Fibromyalgia Syndrome Patients Research Articles

Evaluation of ophthalmic vascular and neuroretinal alterations in fibromyalgia syndrome: a cross-sectional comparative study.

Fibromyalgia syndrome (FMS) is a prevalent rheumatic disorder, and its pathogenesis includes genetic, neuroendocrine, and autonomic abnormalities, which may impact ocular structures. The aim was to conduct a comparative analysis of the ophthalmic vasculature and the retinal nerve fiber layer (RNFL) thickness between FMS and control groups using optical coherence tomography (OCT) and OCT angiography (OCTA). This cross-sectional comparative study included 43 FMS patients and 40 healthy controls recruited from a tertiary education and research hospital between January 2024 and May 2024. All patients satisfied the 2016 American College of Rheumatology criteria for FMS and consented. OCT and OCTA were used to assess the RNFL thickness and the retinal microvasculature structure. The Fibromyalgia Impact Questionnaire (FIQ) was performed to evaluate disease severity. The study found significantly higher total retinal parafoveal thickness and foveal density in FMS patients (p = 0.017 and p = 0.044, respectively). Nevertheless, there were no significant differences among the groups concerning total retinal foveal thickness, foveal avascular zone characteristics, superficial and deep capillary plexus densities, choriocapillaris flow area, and outer retinal flow area values (p > 0.05). The RNFL thickness in all quadrants did not reveal significant differences between the groups (p > 0.05). Furthermore, there was no significant correlation between FIQ scores and OCTA parameters or RNFL thickness values (p > 0.05). The study revealed slight differences in retinal parafoveal thickness and foveal density in FMS patients, but no substantial vascular or neurodegenerative alterations were observed compared to healthy controls. These data indicate that FMS may not substantially affect ocular structures, contrary to earlier hypotheses.

Heart Rate Variability Biofeedback Efficacy on Fatigue and Energy Levels in Fibromyalgia: A Secondary Analysis of RCT NCT0412183.

Background: Fibromyalgia syndrome (FMs) is a chronic condition characterized by widespread musculoskeletal pain and a range of complex symptoms, with chronic fatigue being a central feature significantly impacting daily life. The aim of this study was to analyze the secondary outcomes, specifically those related to perceived energy and fatigue symptoms in a randomized controlled trial (RCT) assessing the efficacy of heart rate variability biofeedback (HRV-BF) as an adjunctive treatment for FMs. Methods: Sixty-four FMs patients were randomly assigned to either receive 10 HRV-BF training sessions alongside standard pharmacological therapy (experimental group) or standard therapy alone for 10 weeks (control group). For this secondary analysis, potential improvements in specific items were evaluated regarding perceived energy (Item 10 of the Short-Form Health Survey), the ability to walk and climb stairs (Item 7 and Item 11 of the Fibromyalgia Impact Questionnaire, respectively), and the impact of pain on movement ability (Item 17 of the Bodily and Emotional Perception of Pain). Results: The experimental group demonstrated an improvement in the perception of energy, the ability to walk, and the impact of pain on movement ability. However, the same improvement was not observed in the ability to climb stairs. Conclusions: Fatigue assessment has emerged as a crucial factor for evaluating treatment efficacy in FMs and related conditions linked to altered energy levels, such as bipolar depression, and can offer valuable insights for precisely guiding HRV-BF treatments. ClinicalTrials.gov with code: NCT04121832.

