and disease activity measurements in pSS. Method Our study included a total of 49 pSS patients (24 with concomitant FMS; 25 without FMS) and 30 patients with primary FMS (pFMS). The EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) were used to evaluate pSS symptoms and disease activity. Sicca symptom severity (SSS) scores were recorded on a visual analogue scale for pSS patients. A minor salivary gland biopsy was performed in 34 pSS patients. The Revised Fibromyalgia Impact Questionnaire (FIQR) was used to evaluate the total spectrum of fibromyalgia-related problems. Results There was no statistically significant difference between disease activity measurements (ESSDAS, ESSPRI) in pSS patients with FMS and pSS patients (p=0.913, p=0.952, respectively). However, SSS scores were significantly higher in pSS patients with FMS than in pSS patients (p=0.045). There was no statistically significant difference between pFMS and pSS patients with FMS in terms of FIQR scores (p=0.149). Conclusions It was demonstrated that the severity of fibromyalgia assessed by FIQR is comparable between both groups.

Delay in fibromyalgia diagnosis and its impact on the severity and outcome: a large cohort study.

To evaluate the impact of the diagnostic delay on fibromyalgia (FM) severity. Data were retrospectively extracted from a large database of patients with FM belonging to the Italian Fibromyalgia Registry (IFR) residents on the Marche Region. The diagnosis of FM was formulated according to the 2016 American College of Rheumatology (ACR) criteria. The following information was obtained: time to diagnosis [categorised in early diagnosis (ED) if FM diagnosed within one year, late diagnosis (LD) if FM diagnosed more than 1 year but less than 5 years, and very late diagnosis (VLD) if FM diagnosed over 5 years from symptoms onset], revised Fibromyalgia Impact Questionnaire (FIQR), modified Fibromyalgia Assessment Status (FASmod), and Polysymptomatic Distress Scale (PDS) [consisting of the sum of Widespread Pain Index (WPI) and Symptom Severity Scale (SSS)]. The study included 616 FM patients (92.2% female), with a mean disease duration of 6.46 (SD 4.14) years and a mean (SD) time to diagnosis of 3.45 (2.39) years. The ED group included 169 patients, the LD 320 patients, and the VLD 127 patients. Comparing the differences among groups, a significant difference in disease severity was observed in all the clinimetric indices in increasing the time to reach the diagnosis (p=0.000001): the median PDS scores were 13.36 (interquartile range [IQR] 7.00-20.00), 16.09 (IQR 9.00-22.00), and 23.00 (IQR 18.25-26.00) for ED, LD, and VLD, respectively. Delayed diagnosis is associated with poorer patient outcomes, including worsening severity.

Significance of Inflammatory Markers in Primary Fibromyalgia Syndrome and Their Relation in Assessing the Disease Severity

Abstract Background Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by diffuse chronic musculoskeletal pain associated with various other symptoms. Although the etiology and pathogenesis of FMS are still unclear, it was reported to have possible inflammatory basis. No laboratory marker is currently available to diagnose the disease. Aim of the Work to assess the serum levels of ESR, CRP, NLR, MPV and PDW in primary Fibromyalgia syndrome patients and their relation with the disease severity and depression scores. Patients and Methods The study included 30 FMS patients, diagnosed according to the 2010 ACR (American Colleague of Rheumatology) criteria who presented to Ain Shams University Physical Medicine and Rehabilitation clinic as well as 30 healthy volunteers who served as a control group. The following laboratory tests were assessed among both groups: Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Neutrophil Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). FMS patients filled out The Revised Fibromyalgia Impact Questionnaire (FIQR) and Montgomery Asberg Deprssion Score (MADRS) as well. Results MPV, NLR, ESR and CRP values were significantly higher among the patients’ group (p &amp;lt; 0.05). Statistically positive correlation was found between FIQR and each of CRP (p = 0.021) and ESR (p = 0.027) levels. Another statistically significant positive correlation was found between MADRS and CRP (p = 0.01). The NLR showed marginal positive significance with FIQR. Conclusion In the light of these previous results, we can state that the serum levels of the tested inflammatory markers being mainly the acute phase reactants, have a positive relation with disease severity and depression scores, which in turn affect the quality of daily living. Accordingly, we arise the possibility of using those markers as good indicators of ongoing inflammatory process among FMS patients reflecting the severity of the disease.

Written narratives to understand the experience of individuals living with fibromyalgia.

