Fibromyalgia – etiology, diagnosis and treatment including perioperative management in patients with fibromyalgia

Dizner-Golab, Anna; Lisowska, Barbara; Kosson, Dariusz

doi:10.5114/reum/163094

Cited by 6 publications

(2 citation statements)

References 89 publications

(171 reference statements)

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“…Fibromyalgia (FM) is a chronic primary pain condition which is characterized by several somatic and cognitive-affective symptoms such as widespread pain, fatigue, waking up unrefreshed, and cognitive deficits (Chakrabarty & Zoorob, 2007;Wolfe, 2016). The underlying mechanisms of FM remain largely unknown (Dizner-Golab et al, 2023). Altered autonomic nervous system (ANS) function has been previously proposed as a factor in FM (Dadabhoy & Clauw, 2006;Martínez-Lavín et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

The relationship between autonomic nervous system function and interoceptive accuracy in persons with fibromyalgia versus healthy controls

Schoofs,

van Wijck,

Schroeter

et al. 2024

Preprint

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Fibromyalgia (FM) is a common chronic primary pain syndrome in which underlying mechanisms remain largely unknown. The role of the autonomic nervous system (ANS) and interoceptive accuracy (IA), the ability to accurately sense internal body signals, in relation to pain sensitivity was examined in persons with FM which were compared to healthy controls. ANS activity was expected to differ in FM compared to controls, both at rest and while performing mental stressful tasks, and IA was expected to be different too. It was further explored whether IA mediates the relationship between ANS activity and pain. In total 108 participants (n=54 healthy controls and n=54 persons with FM) underwent ANS measures during alternating rest and mental stress conditions. These ANS measures consisted of skin conductance levels (SCL), heart rate (HR) and HR variability (HRV), cardiac output, pre-ejection period and stroke volume (SV). IA was measured using a heartbeat perception task and pain sensitivity was assessed by determining pressure pain thresholds. Several questionnaires were administered which were associated to ANS, IA and pain measures. During mental stress as compared to rest conditions, higher levels were found for SCL (p <.001) and HR (p <.001) in both groups, while SV (p <.004) was higher in rest versus in mental stress. Significant interactions between condition (rest versus mental stress) and groups (FM versus controls) were found for SCL (p =.04) and HR (p =.01), pointing to lower reactivity to stress in FM. Posthoc tests showed no significant group effects for the different conditions (i.e., for the rest or stress conditions). Group main effects were neither found for any of the ANS measures. Lower IA scores were found in FM compared to controls (p =.009). IA did not significantly mediate the relationship between ANS measures and pain thresholds. Since no differences between persons with FM and controls were found for any of the ANS measures, it can be concluded that ANS functions do not seem to be a crucial underlying mechanism in FM, at least in the relatively healthy subgroup included in this study. Importantly however, results showed that IA is diminished in FM. The role of IA in the pathogenesis and treatment of (at least a subgroup of persons with) FM requires further study. Also, studies into interoceptive modalities other than heartbeat perception are needed.

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Section: Introductionmentioning

confidence: 99%

The relationship between autonomic nervous system function and interoceptive accuracy in persons with fibromyalgia versus healthy controls

Schoofs,

van Wijck,

Schroeter

et al. 2024

Preprint

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“…This skepticism, rooted in a lack of objective diagnostic markers, hindered the acknowledgment and understanding of fibromyalgia [10]. Over time, however, advancements in research and a growing body of evidence have elucidated the complex interplay of biological, psychological, and social factors contributing to the syndrome [11,12].…”

Section: Introductionmentioning

confidence: 99%

Unraveling the Complex Web of Fibromyalgia: A Narrative Review

Al Sharie,

Varga,

Al-Husinat

et al. 2024

Medicina

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Fibromyalgia is a complex and often misunderstood chronic pain disorder. It is characterized by widespread musculoskeletal pain, fatigue, and heightened sensitivity, and has evolved in diagnostic criteria and understanding over the years. Initially met with skepticism, fibromyalgia is now recognized as a global health concern affecting millions of people, with a prevalence transcending demographic boundaries. The clinical features and diagnosis of fibromyalgia encompass a range of symptoms beyond pain, including sleep disturbances and cognitive difficulties. This study emphasizes the importance of a comprehensive evaluation for accurate diagnosis, considering the shift from tender point reliance to a more holistic approach. Etiology and pathophysiology involve genetic predisposition, neurotransmitter dysregulation, central sensitization, and immune system involvement. Risk factors such as gender, age, family history, and comorbid conditions contribute to susceptibility. The impact on quality of life is profound, affecting physical and social aspects, often accompanied by mood disorders. Management approaches include pharmacological interventions, non-pharmacological therapies, lifestyle modifications, and alternative treatments. This study also delves into emerging research, exploring advances in neurobiological understanding, brain imaging, genetic markers, glutamate modulation, cannabinoids, gut microbiome, and digital health tools for fibromyalgia management. Overall, this study provides a nuanced and up-to-date overview of the complexities surrounding fibromyalgia, aiming to enhance understanding and support for individuals grappling with this challenging condition.

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