학술논문
Understanding the Psychophysiological and Sensitization Mechanisms Behind Fibromyalgia Syndrome: A Network Analysis Approach
MUSCULOSKELETAL, REHABILITATION & REGENERATIVE MEDICINE SECTION
MUSCULOSKELETAL, REHABILITATION & REGENERATIVE MEDICINE SECTION
Document Type
Report
Author
Source
Pain Medicine. March 2023, Vol. 24 Issue 3, p275, 10 p.
Subject
Language
English
ISSN
1526-2375
Abstract
Introduction Fibromyalgia syndrome (FMS) is a chronic pain condition affecting up to the 6.6% of the general population [1]. The annual economic burden per FMS patient is estimated at $3804 [...]
Objective. Current evidence suggests that fibromyalgia syndrome (FMS) involves complex underlying mechanisms. This study aimed to quantify the multivariate relationships between clinical, psychophysical, and psychological outcomes in women with FMS by using network analysis to understand the psychobiological mechanisms driving FMS and generating new research questions for improving treatment strategies. Methods. Demographic (age, height, weight), clinical (pain history, pain intensity at rest and during daily living activities), psychophysical (widespread pressure pain thresholds [PPT]), sensory-related (PainDETECT, S-LANSS, Central Sensitization Inventory [CSI]) and psychological (depressive and anxiety levels) variables were collected in 126 women with FMS. Network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network). Results. The network showed several local associations between psychophysical and clinical sensory-related variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs on the knee and tibialis anterior muscle ([rho]: 0.33). PainDETECT was associated with LANSS ([rho]: 0.45) and CSI ([rho]: 0.24), whereas CSI was associated with HADS-A ([rho]: 0.28). The most central variables were PPTs over the tibialis anterior (the highest Strength centrality) and CSI (the highest Closeness and Betweenness centrality). Conclusion. Our findings support a model where clinical sensory-related, psychological, and psycho-physical variables are connected, albeit in separate clusters, reflecting a nociplastic condition with a relevant role of sensitization. Clinical implications of the findings, such as developing treatments targeting these mechanisms, are discussed. Key Words: Fibromyalgia; Pain; Central Sensitization; Pressure Pain, Network Analysis
Objective. Current evidence suggests that fibromyalgia syndrome (FMS) involves complex underlying mechanisms. This study aimed to quantify the multivariate relationships between clinical, psychophysical, and psychological outcomes in women with FMS by using network analysis to understand the psychobiological mechanisms driving FMS and generating new research questions for improving treatment strategies. Methods. Demographic (age, height, weight), clinical (pain history, pain intensity at rest and during daily living activities), psychophysical (widespread pressure pain thresholds [PPT]), sensory-related (PainDETECT, S-LANSS, Central Sensitization Inventory [CSI]) and psychological (depressive and anxiety levels) variables were collected in 126 women with FMS. Network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network). Results. The network showed several local associations between psychophysical and clinical sensory-related variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs on the knee and tibialis anterior muscle ([rho]: 0.33). PainDETECT was associated with LANSS ([rho]: 0.45) and CSI ([rho]: 0.24), whereas CSI was associated with HADS-A ([rho]: 0.28). The most central variables were PPTs over the tibialis anterior (the highest Strength centrality) and CSI (the highest Closeness and Betweenness centrality). Conclusion. Our findings support a model where clinical sensory-related, psychological, and psycho-physical variables are connected, albeit in separate clusters, reflecting a nociplastic condition with a relevant role of sensitization. Clinical implications of the findings, such as developing treatments targeting these mechanisms, are discussed. Key Words: Fibromyalgia; Pain; Central Sensitization; Pressure Pain, Network Analysis