To explore the experiences of individuals with fibromyalgia (FM) through written narratives (WN) and to preliminarily investigate the potential value of these narratives for healthcare professionals in assessing the overall perceived severity and disability experienced by individuals with FM. This cross-sectional study was conducted with 46 participants with a FM diagnosis. They were asked to complete a WN task that aimed to capture their personal experiences. The degree of severity and disability expressed in their texts was assessed by researchers, and participants were also asked to complete the Revised Fibromyalgia Impact Questionnaire (FIQR), the Hospital Anxiety and Depression Scale (HAD), and the Tampa Scale for Kinesophobia. Eight main themes were identified after qualitatively analysing the narratives provided by participants: story of their illness, FM characteristics, other illnesses, impact, coping strategies, social support, pain triggers and treatments. Pain emerges as a profound symptom affecting mental, physical, and social well-being, with diverse triggers and coping mechanisms. Participants highlighted difficulties in the diagnostic process, used multiple treatment strategies, and expressed a lack of understanding from healthcare professionals and society. There were significant correlations between researchers' assessments of severity and disability of the writings and FIQR and HAD scores. This study emphasises the value of narratives in capturing the multifaceted nature of FM experiences and hints at their potential for clinical understanding and management.

Cervical and Ocular Vestibular Evoked Myogenic Potentials in Fibromyalgia Syndrome Patients.

Fibromyalgia syndrome (FMS) is a chronic pain condition that may be associated with dysfunction in the central nervous system. The aim of this study was to assess the vestibulo-spinal reflex (VSR) and vestibulo-ocular reflex (VOR) in FMS using the cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) tests, respectively, and to evaluate their relation to disease severity. This study included 30 female FMS patients and 30 well-matched healthy controls. They underwent full history taking and assessment of the severity of dizziness/vertigo using the Dizziness Handicap Inventory; assessment of the severity of FMS symptoms using the Revised Fibromyalgia Impact Questionnaire; bedside examination of the dizzy patient; videonystagmography, cVEMP, and oVEMP tests; basic audiologic evaluation; and uncomfortable loudness level (UCL) testing. Dizziness was reported in 46.6% and vertigo in 11.1% of patients. Abnormalities in cVEMP (50%) and oVEMP (63.3%) were mostly unilateral, irrespective of FMS severity. Disease duration affected only the oVEMP amplitude. Fibromyalgia syndrome patients had a statistically significant lower UCL and narrower dynamic range compared to controls. The VSR and VOR are commonly affected in FMS patients, and findings suggest central sensitization involving the brain stem. We recommend routine cVEMP and oVEMP testing to assess brainstem function in FMS patients.

Role of Repetitive Transcranial Magnetic Stimulation in Treatment of Fibromyalgia: A Randomized Controlled Trial.

Fibromyalgia syndrome (FMS) is a chronic disease characterized by widespread, persistent musculoskeletal pain in association with impaired health-related quality of life. Repetitive transcranial magnetic stimulation (rTMS) is an emerging tool for the management of fibromyalgia. There is no standardized protocol of rTMS for the treatment of FMS, and both low- and high-frequency stimulation of the dorsolateral prefrontal cortex (DLPFC) are described in the literature with variable efficacy. The objective of this study was to determine the effectiveness of rTMS in people with fibromyalgia and compare the response of low- and high-frequency stimulation with sham stimulation. This study was a single-blinded, randomized, placebo-controlled trial. Ninety patients with the diagnosis of FMS were randomly allocated into one of the following three groups: low-frequency (1 Hz) group, high-frequency (10 Hz) group, and sham group. Pain, depression, anxiety, and quality of life were measured using the Numerical Pain Rating Scale (NPRS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HDRS), and Revised Fibromyalgia Impact Questionnaire (FIQR) immediately following treatment as well as at 1 and 3 months after treatment. The data was statistically analyzed using Statistical Package for the Social Sciences version 23 software. P value < 0.05 was considered statistically significant. Intergroup analysis revealed a significant improvement in NPRS, HAM-A, HDRS, and FIQR scores in both low- and high- frequency groups immediately following treatment and for 3 months after treatment. No significant difference in the efficacy of low- and high-frequency stimulation was noticed. rTMS is an effective mode of treatment in people with FMS. Both low and high frequencies of stimulation at DLPFC are equally effective in reducing pain and associated symptoms.

Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial

ObjectiveTo determine the efficacy of two physiotherapeutic interventions – aquatic therapy (AT) and land-based therapy (LBT) – for reducing pain in women with fibromyalgia. DesignSingle-blind, randomised controlled, equivalence trial. SettingFibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivity Association in A Coruña, Spain. ParticipantsForty women with fibromyalgia were assigned at random in a 1:1 manner to two groups: AT (n = 20) and LBT (n = 20). InterventionsTwo therapeutic exercise programmes, with 60-min sessions, were undertaken three times per week for 12 weeks. Sessions were carried out in groups by a trained physiotherapist. OutcomeThe primary outcome was pain intensity (visual analogue scale). The secondary outcomes were pressure pain threshold (algometer), quality of life (Revised Fibromyalgia Impact Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory) and physical ability (6-Minute Walk Test). Patients were evaluated at baseline, 12 weeks (post-treatment) and 18 weeks (follow-up). The statistical analysis was per-protocol. P < 0.05 was considered to indicate significance. Effect size was calculated. ResultsThe mean age was 50 [standard deviation (SD) 9] years, with median body mass index of 27 [interquartile range (IQR) 25–30] kg/m2 and median symptom duration of 11 (IQR 6–15) years. No differences were observed between the groups post-treatment, but differences in favour of AT were found in pain intensity [2.7 (IQR 1.5-4.9) vs 5.5 (IQR 3.3-7.6); p= 0.023; large effect, Cohen's d= 0.8; 95% confidence interval (CI) 0.1-1.5] and sleep quality [12.0 (IQR 7.3-15.3) vs 15.0 (IQR 13.0-17.0); p= 0.030; large effect, Cohen's d= 0.8; 95% CI 0.1-1.5] at follow-up. ConclusionsThe results suggest that AT is better than LBT for reducing pain intensity and improving sleep quality after 6 weeks of follow-up. AT may be a good treatment option for women with fibromyalgia. Clinical Trials Registration NumberClinicalTrials.gov NCT02695875 Contribution of the paper•This paper provides evidence that aquatic therapy is an effective intervention for reducing pain and improving sleep quality of women with fibromyalgia.•The matched protocols designed for this study highlighted the influence of the environment on symptom management in women with fibromyalgia.

Cross-sectional and longitudinal analysis of conditioned pain modulation and pain in fibromyalgia: CPM as an effect modifier of pain changes over time.

Fibromyalgia (FM) is associated with altered descending pain modulatory pathways, which can be assessed through Conditioned Pain Modulation (CPM). In this study, we aimed to explore the relationship between CPM and self-reported baseline characteristics in patients with fibromyalgia. We also performed a longitudinal analysis exploring CPM as a potential predictor of clinical improvement over time in individuals with FM. We performed cross-sectional univariable and multivariable analyses of the relationship between CPM and other variables in 41 FM patients. We then performed longitudinal analyses, building linear mixed effects models with pain in the Visual Analogue Scale (VAS) as the dependent variable, and testing for the interaction between time and CPM. We also tested the interaction between CPM and time in models using other outcomes, such as the revised Fibromyalgia Impact Questionnaire (FIQR) and Quality of Life Scale (QOLs). We found no association between CPM and other demographic and clinical variables in the univariable analysis. We found a statistically significant association in the multivariable linear regression model between CPM and the QOLs at baseline, after controlling for age, sex, and duration of symptoms. In the longitudinal analyses, we found that CPM is an effect modifier for clinical improvement over time for the pain VAS, QOLs and FIQR: individuals with low-efficient CPM at baseline have a different (improved) pattern of response over time when compared to those with high-efficient CPM. Our findings suggest that CPM is not a reliable biomarker of clinical manifestations in chronic pain patients during cross-sectional assessments. However, our results are consistent with previous findings that CPM can be used to predict the evolution of clinical pain over time. We expect that our findings will help in the selection of patients with the best profile to respond to specific interventions and assist clinicians in tailoring pain treatments.

Frequency of idiopathic intracranial hypertension with ultrasound in patients with fibromyalgia: Relation with function, central sensitization, and neuropathic pain.

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. 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. 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. 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.

Factors that influence medication adherence in women with fibromyalgia: A path analysis.

To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient-provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections. Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient-provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear. A cross-sectional, correlational study. The STROBE guidelines for cross-sectional studies were followed. Participants included Hebrew-speaking participants who were members of two Facebook groups: 'Shades of Purple' and 'Fibromyalgia- Get to Know!' Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire-9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient-provider communication, and used the 8-item Morisky Medication Adherence Scale (MMAS-8). Associations between the variables were explored using Pearson's correlations and path analyses. The study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)-low, 33.3% (N = 47)-medium and 13.5% (N = 19)-high. Depression positively correlated with stigma. Stigma negatively correlated with patient-provider communication. Patient-provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient-provider communication was found. Perceived stigma and patient-provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia. Addressing stigma related to fibromyalgia and effective patient-provider communication can positively influence treatment adherence. No patient or public contribution.

