Search Results (258)

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been addressed yet in this population. This research aimed to firstly explore how low-level EFs play a role in planning and problem-solving performances. Methods: Thirty FMS patients and thirty healthy participants completed a series of neuropsychological tests evaluating low- and high-order EFs. Clinical and emotional symptoms were assessed with self-report questionnaires, while pain and fatigue levels were measured with numerical scales. Importantly, specific drug restrictions were accounted for. Results: Patients scored lower in most neurocognitive tests, with statistical significance noted only for visuospatial working memory (WM) and two planning and problem-solving tests. Pain, fatigue, and sleep disturbances showed important effects on most of the cognitive outcomes. Multiple regression analyses reflected that planning and problem-solving were successfully and partially predicted by updating, inhibition, and mental flexibility (though differences emerged between tasks). Conclusions: Our study confirms the presence of cognitive impairments in FMS, especially in high-order EFs, supporting patients’ complaints. Clinical symptoms play a role in FMS dyscognition but do not explain it completely. For the first time, as far as the authors know, simple EF influences on planning and problem-solving tests have been described for FMS patients. These results might help in unraveling the dysexecutive profile in FMS to design more adjusted treatment options. Full article

Background and Objectives: This study aimed to evaluate the diagnostic value of oxidative stress parameters in fibromyalgia syndrome (FMS) and to investigate their potential associations with disease severity, functional impairment, anxiety, and depression. Materials and Methods: The study included 84 participants, consisting of 42 women diagnosed with fibromyalgia (FM) and 42 healthy female controls. Serum levels of total antioxidant status (TAS), total oxidant status (TOS), and malondialdehyde (MDA) were measured in all participants, and the oxidative stress index (OSI) was calculated. Additionally, the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to assess mental health and functional status. Results: The levels of TOS, TAS, MDA, and the OSI were significantly higher in the fibromyalgia group compared to the control group (p < 0.001). The relationship between TAS, TOS, MDA, and OSI levels and BDI, BAI, and FIQ scale scores was investigated in the case group, but no significant associations were identified between oxidative stress markers and psychological or functional scores. When all participants were analyzed as a single group, significant correlations were found between TAS, TOS, MDA, and OSI levels and several biochemical parameters, including CRP, AST, free T4, HbA1c, ferritin, and folic acid. Conclusions: Our study adds to the growing body of evidence indicating elevated oxidative stress in female patients with fibromyalgia syndrome (FMS) and suggests that TAS, TOS, MDA, and OSI may serve as potential biomarkers for its diagnosis. Full article

Background/Objectives: The main objective of the present study is to assess the short-term effects of Forest Bathing (FB) conducted in a Mediterranean forest on individuals with fibromyalgia (FM) and/or chronic fatigue syndrome/myalgia encephalomyelitis (CFS/ME) on perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and state mindfulness. Methods: A total of 44 participants with FM and/or CSF/ME agreed to participate in this study. The FB session consisted of a 3 km silent walk, lasting three hours and guided by a specialized psychologist and a mountain guide to guarantee the safety of the activity. Paired-sample t-tests were used to analyze the pre–post changes in perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and mindfulness. Results: All reported variables but self-reported pain showed statistically significant pre–post variations after the FB session. Particularly, large-to-very-large improvements in positive and negative affect, state anxiety, tension, depression, anger, and vigor were found. Small-to-moderate effect sizes for fatigue, friendliness, and state mindfulness were also reported. Conclusions: This study provides preliminary evidence of the short-term benefits of FB in individuals with FM and/or CFS/ME, especially on state anxiety and negative affect. Full article