Heart Rate Variability Biofeedback Efficacy on Fatigue and Energy Levels in Fibromyalgia: A Secondary Analysis of RCT NCT0412183

Background: Fibromyalgia syndrome (FMs) is a chronic condition characterized by widespread musculoskeletal pain and a range of complex symptoms, with chronic fatigue being a central feature significantly impacting daily life. The aim of this study was to analyze the secondary outcomes, specifically those related to perceived energy and fatigue symptoms in a randomized controlled trial (RCT) assessing the efficacy of heart rate variability biofeedback (HRV-BF) as an adjunctive treatment for FMs. Methods: Sixty-four FMs patients were randomly assigned to either receive 10 HRV-BF training sessions alongside standard pharmacological therapy (experimental group) or standard therapy alone for 10 weeks (control group). For this secondary analysis, potential improvements in specific items were evaluated regarding perceived energy (Item 10 of the Short-Form Health Survey), the ability to walk and climb stairs (Item 7 and Item 11 of the Fibromyalgia Impact Questionnaire, respectively), and the impact of pain on movement ability (Item 17 of the Bodily and Emotional Perception of Pain). Results: The experimental group demonstrated an improvement in the perception of energy, the ability to walk, and the impact of pain on movement ability. However, the same improvement was not observed in the ability to climb stairs. Conclusions: Fatigue assessment has emerged as a crucial factor for evaluating treatment efficacy in FMs and related conditions linked to altered energy levels, such as bipolar depression, and can offer valuable insights for precisely guiding HRV-BF treatments. ClinicalTrials.gov with code: NCT04121832.

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 < 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.

Hyperbaric oxygen therapy vs. pharmacological intervention in adults with fibromyalgia related to childhood sexual abuse: prospective, randomized clinical trial

Fibromyalgia syndrome (FMS) is a chronic pain syndrome characterized by disruptions in pain processing within the central nervous system. It exhibits a high prevalence among patients with a history of traumatic experiences, notably childhood sexual abuse (CSA). This study compared the efficacy of hyperbaric oxygen therapy (HBOT) to the current pharmacological standard of care for individuals suffering from CSA-related FMS. Forty-eight participants diagnosed with FMS and a history of CSA were randomly assigned to either the HBOT group (60 sessions of 100% oxygen at 2 ATA for 90 min, with air breaks every 5 min) or the medication (MED) group (FDA-approved medications, Pregabalin and Duloxetine). The primary endpoint was the Fibromyalgia impact questionnaire (FIQ) score, while secondary endpoints encompassed emotional status and daily functioning questionnaires, as well as pain thresholds and conditioned pain modulation tests. Brain activity was evaluated through single photon emission computed tomography (SPECT). Results revealed a significant group-by-time interaction for the FIQ score favoring HBOT over MED (p < 0.001), with a large effect size (Cohen's d = − 1.27). Similar findings were observed in emotional symptoms and functional measures. SPECT imaging demonstrated an increase in activity in pre-frontal and temporal brain areas, which correlated with symptoms improvement. In conclusion, HBOT exhibited superior benefits over medications in terms of physical, functional, and emotional improvements among FMS patients with a history of CSA. This associated with increased activity in pre-frontal and temporal brain areas, highlighting the neuroplasticity effect of HBOT.

AN OVERVIEW OF SYSTEMIC IMMUNE-INFLAMMATION INDEX AND HEMATOLOGICAL LABORATORY FINDINGS IN FIBROMYALGIA SYNDROME

This study aimed to determine disease activity by evaluating the relationship between the Systemic Immune-Inflammation Index (SII) and blood parameters in fibromyalgia syndrome (FMS). 109 FMS patients and 82 healthy controls were included in this retrospective study. Age, gender, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), hemoglobin (HGB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution (RDW), platelet distribution width (PDW), mean platelet volume (MPV), platelet (PLT), platelet crit (PCT), lymphocyte (LYM), monocyte (MONO), neutrophil (NEU) levels were scanned retrospectively from the hospital information system. Platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and SII were calculated. CRP and ESR levels were elevated in fibromyalgia (FMS) patients compared to healthy controls, although they remained within the standard value range (p

Impact of fibromyalgia severity on patients mood, sleep quality, and quality of life.

