Fibromyalgia: Pathophysiology, Neuropsychological Alterations, Clinical Variables, and Therapeutic Interventions for Clinical Pain Management

Dear Colleagues,

This Special Issue addresses the Fibromyalgia and the pathophysiology, neuropsychological alterations, clinical variables, and therapeutic interventions for clinical pain management.

Fibromyalgia (FM) can be understood as a complex clinical and rheumatological condition characterized by widespread and diffuse musculoskeletal pain, accompanied by symptoms such as fatigue, morning stiffness, sleep disturbances, and cognitive dysfunction. In this context, cognitive dysfunction gains particular relevance, as patients refer to it as one of the most debilitating symptoms, positioning it as a central symptom in the clinical presentation of FM. Despite the considerable prevalence of FM and its dramatic impact on patients' quality of life, the etio-pathogenesis and pathophysiology of this condition are currently unknown.

However, the central sensitization hypothesis emerges as a physiopathological process of notable relevance in understanding FM. Nevertheless, a comprehensive understanding of the neurobiological mechanisms underlying neuropsychological alterations in this population is still in a much more exploratory phase than the former, and certainly warrants more exhaustive study. Current scientific evidence suggests a relationship between deficits in cognitive domains such as memory, attention, executive functions, and emotional processing, not only with pain intensity but also with psychiatric comorbidities like anxiety, depression, and other clinical variables such as sleep quality and body mass index (BMI). Furthermore, the frequent coexistence of different psychiatric comorbidities, sleep disorders, and psychosocial factors modulates the pain experience and therapeutic response. Current therapeutic approaches promote a multidisciplinary focus that integrates pharmacological interventions with non-pharmacological strategies, with the aim of optimizing symptomatic management and improving patients' quality of life.

This Special Issue's primary objective is to deepen the understanding of FM, covering its pathophysiology, neuropsychological alterations, psychiatric comorbidities and clinical variables, and therapeutic interventions for clinical pain management. We invite the submission of original research manuscripts, systematic reviews, and meta-analyses addressing the connection between cognitive deficits and their neurophysiological correlates. Priority will be given to studies employing advanced neuroimaging techniques to investigate variations in cerebral blood flow and functional connectivity. Additionally, we particularly welcome works that integrate the study of psychosocial variables and psychiatric comorbidities in the context of FM. Contributions presenting and evaluating the efficacy of both pharmacological and non-pharmacological interventions specifically designed to optimize cognitive function and mitigate pain perception will be received with special interest. We seek contributions that advance knowledge on the pathophysiology of cognitive dysfunction in FM and propose more effective and personalized therapeutic strategies aimed at substantially improving the quality of life for individuals affected by FM.

Dr. Cristina Muñoz Ladrón de Guevara
Dr. Sandra Melero Santos
Guest Editors

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• fibromyalgia
• neuropsychology
• cognitive dysfunction
• pathophysiology
• central pain sensitization
• neuroimaging
• therapeutic interventions
• psychiatric comorbidities
• clinical variables
• chronic pain management