Fibromyalgia is a syndrome that causes chronic musculoskeletal pain accompanied by symptoms such as fatigue, sleep disorders, headaches, anxiety, and depression. People diagnosed with fibromyalgia usually have higher levels of reactive oxygen species and lower antioxidant capacity compared to healthy individuals. This condition can contribute to elevated oxidative stress in the body, especially within the lipid-rich nervous system. Treatment with antioxidants through diet or supplements is one method being investigated to reduce the symptoms of fibromyalgia. This narrative review focuses on the latest research, specifically peer-reviewed publications within the last 10 years, on potential antioxidant treatments for patients with fibromyalgia. Relevant micronutrients, such as vitamin B12, vitamin D, and iron, and supplements such as melatonin, coenzyme Q, alpha-lipoic acid, and palmitoylethanolamide are discussed. Based on the current evidence, many of these antioxidants show potential for the management of fibromyalgia symptoms as standalone treatments or in combination with other antioxidants or pharmacological agents. More clinical research is required to understand the long-term efficacy and safety of these micronutrients and supplements, as well as their overall health impact. Full article

Human T-lymphotropic virus 1 (HTLV-1) infection has been associated with inflammatory, autoimmune, and lymphoproliferative diseases with a wide spectrum of clinical manifestations. Among patients with inflammatory rheumatological disease manifestations, cases of rheumatoid arthritis, Sjögren’s syndrome, polymyositis, and fibromyalgia, among others, have been reported. Another common feature of rheumatological diseases is the presence of joint manifestations, such as arthralgia and arthritis. In the present study, we sought to determine the laboratory profile and clinical rheumatological manifestations of people living with HTLV-1/2 residing in a metropolitan area in the Brazilian Amazon. A total of 957 individuals were screened for HTLV-1/2 infection by enzyme-linked immunosorbent assay (ELISA), and samples from seropositive individuals were subjected to infection confirmation by Western blotting or quantitative polymerase chain reaction (qPCR). Individuals with confirmed HTLV-1 and HTLV-2 infection were clinically evaluated for signs and symptoms of rheumatological diseases. Of the 957 individuals tested, 69 were positive for HTLV-1/2 infection, with 56 confirmed cases of HTLV-1 infection (5.9%), 12 of HTLV-2 infection (1.2%), and 1 classified as undetermined (0.1%). After clinical screening, 15 infected individuals with complaints suggestive of rheumatological disease were selected for evaluation by a rheumatologist (11 with HTLV-1 infection (1.1%) and 4 with HTLV-2 infection (0.4%)). The predominant pain pattern was symmetrical polyarthralgia, with large joints predominantly being affected. The diseases diagnosed were psoriatic arthritis, osteoarthritis, fibromyalgia, and regional pain syndromes. Antinuclear antibody (ANA) positivity was observed in two patients. Our findings confirm that HTLV-1 infection is associated with rheumatological disease manifestations and highlight the novel finding of cases of HTLV-2 infection in patients with rheumatoid arthritis symptoms. Full article

Fibromyalgia syndrome (FMS) is a complex, heterogeneous disorder characterized by chronic widespread pain, fatigue, and cognitive disturbances. The multifactorial nature of FMS, with the involvement of central and peripheral mechanisms, hampers diagnosis and effective treatment. In recent years, positron emission tomography (PET) imaging has emerged as a valuable tool for exploring the neurobiological underpinnings of FMS. Several studies have investigated alterations in glucose metabolism, neurotransmitter systems (including opioid, dopamine, and GABAergic pathways), and neuroinflammation using various PET tracers. These findings have revealed distinct brain metabolic and molecular patterns in FMS patients compared to healthy controls, particularly in pain-related regions such as the thalamus, insula, and anterior cingulate cortex (ACC). Moreover, preliminary data suggest that PET imaging may help identify FMS subgroups with different pathophysiological profiles, potentially allowing for tailored therapeutic approaches. This review summarizes the current evidence on PET applications in FMS and discusses the potential role of molecular imaging in improving patient stratification and predicting treatment response. Full article