Fibromyalgia syndrome (FMS) is characterized by persistent widespread pain which greatly impacts the quality of life (QOL). Pain not only limits patients' daily activities but also restricts their social activities further leading to depression, anxiety, and stress. The present cross-sectional study elucidated the association of sleep quality and mood with increasing symptom severity of fibromyalgia and its impact on the QOL of fibromyalgia patients. Hundred adult fibromyalgia patients diagnosed by the American College of Rheumatology 2010 criteria were evaluated for: sleep - using the Pittsburgh sleep quality index, QOL by SF-36, pain-visual analog scales (VASs) and global pain scale (GPS), mood-depression, anxiety, stress scale-21, somatic symptoms, anxiety and depression - by patients health questionnaire somatic, anxiety, and depressive symptom scales (PHQ-SADS), and FMS severity was evaluated using fibromyalgia impact questionnaire (FIQR). The mean pain score was 6.80 ± 1.58 on VAS and 54.10 ± 14.33 on GPS. FIQR score was 50.62 ± 13.68, mean sleep quality was poor (9.30 ± 3.88), and depression, anxiety, and stress scores were increased (10.04 ± 4.59, 8.33 ± 4.48, and 10.75 ± 4.66). An increasing trend of depression, anxiety, stress, and somatoform symptoms was observed with an increase in the severity of FMS when patients were compared according to FMS severity scores. Sleep also deteriorated with increasing severity of FMS from 5.66 ± 1.92 in mild FMS to 12.0 ± 3.41 in highly severe FMS patients. The QOL too deteriorated in all the domains with increasing severity. With the increasing severity of fibromyalgia, not only does the pain increase but mood and sleep quality also deteriorate, which further impacts the QOL of FMS patients. Thus, comorbid mood derangements must also be screened and addressed for maximum benefit of the patients.

Thiol-Disulfide Balance in Fibromyalgia: A Case-Control Study

Aim. We aimed to examine the thiol-disulfide (SS) balance, a recognized marker of oxidative stress, in fibromyalgia syndrome (FMS).&#x0D; Methods. The study comprised 98 female participants (61 newly diagnosed patients and 37 patients under treatment) with FMS, along with 82 apparently healthy female volunteers. In both groups, assessments were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Short Form-36 (SF-36), Tender Point Count, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Native thiol (NT) and total thiol (TT) levels were measured, SS levels and SS/NT ratio were calculated.&#x0D; Results. FMS patients demonstrated significantly lower NT levels, higher SS levels, and an elevated SS/NT ratio compared to the control group (p&lt; 0.05 for all groups). In FMS patients, a statistically significant correlation was found between SS level and the SS/NT ratio, as well as the number of tender points (r=-0.24, p=0.02; r=-0.21, p=0.04), SF-36 pain subscales (r=0.22, p=0.032; r=0.21, p=0.04), and BAI scores (r=-0.22, p=0.01; r=-0.23 p=0.03). In the subgroup analysis, all health assessment scales were observed to exhibit statistically significant differences between the under-treatment group and newly-diagnosed group when compared to the control group (p&lt; 0.05 for all groups). The FIQ, VAS, FSS, and BAI scores were found to be significantly lower in the under-treatment group as compared to the newly-diagnosed group (p&lt; 0.05 for all groups). In the newly-diagnosed group, NT was significantly lower and the SS/NT ratio was significantly higher than those in the control group (p&lt; 0.05). In the under-treatment group, SS levels and SS/NT ratio were significantly higher as compared to the control group (p&lt; 0.05). In the multivariate regression analysis, which incorporated age, health assessment scales, patient subgroups, tender points, and duration of symptoms to predict the SS/NT ratio, variabes such as being in the under-treatment group, tender points, and BAI score were identified as significant predictors (p&lt; 0.05).&#x0D; Conclusions. The thiol-SS balance was observed to shift in the oxidative direction, and oxidative stress was higher in the FMS group. The absence of a significant difference between the under-treatment group and the newly-diagnosed group in terms of thiol-SS balance parameters suggests a shift to oxidative stress in patients, independent of the treatment status.

Distinguishing fibromyalgia syndrome from small fiber neuropathy: a clinical guide.

Fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) are distinct pain conditions that share commonalities and may be challenging as for differential diagnosis. To comprehensively investigate clinical characteristics of women with FMS and SFN to determine clinically applicable parameters for differentiation. We retrospectively analyzed medical records of 158 women with FMS and 53 with SFN focusing on pain-specific medical and family history, accompanying symptoms, additional diseases, and treatment. We investigated data obtained using standardized pain, depression, and anxiety questionnaires. We further analyzed test results and findings obtained in standardized small fiber tests. FMS patients were on average ten years younger at symptom onset, described higher pain intensities requiring frequent change of pharmaceutics, and reported generalized pain compared to SFN. Pain in FMS was accompanied by irritable bowel or sleep disturbances, and in SFN by paresthesias, numbness, and impaired glucose metabolism (P < 0.01 each). Family history was informative for chronic pain and affective disorders in FMS (P < 0.001) and for neurological disorders in SFN patients (P < 0.001). Small fiber pathology in terms of skin denervation and/or thermal sensory threshold elevation was present in 110/158 (69.7 %) FMS patients and 39/53 (73.6 %) SFN patients. FMS patients mainly showed proximally reduced skin innervation and higher corneal nerve branch densities (p<0.001) whereas SFN patients were characterized by reduced cold detection and prolonged electrical A-delta conduction latencies (P < 0.05). Our data show that FMS and SFN differ substantially. Detailed pain, drug and family history, investigating blood glucose metabolism, and applying differential small fiber tests may help to improve diagnostic differentiation and targeted therapy.

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.

Adherence to ACSM exercise guidelines and its influence on Fibromyalgia treatment outcomes: a meta-analysis of randomized controlled trials.

The Fibromyalgia Syndrome (FMS) is a multifaceted chronic pain disorder that exerts a substantial impact on the overall state of health and quality of life of patients. Investigate the effects of exercise therapy and adherence to the American College of Sports Medicine (ACSM) guidelines on treatment outcomes in FMS patients. The literature search, which concluded in October 2023, encompassed studies investigating the impact of exercise interventions on patients diagnosed with FMS and providing adequate data for calculating standardized mean difference (SMD). The primary outcome measures encompassed the Fibromyalgia Impact Questionnaire (FIQ) and Health Assessment Questionnaire (HAQ), while secondary outcome measures comprised pain levels, sleep quality, fatigue, and mental health. Among 4,008 records, 19 studies (patients = 857) were eligible for qualitative synthesis. The meta-analysis revealed that the SMD for overall state of health impact was -0.94 (95%CI -1.26, -0.63), and the pooled SMD for the subgroup with high adherence to ACSM guidelines was -1.17 (95%CI -1.65, -0.69). The SMD for the subgroup with low or uncertain adherence was -0.73 (95%CI -1.12, -0.34). The overall effects included a -1.21 (95%CI -1.62, -0.79) SMD for pain relief, with high adherence achieving a -1.32 (95%CI -2.00, -0.64) SMD and low adherence a -1.06 (95%CI -1.55, -0.57) SMD. Mental health improvements showed a -0.95 (95%CI -1.32, -0.57) overall SMD, with high and low adherence subgroups at -0.96 (95%CI -1.62, -0.30) and -0.94 (95%CI -1.29, -0.60), respectively. Sleep quality impact was -1.59 (95%CI -2.31, -0.87) overall, with high adherence at -1.71 (95%CI -2.58, -0.83) and low adherence at -1.11 (95%CI -1.88, -0.33). Fatigue impact had a -1.55 (95%CI -2.26, -0.85) overall SMD, with -1.77 (95%CI -3.18, -0.36) for high adherence and -1.35 (95%CI -2.03, -0.66) for low adherence. Exercise therapy can improve the overall state of health, pain, sleep, and fatigue of FMS patients, particularly when adhering to ACSM guidelines. However, adherence levels do not affect mental health gains, indicating a need for future research on psychological impact. https://inplasy.com/inplasy-2024-3-0106/, identifier INPLASY202430106.

