Fibromyalgia Syndrome Patients Research Articles

Use of pain-related gene features to predict depression by support vector machine model in patients with fibromyalgia.

The prevalence rate of depression is higher in patients with fibromyalgia syndrome, but this is often unrecognized in patients with chronic pain. Given that depression is a common major barrier in the management of patients with fibromyalgia syndrome, an objective tool that reliably predicts depression in patients with fibromyalgia syndrome could significantly enhance the diagnostic accuracy. Since pain and depression can cause each other and worsen each other, we wonder if pain-related genes can be used to differentiate between those with major depression from those without. This study developed a support vector machine model combined with principal component analysis to differentiate major depression in fibromyalgia syndrome patients using a microarray dataset, including 25 fibromyalgia syndrome patients with major depression, and 36 patients without major depression. Gene co-expression analysis was used to select gene features to construct support vector machine model. The principal component analysis can help reduce the number of data dimensions without much loss of information, and identify patterns in data easily. The 61 samples available in the database were not enough for learning based methods and cannot represent every possible variation of each patient. To address this issue, we adopted Gaussian noise to generate a large amount of simulated data for training and testing of the model. The ability of support vector machine model to differentiate major depression using microarray data was measured as accuracy. Different structural co-expression patterns were identified for 114 genes involved in pain signaling pathway by two-sample KS test (p < 0.001 for the maximum deviation D = 0.11 > D critical = 0.05), indicating the aberrant co-expression patterns in fibromyalgia syndrome patients. Twenty hub gene features were further selected based on co-expression analysis to construct the model. The principal component analysis reduced the dimension of the training samples from 20 to 16, since 16 components were needed to retain more than 90% of the original variance. The support vector machine model was able to differentiate between those with major depression from those without in fibromyalgia syndrome patients with an average accuracy of 93.22% based on the expression levels of the selected hub gene features. These findings would contribute key information that can be used to develop a clinical decision-making tool for the data-driven, personalized optimization of diagnosing depression in patients with fibromyalgia syndrome.

The vicious cycle of physical inactivity, fatigue and kinesiophobia in patients with fibromyalgia syndrome.

This study aims to determine the association between fatigue, kinesiophobia, disease severity, and physical inactivity by comparing fibromyalgia syndrome (FMS) patients with healthy controls. Pain and fatigue are significant barriers to the participation in functional activities. Inactivity is a result of fatigue, but exercise is the foundation of FMS treatment. This case-control study included a total of 203 participants (107 patients with FMS and 96 healthy volunteers). The fibromyalgia impact questionnaire, the fatigue severity scale, the international physical activity questionnaire, and the Tampa scale for kinesiophobia were assessed. The FMS group scored significantly higher on the fatigue severity scale and kinesiophobia than the control group (p<0.001). Significantly lower metabolic task equivalent (MET) scale values were observed in the FMS group compared to the control group (p<0.001). The severity of fatigue and kinesiophobia correlated positively with the FMS impact questionnaire (p=0.001, r=0.621) and negatively with the MET scale (p=0.009, r= -0.287). Patients with FMS experience greater fatigue, kinesiophobia, and inactivity. As the severity of FMS worsens, so do disability, kinesiophobia, and fatigue. This study highlights the importance of breaking the cycle of fatigue and inactivity in the treatment of FMS.

Duloxetine: an effective treatment for fibromyalgia syndrome?