Background: Fibromyalgia is a chronic syndrome characterized by widespread pain and complex pathophysiology, requiring new therapeutic approaches. This study aims to investigate the effects of resistance training (RT) before hyperalgesia induction on pain sensitivity, IL-6 and IL-10 expression in skeletal muscle, and thalamic serotonin levels in a fibromyalgia (FM)-like rat model. Methods: Wistar female rats aged 12 months were divided into four groups: untrained neutral saline (UNS), untrained acid saline (UAS), RT neutral saline (RTN), and RT acid saline (RTA). Both the RTN and RTA groups were subjected to an RT protocol comprising vertical ladder climbing three times a week throughout 14 weeks. The UAS and RTA groups received 100 µL of neutral, sterile saline (pH 4.0) in the left gastrocnemius muscle, while the UNS and RTN groups received 100 µL of neutral saline (pH 7.4). Mechanical hyperalgesia was assessed using Von Frey’s electronic esthesiometer. Expression of interleukins 6 (IL-6) and 10 (IL-10) was analyzed in skeletal muscle, and serotonin expression was quantified in the thalamus. Results: After hyperalgesia induction, the RT groups demonstrated higher paw withdrawal thresholds than the UAS group (p < 0.05). Both IL-6 and IL-10 expression was lower in the RTA group compared to the UAS group (p < 0.05). Thalamic serotonin expression was higher (p < 0.05) in the RTA group compared to the UAS group. Conclusion: Previous RT was able to prevent mechanical hyperalgesia experienced by rats after its induction by acid saline by preventing the increase in the IL-6 and IL-10 levels in skeletal muscle and preventing the decrease in thalamic serotonin expression. Full article

Background/Objectives: Fibromyalgia is a debilitating syndrome characterized by persistent pain. Emerging evidence highlights the role of emotional and cognitive processes in modulating pain experience. Anger, for example, can influence pain and patients’ adjustment to the disease. Studies showed that metacognitions and anger rumination can worsen state anger, thereby increasing perceived pain intensity. The present study aims to investigate the presence of a relationship between pain, dysfunctional metacognitions, anger rumination, and state anger. Methods: The study included 446 participants who self-reported having a diagnosis of fibromyalgia confirmed by a rheumatologist or pain specialist. Participants completed self-report measures of metacognitions, anger rumination, state anger, and pain intensity. The serial mediation analysis was performed using Hayes’ PROCESS macro (Model 6). Results: Pain intensity showed a significant positive effect on negative beliefs about worry (β = 0.09; p < 0.05), need to control thoughts (β = 0.09; p < 0.05), and cognitive self-consciousness (β = 0.12; p < 0.05), but not on anger rumination. Across all serial mediation models, the direct effect of pain intensity on state anger remained significant even after controlling for the effect of mediators, indicating partial mediation. Conclusions: This study suggests a vicious cycle involving dysfunctional metacognitions, anger rumination, state anger, and pain intensity. Our findings also indicate a potential influence of pain on metacognitions and suggest a direct association between pain intensity and state anger. Interventions for anger management in fibromyalgia should consider dysfunctional metacognitions and anger rumination. Full article

Background/Objectives: Genetic variants, such as the µ-opioid receptor 1 (OPRM1) rs1799971 and the catechol-O-methyltransferase (COMT) rs4680, have been considered among the potential causes in the development of some chronic pain conditions. In this regard, there are controversial results regarding their roles in fibromyalgia (FM). We aimed to investigate whether the OPRM1 rs1799971 and COMT rs4680 polymorphisms are associated with the development of or susceptibility to FM, as well as their potential association with syndrome characteristic variables, in a sample of the Spanish population with and without FM. Methods: The present study analysed COMT Val158Met and OPRM1 Asn40Asp genetic variants in 311 FM patients (301 women and 10 men) and 135 non-FM participants (120 women and 15 men). In addition to clinical variables, widespread pain index (WPI), symptom severity scale (SSS) (fatigue, rest quality, and cognitive symptoms), pain, stress episodes, and Borg scale were collected. Results: The main results indicate that women carrying the Val/Val genotype (i.e., high COMT activity) exhibited significantly lower levels of fatigue, cognitive impairment, and total SSS than heterozygote carriers. In addition, Met allele carriers (i.e., lower COMT activity) showed higher probabilities of suffering a stress episode and higher levels of exertion during daily activities. Conclusions: The present research suggests a link between dopaminergic dysfunction and exacerbated, frequently described symptoms in female FM patients. Although further research with wider genetic variants and recruited patients is needed, these results point out the necessity of considering gender as a separate category in chronic pain studies. Full article