Editorial

Dear Readers There is no doubt that 2023 has inflicted more war, hardships and frustrations upon our world than anyone could have predicted, but we are ready to embrace any and all things that 2024 has to offer. Here are some insights, hopes and dreams for the New Year and the upcoming Christmas: on behalf of the entire Editorial Office of the Archives in Psychiatry and Psychotherapy, I would like to wish you, Dear Readers, peace, creative thinking and health. May the Holiday Season be merry, prosperous and rich in inspirations for compelling future works. Meanwhile, this current issue of the APP abounds with interesting reads. We would like to open with “Social cognition and attachment profiles of women with fibromyalgia syndrome (FM): a case-control study” by Beycan Ayhan et al. from Turkyie. In this study, the authors aimed to examine social cognitive and attachment profiles of FM patients. FM patients may have no social cognition impairments, especially in lack of any psychiatric comorbidities. Moreover, they may suffer from the avoidant type of insecure attachment, which may further affect social support seeking behavior they display. The authors conclude that attachment-based interventions may be important in the treatment of the FM Syndrome.

Effect of Hypnosis on Pain, Anxiety, and Quality of Life in Female Patients with Fibromyalgia: Prospective, Randomized, Controlled Study

ABSTRACT This prospective, randomized, controlled study aimed to investigate the effects of standardized adjuvant hypnosis on pain, depression, anxiety, aerobic exercise practices, quality of life, and disease impact score in female patients with fibromyalgia syndrome (FMS). This study included 47 female patients with FMS who had been under treatment for at least six months. The hypnosis group (n = 24) received a total of three hypnosis sessions and was taught to patients’ self-hypnosis. The patients in this group practiced self-hypnosis for six months. During this period, all patients also continued their medical treatment. The Visual Analogue Scale (VAS) was used to determine the intensity of pain. At the end of the six-month follow-up period, it was determined that the patients of FMS with hypnosis therapy had lower pain intensity, FMS symptoms, depression, and anxiety symptoms, and better well-being than those in the control group (p < .05). Standardized hypnosis is an effective method in reducing pain, depression and anxiety symptoms and improving quality of life in patients with FMS.

Fibromyalgia is associated with hypersensitivity but not with abnormal pain modulation: evidence from QST trials and spinal fMRI.

Widespread pain and hyperalgesia are characteristics of chronic musculoskeletal pain conditions, including fibromyalgia syndrome (FM). Despite mixed evidence, there is increasing consensus that these characteristics depend on abnormal pain augmentation and dysfunctional pain inhibition. Our recent investigations of pain modulation with individually adjusted nociceptive stimuli have confirmed the mechanical and thermal hyperalgesia of FM patients but failed to detect abnormalities of pain summation or descending pain inhibition. Furthermore, our functional magnetic resonance imaging evaluations of spinal and brainstem pain processing during application of sensitivity-adjusted heat stimuli demonstrated similar temporal patterns of spinal cord activation in FM and HC participants. However, detailed modeling of brainstem activation showed that BOLD activity during "pain summation" was increased in FM subjects, suggesting differences in brain stem modulation of nociceptive stimuli compared to HC. Whereas these differences in brain stem activation are likely related to the hypersensitivity of FM patients, the overall central pain modulation of FM showed no significant abnormalities. These findings suggest that FM patients are hyperalgesic but modulate nociceptive input as effectively as HC.

Investigation of Early Growth Response Protein (EGR) Levels in Patients with Fibromyalgia Syndrome: A Cross-Sectional Study.