Duloxetine hydrochloride (duloxetine) is a powerful selective serotonin and norepinephrine reuptake inhibitor (SSRI), which in recent years has shown measurable success in treating a wide variety of disorders, including fibromyalgia syndrome (FMS). Among the clinical symptoms of FMS is the dysfunction of the monoamine systems in the nervous system, and since those are what duloxetine regulates, it is successful in managing its symptoms.1 Therefore, the United States Food and Drug Administration has cleared it for treating major depressive disorder, generalized anxiety disorder, for managing diabetic peripheral neuropathic pain and chronic musculoskeletal pain2. FMS is prevalent worldwide and affects nearly 1 in 20 people globally, including about 3 million adults in the United States3. Usually, patients diagnosed with FMS also have other chronic overlapping pain conditions and mental disorders, therefore it is uncommon to have FMS as an independent diagnosis4. Chronic stress exacerbates neuropathic pain by integrating stress affect–related information with nociceptive information in the amygdala’s central nucleus5,6. Its symptoms include restless sleep, fatigue, anxiety, depression, and problems regulating mood. There is a central magnification of pain signals, which evidence suggests is caused by the fact that both the ascending and descending pain pathways are functioning abnormally7. Although there is little evidence supporting this, it is believed that the symptoms are caused by neural over-sensitization, decreased conditioned pain modulation, combined with cognitive dysfunction, memory impairment, and altered information processing caused by negative events, stressful environments, or physical/emotional trauma8,9. Patients suffering from FMS have also been reported to experience a phenomenon known as fibrofog, which entails a decreased ability to think and process new information. The inference that disruptions in the perception of physiological pain, sleep, fatigue, cognition, and mood (hallmark symptoms of patients with FMS) may be consequences of abnormalities in serotonin and norepinephrine metabolism and transmission is supported by the fact they are both important regulators of these functions in healthy individuals10. Duloxetine works by reinforcing the serotonergic and adrenergic pathways involved in descending inhibition of pain at the dorsal horn of the spinal cord. The subsequent increased threshold for pain stimuli to reach the brain results in significant neuropathic pain relief. In a study, Write et al11 concluded that because the average FMS patient is on 3–6 medications to manage the symptoms, there may be an increased risk for the drug-to-drug interactions. Serotonin toxicities can develop from using serotonergic drugs and duloxetine simultaneously as it can lead to adverse drug-drug interactions12. Furthermore, little is known about how it may affect pregnancies or lead to complications for the mother and child before and after delivery. SSRIs increase the possibility of developing suicidality in children and young adults aged 18–24, which is one of its more tendentious side effects. Thus, the FDA has released a black box warning for duloxetine use13. Furthermore, duloxetine increases both levels of serotonin and norepinephrine, which directly results in tachycardia and hypertension14. Even though systematic reviews have proven its effectiveness in pain management, improving symptoms in up to 80% of patients, a careful examination of its adverse effects and advantages must be taken into consideration when prescribing SSRIs to any patient13,14. Diagnosis and eventual management of this disease are delayed because patients usually present with a variety of symptoms15. FMS patients must spend up to $35,920 on health care every year in the United States to treat the various symptoms of this disease16. Frequent physical therapy appointments to reduce stiffness, frequent blood work, and hospital visits take up significant time and place a financial strain on the patient. In a recent study, it was found that most patients with FMS view themselves as being moderate to severely disabled. The intensity of pain they experience and psychological factors (alexithymia and depression) were found to be the main reasons for this17. Clear, distinct guidelines for its diagnosis should be established so as not to delay the beginning of treatment, and awareness needs to be created among clinicians in third-world countries about this disease as well. Newer, more effective drugs need to be designed to not only improve the patient’s quality of life but to reduce the burden on the already overwhelmed health care systems as well. Ethical approval None. Sources of funding None. Authors’ contribution N.E.: wrote the article, suggested a topic, conducted a literature search A.E.: conducted a final review and corrections Conflicts of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) None. Guarantor Naz Elahi.

Physical activity and quality of life of patients with fibromyalgia.

Fibromyalgia Syndrome (FMS) has been linked to decreased social functioning, poor mental health, and quality of life (QOL). Increased physical functioning and activity can result in improvements in social, mental and overall health, as well as lowered depression and anxiety levels. The aim of this study was to determine physical activity levels and QOL amongst patients diagnosed with fibromyalgia in the Johannesburg region of South Africa. The research design was cross-sectional. Descriptive and quantitative data were collected. FMS patients (n=38) completed an online questionnaire on the Google Forms platform. The questionnaire was comprised of four components, namely Demographics, the Global Physical Activity Questionnaire (GPAQ), the Fibromyalgia Impact Questionnaire (FIQR), and the Short Form-36 (SF-36). During data analysis, descriptive characteristics and correlations were computed. The significance level was set at p ≤ 0.05. Results revealed high FIQR scores (67%) accompanied with low QOL scores (<50% in all domains). There was no correlation between physical activity and FIQR, and physical activity and QOL. High scores on the impact of FMS were associated with lower overall QOL scores. However, the relationship between physical activity, and the impact of FMS and QOL remain inconclusive.