A retrospective analysis of the prevalence and impact of associated comorbidities on fibromyalgia outcomes in a tertiary care center.

This retrospective study was designed to analyze the prevalence and impact of associated comorbidities on fibromyalgia (FM) outcomes (functionality, pain, depression levels) for patients who participated in an intensive multicomponent clinical program in a tertiary care center. Participants included a sample of 411 patients diagnosed with FM at a large tertiary medical center using the 2016 ACR criteria. Patients completed an intensive 2-day cognitive behavioral treatment (CBT) program, filled out the Fibromyalgia Impact Questionnaire Revised (FIQR), the Center for Epidemiologic Studies Depression Scale (CES-D), the Pain Catastrophizing Scale (PCS), and were followed for 6 months after treatment completion. T-tests were performed to analyze differences between the presence or absence of select comorbidities for the three outcomes at follow-up. Statistically significant comorbidities (p < 0.05) were used as predictors in multivariable logistic regression models. The FM associated comorbidities in this cohort that had significant impact on the measured outcome domains after treatment program completed were Obesity (FIQR p = 0.024), Hypothyroidism (CES-D p = 0.023, PCS p = 0.035), Gastroesophageal reflux disease GERD (PCS p < 0.001), Osteoarthritis (CES-D p = 0.047). Interestingly, Headache, the most frequent FM associated comorbidity in this cohort (33.6%), did not have a significant impact on the outcome domains at follow-up. Obesity (18.2%) was the only FM associated comorbidity significantly impacting all three outcome domains at follow-up. The present study suggests that addressing obesity may significantly impact outcomes in FM patients.

Significance of inflammatory markers in primary Fibromyalgia syndrome and their relation in assessing the disease severity

Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by diffuse chronic musculoskeletal pain associated with various other symptoms. Although the etiology and pathogenesis of FMS are still unclear, it was reported to have a possible inflammatory basis. No laboratory marker is currently available to diagnose the disease. This study aimed to search for biomarkers useful in diagnosis of FMS. We assessed blood erythrocyte sedimentation rate (ESR), neutrophil lymphocyte ratio (NLR), the mean platelet volume (MPV) and platelet distribution width (PDW), and serum levels of C-reactive protein (CRP), as inflammatory markers in primary FMS patients and their relationship with disease severity and depression scores. The study included 30 FMS patients, diagnosed according to the 2010 ACR (American Colleague of Rheumatology) criteria and 30 normal volunteers as a control group. FMS patients filled out the Revised Fibromyalgia Impact Questionnaire (FIQR) and Montgomery Asberg Depression Score (MADRS) as well. There was a significant difference in the studied parameters including ESR, CRP, NLR, MPV between study patients and control groups (p&lt;0.05 for all). However, PDW did not differ between the two study groups. Based on our study findings, we can conclude that serum levels of the tested inflammatory markers including ESR, CRP, NLR, and MPV were higher in patients than in controls which makes them of good diagnostic value in patients with fibromyalgia. Meanwhile, some of these markers, mainly the acute phase reactants, have a positive relation with disease severity and depression scores, which in turn affect the quality of daily living.

Evaluation of fibromyalgia symptoms in patients with nasal septum deviation

Aim: To examine the symptoms and effects of fibromyalgia in patients with nasal septum deviation, which is an important cause of nasal obstruction. Materials and Methods: Seventy eight patients with nasal septum deviation and 78 healthy volunteers similar in age and gender were included in the study. Patients with systemic rheumatic disease, cardiovascular system disease, infectious disease, any other disease that may affect the respiratory passage other than nasal septum deviation, with a history of regular drug use, and under the age of 18 were not included in the study. Widespread pain score and symptom severity score were calculated for all participants according to the fibromyalgia syndrome American College of Rheumatology 2016 diagnostic criteria, and revised fibromyalgia impact questionnaire was filled out. Results: While the incidence of fibromyalgia syndrome was higher in patients with septal deviation, this difference was not statistically significant(p=0.072). There was no difference between the groups in terms of widespread pain score, symptom severity score, total score and revised fibromyalgia impact questionnaire score (p=0.438; p=0.933; p=0.502; p=0.081, respectively). Conclusion: Although no significant relationship has been found between fibromyalgia and septal deviation, further studies on this subject should be conducted.