Juvenile Primary Fibromyalgia Syndrome (JPFS) is a complex, multifactorial condition characterized by widespread musculoskeletal pain, often accompanied by sleep disturbances, headaches, cognitive and mood disorders, and fatigue, resulting in a significant impact on the quality of life for affected children, adolescents, and their families. Although recent advances have improved the understanding of the underlying pathophysiological mechanisms and therapeutic approaches, its etiology and optimal treatments remain largely unknown. In this review, we summarize recent advances in the etiopathogenesis, clinical assessment, and treatment of JPFS. Our aim is to support clinicians in the diagnosis and management of JPFS patients, while also highlighting key areas that require further research to improve diagnostic accuracy and therapeutic outcomes. Full article

Background/Objectives: Quantitative sensory testing (QST) is one of the most reliable methods for assessing Fibromyalgia Syndrome (FMS). Despite its importance, there are still controversies regarding the correct interpretation of evoked responses, as they may vary depending on the protocol, individual characteristics, disease severity, and other factors. This study aims to examine how QST has been applied as an outcome measure in FMS. Methods: We considered three databases (Medline, Embase, and Web of Science) until June 2024. From a total of 2512 studies, 126 (39 RCTs and 87 non-RCTs) were selected for full reading after assessment for risk of bias and eligibility criteria. These criteria included at least one type of QST and a clear diagnosis of fibromyalgia (FMS). Results: The results highlighted a lack of standardization in QST, as no reported protocols were followed and there was no specific number of tender points tested for FMS. Additionally, there was inconsistency in the selection of sites and types of tests conducted. Conclusions: This heterogeneity in methodology may affect the comparability and interpretation of results, underscoring the urgent need for standardized guidelines for conducting QST in fibromyalgia studies. A clear understanding of how QST has been measured could prompt a reevaluation of current approaches to FMS assessment, leading to more accurate interpretations and, ultimately, improved management of this complex condition. Full article

Fibromyalgia syndrome is a chronic pain condition involving altered nociceptive processing, which requires multidisciplinary management. Photobiomodulation therapy (PBMT) has recently emerged as a promising non-pharmacological approach, but its clinical effectiveness and optimal application methods remain unclear. This systematic review evaluated the efficacy of PBMT in managing Fibromyalgia symptoms, including pain, physical function, sleep quality, and overall well-being, while comparing localized and whole-body delivery. A systematic review was conducted in accordance with the PRISMA guidelines and previously registered on PROSPERO (CRD42024626368). Literature searches were performed across MEDLINE ((PubMed)), PEDro, SPORTDiscus, Scopus, Elsevier (ScienceDirect), and Web of Science (WOS), identifying 17 eligible studies (n = 857 participants). PBMT was applied via low-level laser, infrared, or LED-based devices, delivered either locally or to the whole body. The methodological quality of the studies was assessed using the PEDro scale, and the risk of bias was evaluated using the RoB 2.0 tool. PBMT showed significant clinical benefits, including reduced pain intensity, improved physical function, decreased fatigue, and enhanced quality of life. Whole-body PBMT showed greater and more sustained effects than localized applications, likely due to its systemic modulation of nociceptive pathways and autonomic regulation. Improvements were also observed in terms of psychological well-being, sleep quality, and reduced kinesiophobia. In conclusion, PBMT appears to be an effective therapeutic option for Fibromyalgia syndrome, with whole-body applications offering superior benefits. However, the variability in treatment parameters and study methodologies underscores the need for standardized protocols and high-quality clinical trials to support its integration into multidisciplinary pain management strategies. Full article