The Influence of Emotional and Cognitive Factors on Limb Laterality Discrimination in Women with Fibromyalgia Syndrome: A Cross-Sectional Study Secondary Analysis

Previous scientific evidence has shown that patients with fibromyalgia syndrome (FMS) have alterations in the body schema. There have also been findings regarding the influence of psychological factors on pain, as well as evidence that patients with FMS have difficulty performing laterality discrimination tasks. The main objective of this study was to evaluate whether emotional and cognitive factors influence the limb laterality discrimination task in women with FMS. Seventeen of the participants were healthy female controls, and the other seventeen were women diagnosed with FMS. The main outcome measures were laterality discrimination, anxiety symptoms, depression symptoms, pain catastrophizing, and fear-related movement. The main analysis showed that patients with FMS had longer reaction times for laterality discrimination in hands (hand 20 images, p &lt; 0.031; hands 50 images p &lt; 0.013). In the secondary analysis, FMS patients showed emotional (anxiety (p &lt; 0.0001); depression (p &lt; 0.0001)) and cognitive (pain catastrophizing (p &lt; 0.0001); fear-related movement (p &lt; 0.0001)) disorders compared with healthy subjects. There was no correlation between limb laterality discrimination and psychological variables. In conclusion, patients with FMS showed impaired laterality discrimination, but psychological variables were not influenced. This could be due to the implicit nature of the task.

Vitamin D, VDR, and VDBP Levels Correlate with Anti-inflammatory Cytokine Profile in FMS Patients

Aim: The major target of this research is to examine whether there is any connection between the levels of vitamin D and anti-inflammatory mediators in patients with fibromyalgia syndrome (FMS). Materials and Methods: The study contains 30 FMS diagnosed and 25 healthy female individuals and the determination of FMS was made according to the standards of 2010 American College of Rheumatology (ACR). Vitamin D, vitamin D receptor (VDR), vitamin D binding protein (VDBP) levels, and anti-inflammatory cytokine (IL-4, IL-10, TGF-β) levels in the serum of patients with FMS and healthy individuals were measured using enzyme-linked immunosorbent assay (ELISA).Results: The concentrations of vitamin D, VDR, and VDBP were determined to be higher in healthy controls than in patients with FMS (p&amp;lt;0.001). Correlating with this, IL-4, IL-10, and TGF-β levels were measured remarkably higher in the healthy group than in the FMS patients (p&amp;lt;0.001). Conclusion: Low vitamin D levels may cause a decrease in anti-inflammatory cytokine levels and their immunosuppressive effect in FMS.

Prevalence and Impact of obesity on fibromyalgia syndrome and its allied symptoms.

Fibromyalgia syndrome (FMS) is a commonly occurring and disabling chronic pain disorder of unknown etiology. It is a syndrome of widespread diffuse pain with a low pain threshold and different FMS allied symptoms. Obesity is a comorbidity that is commonly occurring with FMS and may be linked to its severity. This study aims to estimate the prevalence of overweight and obesity in FMS and their effect on pain and FMS allied symptoms. One hundred and ten (10 male and 100 female) FMS patients diagnosed following the 1990 American College of Rheumatology (ACR) classification criteria for FMS completed a questionnaire about age, gender, and pain severity on a visual analog scale (VAS), evaluated for morning stiffness, disturbance of sleep, fatigue, anxiety, depression, and irritable bowel and the count of tender points. Weight, height, and body mass index (BMI) were calculated for all participants. Seventy-four (67.27%) were overweight/obese; of them, 68 (61.81%) were females. All the FMS allied symptoms were more prevalent in overweight/obese FMS patients. Overweight/obese FMS patients have a high number of TP and greater pain sensitivity to TP palpation. Overweight and obesity are commonly associated with FMS. Obesity may contribute to the severity of FMS and its allied symptoms.