Fibromyalgia is a soft tissue rheumatism characterized by chronic and widespread musculoskeletal pain at specific points in the body. In this study, we aimed to investigate the relationship between Early Growth Response (EGR1, EGR2, and EGR3) protein levels in patients with Fibromyalgia Syndrome (FMS) and healthy controls. In our studies, 76 FMS patient group and 78 healthy control group who were newly diagnosed with primary FMS according to the 2010 American College of Rheumatology criteria for fibromyalgia in Sivas Cumhuriyet University Hospital, Physical Therapy, and Rehabilitation were used. Venous blood samples were taken from both groups for the measurement of EGR1, EGR2, and EGR3 protein plasma levels, and protein levels were determined using ELISA methods. Statistical parametric test assumptions were compared using the Independent Student's t-test. In addition, specificity, sensitivity, and AUC values were calculated with the ROC curve. The relationship between plasma EGR1 protein levels of FMS patients and control groups was statistically significant (p=0.001). EGR1 protein levels were found to be lower in the patient group diagnosed with FMS compared to the control group. It has been suggested that EGR1 protein levels can be important in the diagnosis of FMS disease.

Temporomandibular Disorders and Fibromyalgia Prevalence: A Systematic Review and Meta-Analysis.

To evaluate the prevalence of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS) in TMD patients and the prevalence of TMDs in patients with FMS. A systematic search was performed in electronic databases. Studies published in English examining the prevalence of comorbid TMDs and CWP/FMS were included. The Newcastle-Ottawa Scale was used to assess study quality, and meta-analyses using defined diagnostic criteria were conducted to generate pooled prevalence estimates. Nineteen studies of moderate to high quality met the selection criteria. Meta-analyses yielded a pooled prevalence rate (95% CI) for TMDs in FMS patients of 76.8% (69.5% to 83.3%). Myogenous TMDs were more prevalent in FMS patients (63.1%, 47.7% to 77.3%) than disc displacement disorders (24.2%, 19.4% to 39.5%), while a little over 40% of FMS patients had comorbid inflammatory degenerative TMDs (41.8%, 21.9% to 63.2%). Almost a third of individuals (32.7%, 4.5% to 71.0%) with TMDs had comorbid FMS, while estimates of comorbid CWP across studies ranged from 30% to 76%. Despite variable prevalence rates among the included studies, the present review suggests that TMDs and CWP/FMS frequently coexist, especially for individuals with painful myogenous TMDs. The clinical, pathophysiologic, and therapeutic aspects of this association are important for tailoring appropriate treatment strategies.

Pelvic floor awareness in women with fibromyalgia: A controlled cross-sectional study

Objective: Fibromyalgia syndrome (FMS), is a painful syndrome of the musculoskeletal system with associating somatic symptoms which may include PF dysfunction (PFD). We aimed to investigate the patients’ awareness of pelvic floor (PF), the frequency, impact and severity of PFD in FMS and to investigate the effect of psychological state on PFD. Methods: Women with FMS and healthy controls enrolled to the study. Demographic data, urinary symptoms and questions regarding PF awareness asked. Fibromyalgia Impact Questionnaire, Beck Depression Questionnaire and Beck Anxiety Questionnaire were filled. SPSS 26 used for statistical analysis. Results: A total of 48 FMS and 48 healthy controls, with a mean age of 44 years were enrolled. The rate of UI in FMS group was significantly higher than the control group ( p &lt; 0.001). The frequency of urinary incontinence (UI) was found 60% in FMS patients, and 25% in the control group. UI duration was significantly longer in the FMS group ( p = 0.013). There was a relation between the duration of UI and anxiety scores. As the duration of UI increases, the anxiety score also increases significantly ( r = 0.318; p = 0.043). The majority of the subjects, 25 (86.2%) patients from the FMS group and 11 (91.7%) patients from the control group, have not consulted any physician about UI complaints, therefore did not receive any treatment. Conclusion: PF awareness is quite low in the general population and in FMS. Studies should be carried out to inform the society about PFD and increase their awareness of the PF, and social responsibility projects should be prepared.

Investigating the Influential Factors of Mild Water-Filtered Infrared-A Whole-Body Hyperthermia for Pain Relief in Fibromyalgia: A Mixed-Methods Approach Focusing on Predictors and Patient Perspectives.

