Associations between cognitive performance and pain in chronic fatigue syndrome: comorbidity with fibromyalgia does matter

Ickmans, Kelly; Meeus, Mira; Kooning, Margot De; Lambrecht, Luc; Pattyn, Nathalie; Nijs, Jo

doi:10.1016/j.physio.2015.03.3465

Cited by 21 publications

(15 citation statements)

References 44 publications

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“…and Sarzi‐Puttini et al . The enhanced temporal summation in the CFS/FM group is in accordance with earlier studies …”

Section: Discussionsupporting

confidence: 92%

“…Therefore, central sensitization presumably occurs in a subgroup of RA patients, as assumed in the reviews of Meeus et al 9 and Sarzi-Puttini et al 11 The enhanced temporal summation in the CFS/FM group is in accordance with earlier studies. 15,36 This study did not reveal a significant difference in CPM between groups. However, inferior CPM in CFS/ FM patients had been described in several earlier studies.…”

Section: Baseline Comparisonmentioning

confidence: 57%

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Influence of Morphine and Naloxone on Pain Modulation in Rheumatoid Arthritis, Chronic Fatigue Syndrome/Fibromyalgia, and Controls: A Double‐Blind, Randomized, Placebo‐Controlled, Cross‐Over Study

et al. 2017

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This study revealed anti-hyperalgesia effects of morphine in CFS/FM and RA patients. Nevertheless, these effects were comparable to placebo. Besides, neither morphine nor naloxone influenced deep tissue pain, temporal summation or CPM. Therefore, these results suggest that the opioid system is not dominant in (enhanced) bottom-up sensitization (temporal summation) or (impaired) endogenous pain inhibition (CPM) in patients with CFS/FM or RA.

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“…and Sarzi‐Puttini et al . The enhanced temporal summation in the CFS/FM group is in accordance with earlier studies …”

Section: Discussionsupporting

confidence: 92%

Section: Baseline Comparisonmentioning

confidence: 57%

Influence of Morphine and Naloxone on Pain Modulation in Rheumatoid Arthritis, Chronic Fatigue Syndrome/Fibromyalgia, and Controls: A Double‐Blind, Randomized, Placebo‐Controlled, Cross‐Over Study

et al. 2017

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“…First, pressure pain thresholds (PPT) and TS were measured by manual algometry on the lower back, quadriceps, trapezius, and hand. TS started 2 minutes Differences in Pain Processing a constant rate (1kg/s) to the tissue surface, bilaterally at 4 spots: erector spinae muscle (lower back) at 5 cm laterally of the processus spinosus vertebrae at L3 (28), quadriceps muscle (quadriceps) at the middle between anterior superior iliac spine and basis patella (26), trapezius muscle (trapezius) at the middle between acromion and processus spinosus at C7 (29)(30)(31), and the web (hand) between the index finger and thumb at the dorsal hand side (13,32). For each site, 2 PPT measurements were taken with a 30 second interval (29) and the mean of both recordings was used for further analysis.…”

Section: Methodsmentioning

confidence: 99%

Differences in Pain Processing Between Patients with Chronic Low Back Pain, Recurrent Low Back Pain, and Fibromyalgia

et al. 2017

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Background: The impairment in musculoskeletal structures in patients with low back pain (LBP) is often disproportionate to their complaint. Therefore, the need arises for exploration of alternative mechanisms contributing to the origin and maintenance of non-specific LBP. The recent focus has been on central nervous system phenomena in LBP and the pathophysiological mechanisms underlying the various symptoms and characteristics of chronic pain. Knowledge concerning changes in pain processing in LBP remains ambiguous, partly due to the diversity in the LBP population. Objective: The purpose of this study is to compare quantitative sensory assessment in different groups of LBP patients with regard to chronicity. Recurrent low back pain (RLBP), mild chronic low back pain (CLBP), and severe CLBP are compared on the one hand with healthy controls (HC), and on the other hand with fibromyalgia (FM) patients, in which abnormal pain processing has previously been reported. Study Design: Cross-sectional study. Setting: Department of Rehabilitation Sciences, Ghent University, Belgium. Methods: Twenty-three RLBP, 15 mild CLBP, 16 severe CLBP, 26 FM, and 21 HC participated in this study. Quantitative sensory testing was conducted by manual pressure algometry and computercontrolled cuff algometry. A manual algometer was used to evaluate hyperalgesia as well as temporal summation of pain and a cuff algometer was used to evaluate deep tissue hyperalgesia, the efficacy of the conditioned pain modulation and spatial summation of pain. Results: Pressure pain thresholds by manual algometry were significantly lower in FM compared to HC, RLBP, and severe CLBP. Temporal summation of pain was significantly higher in FM compared to HC and RLBP. Pain tolerance thresholds assessed by cuff algometry were significantly lower in FM compared to HC and RLBP and also in severe CLBP compared to RLBP. No significant differences between groups were found for spatial summation or conditioned pain modulation. Limitations: No psychosocial issues were taken into account for this study. Conclusion: The present results suggest normal pain sensitivity in RLBP, but future research is needed. In mild and severe CLBP some findings of altered pain processing are evident, although to a lesser extent compared to FM patients. In conclusion, mild and severe CLBP presents within a spectrum, somewhere between completely healthy persons and FM patients, characterized by pain augmentation. Key words: Low back pain, fibromyalgia, pain assessment, quantitative sensory testing, central sensitization, hypersensitivity, temporal summation, spatial summation, conditioned pain modulation