TREINAMENTO DE FORÇA EM PACIENTES COM FIBROMIALGIA: UM ESTUDO DE VIABILIDADE

ABSTRACT Introduction: Fibromyalgia syndrome (FM) is characterized by the presence of diffuse pain lasting for more than three months and is often associated with sleep disorders. Studies have investigated the effect of strength training (ST) on pain and sleep quality in FM patients, but there continue to be diverse perspectives on the effects of this intervention in this population. Objective: The aim of the study was to examine the effects of strength training (ST) on pain and sleep quality in FM patients. Methods: Forty-eight women with FM participated in the study between August and October, 2012. Six (55±6.5 years) performed ST, conducted at Santa Catarina State University, and eight (47±9 years) comprised the control group. The Socio-Demographic and Clinical Questionnaire, the visual analog scale (VAS) for pain, and the Pittsburgh Sleep Quality Index were used. Data were collected before the first session and after the eight-week intervention and were analyzed using descriptive statistics and inferential tests. Results: The eight- week ST intervention decreased pain (p&lt; 0.05) and significantly diminished the daytime sleep dysfunctions (p&lt; 0.05), demonstrating that the proposed program contributes to improving patient quality of life. Conclusion: ST is a feasible treatment for patients with fibromyalgia. Level of evidence II; Therapeutic study.

Which Patients with Carpal Tunnel Syndrome are More Associated with Fibromyalgia Syndrome?

Objective: In this study, it was aimed to detect the presence of Fibromyalgia Syndrome (FMS) and related factors in patients diagnosed by Carpal Tunnel Syndrome (CTS). Materials and Methods: Demographic data and the features of CTS were noted by applying face-to-face questionnaire method. The existence of FMS in patients with CTS was investigated using the 2016 American College of Rheumatology (ACR) Fibromyalgia Diagnostic criteria. The Fibromyalgia Impact Questionnaire (FIQ) was introduced to patients diagnosed with FMS. Then, the correlations between the incidence of FMS in CTS patients, the presence of FMS and the hand with CTS, the severity of CTS and the existence of FMS, the presence of FMS and the duration of CTS symptoms, and finally CTS severity and FIQ were concurrently examined. Results: 151 patients included in the study. Bilateral CTS was detected in 89 (58.9%) patients. CTS was mild in 55 (36.4%), moderate in 87 (57.6%), and severe in 9 (6.0%) patients. Concomitant FMS was detected in 73 (48.3%) of all CTS patients. FMS rate is higher in patients with bilateral CTS (p=0.001). No significant relevance was observed between the severity of CTS and the presence of FMS (p = 0.864). The median duration of CTS symptoms with FMS patients was 24 (1-240) months; this period was found to be 12 (1-120) months in those without FMS. No significant relations between the presence of FMS and the duration of CTS symptoms were encountered (p = 0.073). The severity of CTS and FIQ demonstrated no significant difference (p=0.955). Conclusion: The case of FMS is high in specially bilaterally CTS patients. The fact that there may be common points in the pathogenesis of these two diseases suggests that it should be considered for diagnosis and treatment.

Fibromiyalji Sendromlu Kadın Hastaların Partnerlerinin Yaşam Kalitesi, Uyku Bozuklukları ve Psikolojik Durumları

Objectives:To investigate and compare scores of quality of life(QoL),sleep disturbances,and psychological status between the partners of female patients with fibromyalgia syndrome(FMS) and those of healthy controls. Materials and Methods:The study included partners of 100 female FMS patients under the 1990 criteria of the American Rheumatism Association(ACR) and partners of 100 female healthy controls.The partners of FMS patients and controls were investigated through Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI),Visual Analog Scale(VAS), Sensitive Point Number(SPN), Pittsburgh Sleep Quality Index(PSQI), and Short Form-36 (SF-36). Results:There was a statistically significant difference between partners of patients and controls concerning average scores of VAS, HNS, BDI, BAI, and PSQI (p

Comparison of Pineal Gland Volume Between Patients with Fibromyalgia and Healthy Controls Running Title: Pgv in Fibromyalgia

Objectives: The pineal gland is an important neuroendocrine organ accounting for the melatonin secretion and chronobiology that regulate circadian rhythm. This study was designed to compare pineal gland volume (PGV) with healthy controls and patients with fibromyalgia syndrome (FM), in which sleep quality and efficiency is reduced. Patient and Methods: In this cross-sectional study, PGV and functional pineal gland volume (FPGV) of FM patients with age- and sex-matched healthy controls were compared. All MR imaging studies were performed using a 3 Tesla scanner with a multi-channel phased array head coil. The volume of pineal glands and pineal cysts were calculated from 3D MP RAGE images using the formula: volume= AP x transverse x craniocaudal diameter x 0.523. Results: There was no significant difference in PGV and FPGV between the FM group and healthy controls (p=0.374 and p=0.421, respectively). In the correlation analysis, age was negatively correlated with PGV and FPGV in the FM group (r=-0.496, p=0.010; r=- 0.477, p=0.014, respectively). No significant correlation was detected between age, PGV and FPGV in the control group (r= 0.022, p=0.916; r= -0.019, p=0.925, respectively). Conclusions: Based on the results, there was no significant difference between the FM group and healthy controls regarding PGV and FPGV. However, PGV and FPGV were decreased by advancing age in the FM group in which melatonin therapy is offered as an option.