Background. Fibromyalgia Syndrome (FMS) is characterized by chronic widespread pain, sleep disturbances, fatigue and cognitive impairment. Methods. In this retrospective study, we analyzed data collected between 2017 and 2022 regarding Acetyl-L-Carnitine (ALC) as an add-on treatment in 183 adult patients with FMS according to the 2016 ACR (American College of Rheumatology) criteria and patients’ pain lasting for over three months. Patients with prior exposure to ALC or without informed consent were excluded. Results. Regarding efficacy, in the 137 analyzed patients, the change from baseline to the end of observation in Visual Analogue Scale score (VAS) was statistically significant, ranging from 75.9 ± 1.56 to 51.9 ± 1.99 (p < 0.001). Patients without FMS concomitant drug treatments achieved better VAS reduction than patients who were not drug-free at baseline. Regarding quality of life, a significant improvement in the Revised Fibromyalgia Impact Questionnaire (FIQ-R) score was evidenced, ranging from 75.1 ± 1.13 to 53.5 ± 1.34 (p < 0.001). The Short Form 12 Health Survey (SF12) scores showed a statistically significant improvement in both physical and mental components. Finally, the Pittsburgh Sleep Quality Index (PSQI) did not show a statistically significant difference from baseline. In the whole population, 23 patients (16.7%) reported Adverse Events (AEs), predominantly insomnia, shivering, headaches, and nausea. Only six patients reporting AEs discontinued the ALC treatment. Conclusions. This retrospective study evidenced the efficacy and safety of ALC in FMS patients. This may represent a useful approach, particularly for long-term treatments. Methodologically stronger studies will be necessary to validate our observations. Full article

Objective: The study analyzed the role of traumatic experiences and psychosomatic components as potential predictors of the likelihood of chronic pain patients having or not having fibromyalgia. Methods: We examined the role of stressful life events (Traumatic Experiences Checklist), psychosomatic syndromes (Toronto Alexithymia Scale and Diagnostic Criteria for Psychosomatic Research), pain, and psychological distress (Beck Depression Inventory—II and State-Trait Anxiety Inventory) in 104 patients with fibromyalgia compared with a sample of 104 patients with rheumatoid arthritis. Results: Patients with fibromyalgia reported significantly more traumatic events, a higher prevalence of psychosomatic syndromes, and higher levels of pain, anxiety and depressive symptoms compared with patients with rheumatoid arthritis (all p < 0.01). Hierarchical binary logistic regression with group membership as the dependent variable showed that somatization syndromes (OR = 3.67), pain (OR = 1.56), and childhood trauma (OR = 1.11) were statistically significant predictors of group belonging, and the model explained 67% of the variance in diagnosis [χ²(9) = 143.66, p < 0.001]. Conclusion: These results highlighted that patients with fibromyalgia are characterized primarily by marked somatization and a high prevalence of early stressful life events compared with patients with rheumatoid arthritis, a primarily nociceptive chronic pain condition. A better knowledge of these mechanisms could allow clinicians to develop tailored interventions that take greater account of the psychological dimension of the disease. Full article

Background and Objectives: This study aimed to evaluate serum asprosin levels in female patients with fibromyalgia syndrome (FM), investigate their associations with clinical parameters such as disease severity, anxiety, and depression, and evaluate the potential of serum asprosin levels as a biomarker for fibromyalgia diagnosis. Materials and Methods: A total of 80 participants were included in the study, 40 women aged 18–60 years who were diagnosed with FM according to the American College of Rheumatology (ACR) 2016 criteria and 40 healthy women with similar sociodemographic characteristics to the patient group. All participants were measured for hemograms, biochemistry tests, and serum asprosin levels. Additionally, the Fibromyalgia Impact Questionnaire (FIQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were administered to the patient group. Results: The median asprosin level in the case group was 15.01 (SD = 10.08–31.42), while in the control group it was 31.03 (SD = 25.14–35.7). The asprosin levels in the case group were significantly lower than those in the control group (p = 0.001). In contrast, AST, vitamin B12, and folic acid levels were significantly higher in the case group than in the control group. When all participants were evaluated, asprosin levels showed a significant positive correlation with systolic arterial blood pressure (Rho = 0.337, p = 0.002) and diastolic arterial blood pressure (Rho = 0.238, p = 0.033). A cut-off value of 17.72 ng/mL for asprosin levels in the diagnosis of fibromyalgia demonstrated a sensitivity of 60% and a specificity of 90%. Conclusions: Low asprosin levels may serve as a potential biomarker for the diagnosis of fibromyalgia in women. Full article