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“…Our study follows on from 2 earlier studies which used the same patient groups (29,30). The first of these 2 studies showed that patients with CFS scored higher on symptom severity and worse on handgrip strength, muscle recovery, and cognitive performance compared to patients with MS and controls (29).…”

Section: Discussionmentioning

confidence: 88%

Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study

Collin

Nijs²,

Meeus³

et al. 2017

Pain Phys

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Background: Commonalities in the core symptoms of fatigue and cognitive dysfunction experienced by chronic fatigue syndrome (CFS, also known as ME) and multiple sclerosis (MS) patients have been described. Many CFS and MS patients also experience chronic pain, which has been attributed to central sensitization in both groups of patients. However, the characteristics of pain in CFS and MS patients have not been compared. Objectives: To compare experimental pain measurements in patients with CFS or MS and healthy controls. Study design: Observational study. Setting: This study took place in Belgium at Vrije Universiteit Brussel and the University of Antwerp. Methods: Pressure pain thresholds, temporal summation, conditioned pain modulation, and occlusion cuff pressure thresholds rated as painful (1st cuff pressure threshold) and as 3/10 on a verbal numerical scale (2nd cuff pressure threshold) were measured in patients with CFS (n = 48), MS (n = 19) and healthy pain-free controls (n = 30). Adjusted between-group differences were estimated using linear regression models. Results: Finger pain pressure thresholds of patients with CFS, compared with patients with MS, were 25% lower (difference ratio 0.75 [95% CI 0.59, 0.95], P = 0.02) and shoulder pain pressure thresholds were 26% lower (difference ratio 0.74 [0.52, 1.04], P = 0.08). Compared with patients with MS, patients with CFS had 29% lower first cuff pressure threshold (difference ratio 0.71 [0.53, 0.94], P = 0.02) and 41% lower 2nd cuff pressure threshold (0.59 [0.41, 0.86], P = 0.006). Finger temporal summation was higher in patients with CFS than in patients with MS (mean difference 1.15 [0.33, 1.97], P = 0.006), but there were no differences in shoulder temporal summation or conditioned pain modulation at either site. Differences between patients with CFS and MS tended to be greater than between either patient group and healthy controls. Pain pressure thresholds and cuff pressure thresholds tended to be positively correlated, and temporal summation negatively correlated, with higher physical function and lower fatigue in both groups of patients. Subjective pain in patients with CFS but not in patients with MS was strongly negatively correlated with pain pressure thresholds and cuff pressure thresholds, and positively correlated with temporal summation. Limitations: The main limitations of our study are the relatively small sample sizes, its crosssectional design, and its exploratory nature. Conclusions: We found differences in the characteristics of pain symptoms reported by patients with CFS and patients with MS, which suggest different underlying mechanisms. Specifically, overactive endogenous pain facilitation was characteristic of pain in patients with CFS but not in patients with MS, suggesting a greater role for central sensitization in CFS. Keywords: Chronic fatigue syndrome, CFS/ME, multiple sclerosis, experimental pain, central sensitization

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Associations between cognitive performance and pain in chronic fatigue syndrome: comorbidity with fibromyalgia does matter

Cited by 21 publications

References 44 publications

Influence of Morphine and Naloxone on Pain Modulation in Rheumatoid Arthritis, Chronic Fatigue Syndrome/Fibromyalgia, and Controls: A Double‐Blind, Randomized, Placebo‐Controlled, Cross‐Over Study

Influence of Morphine and Naloxone on Pain Modulation in Rheumatoid Arthritis, Chronic Fatigue Syndrome/Fibromyalgia, and Controls: A Double‐Blind, Randomized, Placebo‐Controlled, Cross‐Over Study

Differences in Pain Processing Between Patients with Chronic Low Back Pain, Recurrent Low Back Pain, and Fibromyalgia

Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study

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