Prevalence of Fibromyalgia Syndrome in Taif City, Saudi Arabia.

Introduction Fibromyalgia syndrome (FMS) is a non-inflammatory, chronic disseminated musculoskeletal pain with unknown etiology. FMS patients suffer from generalized pain that markedly decreases their quality of life and productivity. Objective To investigate the prevalence of FMS and the correlation between people with positive screening criteria for FMS and their socio-demographic characteristics in Taif city. Methodology A cross-sectional study was performed in Taif city, Saudi Arabia, from June 2021 to August 2021. A structured self-estimated electronic questionnaire developed by Google Forms. The questionnaire depended on the 2010 American College of Rheumatology (ACR) criteria. Data analysis was performed by using SPSS, version 21.0 (IBM Corp., Armonk, NY). Result Out of 1015 participants, 77 participants (7.6%) were revealed to have FMS. The prevalence of FMS among females (9.3%) was significantly higher (p<0.001) than that among males (3.1%). In addition, participants aged 40 years old or more showed a significantly higher prevalence of FMS (p=0.003) compared to those aged less than 40 years old (11.7% versus 6.0%, respectively). In addition, occupational status was found to significantly affect FMS prevalence (p=0.040) as the highest prevalence was reported among employees (10.8%) and housewives (9.4%) compared to the unemployed (8.8%), students (5.0%), and retired participants (4.0%). On the other hand, participants' nationality was shown to have no significant effect on fibromyalgia prevalence (p=0.396). Conclusion Results show a slightly high prevalence rate of FMS in Saudi Arabia. Prevalence was seen greater in women, old age, and employed individuals. Poor knowledge of FMS was seen among the general Saudi population. Educational programs are needed to increase awareness of the disease.

Bipolar Spectrum Symptoms in Patients with Fibromyalgia: A Dimensional Psychometric Evaluation of 120 Patients

Fibromyalgia Syndrome (FMS) is characterized by chronic widespread pain, fatigue, unrefreshing sleep and cognitive dysfunction. Depressive and manic symptoms are often reported in FMS patients' history. The aim of this study was to evaluate the prevalence of bipolar spectrum symptoms (BSS) and to correlate these with quality of life (QoL) scores and antidepressant treatment. From October 2017 to July 2018, a battery of QoL questionnaires (FIQ, PSQI and SF-12) was administered to 120 FMS patients after a clinical examination. The MOODS-SR lifetime questionnaire was then remotely administered to the patients included in the study. The presence of depressive and manic lifetime symptoms was found, in line with the results of the available literature. A correlation was found between the history of depressive symptoms and the severity of FIQ and SF-12 scores. Despite a low statistical strength, a trend toward a correlation between a history of manic symptoms and SNRI treatment was detected. The correlation between the MOOD-depressive domains and poor QoL is in line with the available literature. Further studies are needed to corroborate these findings and to elucidate the relationship between manic symptoms and SNRI treatment.

Efficiency of pain inhibition and facilitation of fibromyalgia patients is not different from healthy controls: Relevance of sensitivity-adjusted test stimuli.

