Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome—The role of cortisol and alpha-amylase

Fischer, Susanne; Doerr, Johanna M.; Strahler, Jana; Mewes, Ricarda; Thieme, Kati; Nater, Urs M.

doi:10.1016/j.psyneuen.2015.09.018

Cited by 97 publications

(81 citation statements)

References 56 publications

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“…One study showed that CRH was elevated in CSF of FMS patients and was associated with pain but not fatigue symptoms (McLean et al, 2006). The increased serum CRH reported in the current study may indicate some level of physical or psychologic stress that may exacerbate FMS symptoms (Geenen et al, 2002;Fischer et al, 2016). CRH is typically secreted from the hypothalamus under the influence of stress and activates the hypothalamic-pituitary-adrenal axis but has also been shown to induce inflammation (Chrousos, 1995).…”

Section: Discussionmentioning

confidence: 59%

Neuropeptides CRH, SP, HK-1, and Inflammatory Cytokines IL-6 and TNF Are Increased in Serum of Patients with Fibromyalgia Syndrome, Implicating Mast Cells

Tsilioni

Russell

Stewart

et al. 2016

Journal of Pharmacology and Experimental Therapeutics

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Fibromyalgia syndrome (FMS) is a chronic, idiopathic condition of widespread musculoskeletal pain affecting more women than men. Even though clinical studies have provided evidence of altered central pain pathways, the lack of definitive pathogenesis or reliable objective markers has hampered development of effective treatments. Here we report that the neuropeptides corticotropin-releasing hormone (CRH), substance P (SP), and SP-structurally-related hemokinin-1 (HK-1) were significantly (P 5 0.026, P , 0.0001, and P 5 0.002, respectively) elevated (0.82 6 0.57 ng/ml, 0.39 6 0.18 ng/ml, and 7.98 6 3.12 ng/ml, respectively) in the serum of patients with FMS compared with healthy controls (0.49 6 0.26 ng/ml, 0.12 6 0.1 ng/ml, and 5.71 6 1.08 ng/ml, respectively). Moreover, SP and HK-1 levels were positively correlated (Pearson r 5 0.45, P 5 0.002) in FMS. The serum concentrations of the inflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF) were also significantly (P 5 0.029 and P 5 0.006, respectively) higher (2.97 6 2.35 pg/ml and 0.92 6 0.31 pg/ml, respectively) in the FMS group compared with healthy subjects (1.79 6 0.62 pg/ml and 0.69 6 0.16 pg/ml, respectively). In contrast, serum IL-31 and IL-33 levels were significantly lower (P 5 0.0001 and P 5 0.044, respectively) in the FMS patients (849.5 6 1005 pg/ml and 923.2 6 1284 pg/ml, respectively) in comparison with healthy controls (1281 6 806.4 pg/ml and 3149 6 4073 pg/ml, respectively). FMS serum levels of neurotensin were not different from controls. We had previously shown that CRH and SP stimulate IL-6 and TNF release from mast cells (MCs). Our current results indicate that neuropeptides could stimulate MCs to secrete inflammatory cytokines that contribute importantly to the symptoms of FMS. Treatment directed at preventing the secretion or antagonizing these elevated neuroimmune markers, both centrally and peripherally, may prove to be useful in the management of FMS.

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Section: Discussionmentioning

confidence: 59%

Neuropeptides CRH, SP, HK-1, and Inflammatory Cytokines IL-6 and TNF Are Increased in Serum of Patients with Fibromyalgia Syndrome, Implicating Mast Cells

Tsilioni

Russell

Stewart

et al. 2016

Journal of Pharmacology and Experimental Therapeutics

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“…acute infections, physical overload) or psychosocial stressors (e.g., bullying at work place, conflicts with partner). This notion has recently been endorsed by Fischer et al [11] who showed that higher stress at a given measurement time point (i.e. cortisol and alpha-amylase in saliva samples) was associated with higher reported pain levels at a subsequent time point.…”

Section: Introductionmentioning

confidence: 83%

Struggling With Adversities of Life

Offenbäecher¹,

Dezutter

Kohls

et al. 2017

The Clinical Journal of Pain

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Objectives: We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia (FMS) patients and healthy controls. In addition, we compared FMS and controls on mean levels of these variables. Discussion: Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FMS patients at levels that are of similar size and direction as in healthy controls. However, FMS patients manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FMS to better manage psychological and physical symptoms, thereby enhancing well-being. Methods

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“…[23; 80] Such dilemma has been well described in a recent JAMA case report[17] of a 64-year-old woman with FMS. She states: “I never know what my day is going to be like.…”

Section: Introductionmentioning

confidence: 99%

Activity rhythms and clinical correlates in fibromyalgia

Neikrug¹,

Donaldson²,

Iacob³

et al. 2017

Pain

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The primary aim of this study was to evaluate activity rhythms in fibromyalgia syndrome (FMS) and their association with FMS-related symptoms. We hypothesized that stronger and more consistent activity rhythms would be associated with reduced symptom severity and presentation in FMS. Two hundred ninety-two patients with FMS (mean age = 45.1 ± 11.1; 272 women) provided a 7-day actigraphy recording and responses to questionnaires addressing degree of pain, fatigue, mood, and physical impairment. Using a simple cosine model, we extracted Amplitude (activity range), Phi (time at maximum), Mesor (mean activity), and their variabilities (across days) from each participant's actigraphy. The clinical and actigraphic measures were operationally independent. There was a significant canonical relationship between activity rhythm parameters and clinical FMS measures (r = 0.376, R 2 = 0.14, P < 0.001). The set of Mesor, Amplitude, and Phi activity parameters remained associated with clinical measures when controlled statistically for both demographics and activity variability (P < 0.001). Each activity parameter provided unique discrimination of the clinical set by multivariate test (P = 0.003, 0.018, and 0.007 for Amplitude, Phi, and Mesor, respectively). These results revealed that better pain, fatigue, mood, physical impairment, and sleep outcomes were associated with higher activity range and more rhythmicity (Amplitude), increased mean activity (Mesor), and with earlier timing of peak activity (Phi). Exploratory analyses revealed significantly worse sleep for individuals with low Amplitude and more delayed Phi.

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Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome—The role of cortisol and alpha-amylase

Cited by 97 publications

References 56 publications

Neuropeptides CRH, SP, HK-1, and Inflammatory Cytokines IL-6 and TNF Are Increased in Serum of Patients with Fibromyalgia Syndrome, Implicating Mast Cells

Neuropeptides CRH, SP, HK-1, and Inflammatory Cytokines IL-6 and TNF Are Increased in Serum of Patients with Fibromyalgia Syndrome, Implicating Mast Cells

Struggling With Adversities of Life

Activity rhythms and clinical correlates in fibromyalgia

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