Fibromyalgia syndrome (FMS) is a chronic condition characterized by chronic widespread pain, persistent fatigue, and disrupted sleep, significantly impacting well-being. Mild water-filtered infrared-A (wIRA) whole-body hyperthermia (WBH) is emerging as a promising pain management approach to FMS. Within the present randomized controlled trial (ClinicalTrials ID: NCT05135936), FMS patients underwent six sessions of mild wIRA-WBH over 3 weeks. Their pain levels were assessed at baseline and at week 12, while body core temperature and plateau phase duration were monitored during WBH. Qualitative interviews were conducted at week 12. Results from this mixed-methods study revealed that baseline pain intensity and plateau phase duration significantly predicted pain intensity at week 12. Thematic analysis of the interviews revealed diverse patient experiences with the treatment, with all patients reporting improvements in perceived pain and overall well-being. The onset and duration of pain relief varied among individuals. Overall, the findings suggest that the duration of the plateau phase may serve as an indicator for long-term pain reduction, although individual factors may influence treatment outcomes. Despite varying experiences, a prevailing trend of positive patient evaluations emerged. This study sheds light on the potential of wIRA-WBH as a therapeutic option for alleviating pain for and enhancing the well-being of FMS patients.

DNA Methylation Changes in Blood Cells of Fibromyalgia and Chronic Fatigue Syndrome Patients.

Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) affect 0.4% and 1% of society, respectively, and the prevalence of these pain syndromes is increasing. To date, no strong association between these syndromes and the genetic background of affected individuals has been shown. Therefore, it is plausible that epigenetic changes might play a role in the development of these syndromes. Three previous studies have attempted to elaborate the involvement of genome-wide methylation changes in blood cells in the development of fibromyalgia and chronic fatigue syndrome. These studies included 22 patients with fibromyalgia and 127 patients with CFS, and the results of the studies were largely discrepant. Contradicting results of those studies may be attributed to differences in the omics data analysis approaches used in each study. We reanalyzed the data collected in these studies using an updated and coherent data-analysis framework. Overall, the methylation changes that we observed overlapped with previous results only to some extent. However, the gene set enrichment analyses based on genes annotated to methylation changes identified in each of the analyzed datasets were surprisingly coherent and uniformly associated with the physiological processes that, when affected, may result in symptoms characteristic of fibromyalgia and chronic fatigue syndrome. Methylomes of the blood cells of patients with FM and CFS in three independent studies have shown methylation changes that appear to be implicated in the pathogenesis of these syndromes.

The Effect of Probiotic Consumption Status and Quality of Life in Patients with Fibromyalgia

Aim: Recent studies have suggested that disruptions in the gut microbiota could potentially contribute to the pathogenesis of chronic pain and fibromyalgia syndrome (FMS) by affecting the gut microbiota-brain axis. The increasing prevalence of fibromyalgia syndrome has prompted investigations into the impact of probiotic food consumption, which regulates the microbiota, on quality of life.&#x0D; Material and Methods: The study included 99 patients diagnosed with fibromyalgia syndrome who presented to our Physical Medicine and Rehabilitation outpatient clinic. A questionnaire was administered to assess the patients' knowledge and consumption of probiotic foods, and the Short Form-12 Health Survey(SF-12) was used to gather data and assess health-related quality of life.&#x0D; Results: Of the 99 patients who completed the questionnaire, 89 were female and 10 were male. In response to the question, "Do you know what probiotics are?"7.4% of primary school graduates,64.7% of high school graduates, and 78.6% of university graduates answered affirmatively. When asked, "Have you experienced any benefits from probiotic foods?" 21.2% responded positively, and among those who experienced benefits, the most common accompanying issue (37.04%) was Irritable Bowel Syndrome(IBS). Fibromyalgia syndrome patients who consumed yogurt as a probiotic had higher physical function subdomain scores on the SF-12 Health Survey.&#x0D; Conclusion: The high level of education in FMS patients increased the awareness of probiotics. Probiotic consumption may have a improving effect on irritable bowel syndrome and constipation associated with FMS.Training on probiotics and increasing the frequency of use of probiotics, the quality of life of FMS patients can be increased and accompanying symptoms can be reduced.