Pain is a dynamic phenomenon dependent on the balance of endogenous excitatory and inhibitory systems, which can be characterized by quantitative sensory testing. Many previous studies of pain modulatory capacity of patients with fibromyalgia syndrome (FM) have reported decreased pain inhibition or increased pain facilitation. This is the first study to assess pain modulation, including conditioned pain modulation (CPM) and temporal pain summation, in the same healthy control (HC) and FM participants. Only sensitivity-adjusted stimuli were utilized for testing of conditioned pain modulation (CPM) and temporal pain summation in 23 FM patients and 28 HC. All subjects received sensitivity-adjusted ramp-hold (sRH) during testing of pain facilitation (temporal summation) and pain inhibition (CPM). CPM efficacy was evaluated with test stimuli applied either concurrently or after application of the conditioning stimulus. Finally, the effects of CPM on pressure pain thresholds were tested. FM subjects required significantly less intense test and conditioning stimuli than HC participants to achieve standardized pain ratings of 50 ± 10 numerical rating scale (NRS) (p = 0.03). Using such stimuli, FM subjects' temporal pain summation and CPM efficacy was not significantly different from HC (all p > 0.05), suggesting similar pain facilitation and inhibition. Furthermore, the CPM efficacy of FM and HC participants was similar regardless of whether the test stimuli were applied during or after the conditioning stimulus (p > 0.05). Similar to previous studies, FM participants demonstrated hyperalgesia to heat, cold, and mechanical stimuli. However, using only sensitivity-adjusted stimuli during CPM and temporal summation testing, FM patients demonstrated similarly effective pain inhibition and facilitation than HC, suggesting that their pain modulation is not abnormal.

Fibromiyalji Sendromu Tanısında Oksidatif Stres İndeksi ve C Vitamini

Aim: Still there is no any specific laboratory marker for diagnosis of FMS and it mainly depends on clinical examination. So that we aimed to evaluate whether serum Vitamin C levels and oxidative stress index (OSI) can be used in the diagnosis of Fibromyalgia Syndrome (FMS). &#x0D; Material and Method: 53 female patients and 35 healthy female controls were enrolled to our cross-sectional study. VAS, BDI and FIQ were applied to the patients. Vitamin C levels were measured by HPLC. Total Antioxidant Capacity (TAC) and Total Oxidant Status (TOS) levels were determined by Spectrophotometric Assay method.&#x0D; Results: While vitamin C and TAC levels of FMS patients were significantly lower than those of the controls, OSI was significantly higher in patients (p= 0.004, p= 0.009 and p= 0.048, respectively). There was a moderate positive and significant relationship between the tender points and FIQ, (r = 0.505; p

Fibromyalgia Concomitant with Seropositive Rheumatoid Arthritis in a Tertiary Hospital in South-Western Saudi Arabia: Prevalence and Treatment Patterns

Introduction: Rheumatoid arthritis (RA) patients with fibromyalgia syndrome (FMS) report worse functional status and quality of life hence the association has important clinical implications. FMS can be challenging to treat, and the current evidence recommends a multidisciplinary treatment approach focused on symptom management. Aim: Information regarding the current prevalence of FMS in RA patients is lacking. Thus, this study aims to address the prevalence and predictors of FMS in seropositive RA patients and demonstrate our clinical practice in the management of FMS. Methods: Participants’ data was gathered from Aseer central hospital (ACH) rheumatology clinics and daycare units over a period of 2 years. Subjects were assessed using the 2010 American College of Rheumatology (ACR) criteria for FMS. Data were collected from medical records, including patient demographics, comorbidities and concomitant FMS-related data. Results: Out of 310 seropositive RA patients, 15% (n = 47) fulfilled the diagnostic criteria for FMS. Of them, 29, 11 and 7 were on pregabalin, amitriptyline and duloxetine, respectively. Half of FMS patients showed one or more therapy changes. A significant difference between RA patients with and without concomitant FMS was observed, including age, gender and comorbidities. Conclusion: In this retrospective study, a high prevalence of FMS in individuals with seropositive RA was identified. This study explores real-world practice in the treatment of FMS with remarkable findings regarding underdosing and lower discontinuation rate of pregabalin.

Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study.

This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients. The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS. Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385). The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS.

Pregabalin inhibits proinflammatory cytokine release in patients with fibromyalgia syndrome.

The main goal of the study was to investigate how pregabalin (PGB) affects proinflammatory cytokine release in patients with fibromyalgia syndrome (FMS). This experimental research study was conducted with 85 female participants (mean age: 49.6±10.1 years; range, 30 to 73 years) between April 2020 and November 2020. Of the participants, 30 were FMS patients using PGB 150 mg/day for at least three months, 30 were FMS patients not using PGB, and 25 were healthy individuals. The detection of FMS was carried out according to the 2010 American College of Rheumatology diagnostic criteria. Levels of proinflammatory cytokines (interleukin [IL]-2, IL-6, IL-12, IL-17, interferon-gamma, and tumor necrosis factor-alpha) were measured by enzyme-linked immunosorbent assay. Serum concentrations of proinflammatory cytokines were remarkably decreased in FMS patients using PGB (p<0.001) and were higher in patients with FMS not using PGB than in healthy subjects (p<0.001). The highest values of proinflammatory cytokines were found in the group of FMS patients not using PGB (p<0.001). These results indicate that PGB inhibits the release of proinflammatory cytokines, suggesting that it can be used as an anti-inflammatory agent in inflammatory cases.

Determinants of sleep disturbance and sleep quality in children of mothers with fibromyalgia.

This study aimed to determine whether maternal diagnosis of Fibromyalgia syndrome (FMS) affects the sleep quality of children. This prospective study was conducted with 80 female participants (mean age: 36.2±5.9 years; range 25 to 50 years) and their 80 children (27 males, 53 females; mean age: 6.6±2.6 years; range 2 to 12 years) between August 2019 and November 2020. The FMS group included 40 female FMS patients and their children, whereas the control group consisted of 40 healthy females and their children. In addition to sociodemographic variables, functional status was evaluated by the Fibromyalgia Impact Questionnaire (FIQ), which was completed by mothers with FMS, and the Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate the sleep quality of all children. There was no statistically significant difference between the two groups in terms of demographic characteristics (p>0.05). The CSHQ score of the two groups was above 41 points and was at a clinically significant level. The median value for the CSHQ score was 60.5 and 52 in the FMS and control groups, respectively. Sleep time, waking up at night, parasomnias, disrupted breathing during sleep, and sleepiness scores were higher in the FMS group than in the control group, and the differences were statistically significant (p<0.001). The delayed falling asleep score, which was reversely coded, was lower in the FMS group than in the control group, and the difference was statistically significant (p<0.001). This pilot study showed that the children of mothers with high Fibromyalgia Impact Questionnaire scores had sleep disorders. Maternal diagnosis of FMS negatively affects the sleep quality of children.

Cervical Joint Position Sense and Its Correlations with Postural Stability in Subjects with Fibromyalgia Syndrome.

Cervical joint position sense (JPS) and postural stability are vital to maintaining balance and preventing falls in fibromyalgia syndrome (FMS). Impaired cervical JPS may influence postural stability, and understanding the relationship between them can aid in formulating treatment strategies in individuals with FMS. This study aims to (1) assess cervical JPS and postural stability between FMS and control group and (2) determine the correlation between cervical JPS and postural stability in the FMS group. This cross-sectional study recruited 92 FMS patients (mean age: 51.52 ± 7.7 yrs.) and 92 healthy controls (mean age: 49.36 ± 6.9 yrs.). A cervical range of motion (CROM) unit was utilized to assess cervical JPS. The postural stability was assessed using an IsoFree force platform, and anterior-posterior (A/P) and medial-lateral (M/L) directions of sway and ellipse area were measured. Cervical JPS and postural stability tests were assessed and compared between FMS and control groups. Cervical JPS was significantly impaired in FMS compared to the control group (p &lt; 0.001). The JPS errors in FMS group were larger in flexion (FMS = 5.5°, control = 2.4°), extension (FMS = 6.4°, control = 3.0°), and rotation in left (FMS = 5.4°, control = 2.2°) and right directions (FMS = 5.1°, control = 2.8°). FMS individuals demonstrated statistically significant impaired postural stability compared to control in both the dominant and non-dominant legs tested (p &lt; 0.001). The cervical JPS test showed moderate to strong positive correlations with postural stability variables. Statistically significant correlations were observed in all the JPS directions tested with all the postural stability variables (A/P and M/L sway and ellipse area). The correlation coefficients ranged between r =0.37 (moderate) to 0.75 (strong). Cervical JPS and postural stability are impaired in FMS individuals. A moderate to strong relationship existed between JPS and postural stability. Individuals with FMS who had a greater magnitude of cervical JPS errors exhibited more severe postural control deficits. Therefore, cervical JPS and postural stability tests should be incorporated into routine clinical practice when assessing or formulating treatment strategies for patients with FMS.