A psychophysical study of auditory and pressure sensitivity in patients with fibromyalgia and healthy controls.
ABSTRACT Fibromyalgia (FM) is characterized by widespread tenderness. Studies have also reported that persons with FM are sensitive to other stimuli, such as auditory tones. We hypothesized that subjects with FM would display greater sensitivity to both pressure and auditory tones and report greater sensitivity to sounds encountered in daily activities. FM subjects (n = 30) and healthy control subjects (n = 28) were administered auditory tones and pressure using the same psychophysical methods to deliver the stimuli and a common way of scaling responses. Subjects were also administered a self-report questionnaire regarding sensitivity to everyday sounds. Participants with FM displayed significantly greater sensitivity to all levels of auditory stimulation (Ps < .05). The magnitude of difference between FM patients' lowered auditory sensitivity (relative to control subjects) was similar to that seen with pressure, and pressure and auditory ratings were significantly correlated in both control subjects and subjects with FM. FM patients also were more sensitive to everyday sounds (t = 8.65, P < .001). These findings support that FM is associated with a global central nervous system augmentation in sensory processing. Further research is needed to examine the neural substrates associated with this abnormality and its role in the etiology and maintenance of FM. PERSPECTIVE: Muscle tenderness is the hallmark of FM, but the findings of this study and others suggest that persons with FM display sensitivity to a number of sensory stimuli. These findings suggest that FM is associated with a global central nervous system augmentation of sensory information. These findings may also help to explain why persons with FM display a number of comorbid physical symptoms other than pain.
SourceAvailable from: María T Carrillo-de-la-Peña[Show abstract] [Hide abstract]
ABSTRACT: Background It has been suggested that fibromyalgia (FM) patients show increased sensory processing of nociceptive and non-nociceptive stimuli and also reduced habituation. Although this pattern of increased reactivity has been established for the somatosensory modality, its generalization to other sensory modalities remains controversial.Methods Auditory evoked potentials were obtained using a paired-stimuli paradigm from a sample of 52 FM female patients and 55 healthy women matched for age and socio-economic status. Sensory gating of the P50 component, as indicated by P50 suppression rates to the second identical stimuli, was analysed in relation to clinical indices of FM, including algometry of tender points and a number of self-reported questionnaires.ResultsSensory gating mechanisms in FM patients proved to be normal, robust and as efficient as those recorded in control subjects. There was no correlation between P50 suppression rates and indices of clinical or experimental (threshold or tolerance) pain. In addition, P50 sensory gating was not related to the other main symptoms of FM, including fatigue, sleep dysfunction or co-morbid depression, nor to hypersensitivity to noise or headache.Conclusions The results indicate that FM patients do not present significant deficits in early sensory gating when processing auditory stimuli, and therefore challenge the ‘generalized hypersensitivity’ hypothesis of FM.European journal of pain (London, England) 12/2014; DOI:10.1002/ejp.627 · 3.22 Impact Factor
Article: Chatham Kent Health Alliance[Show abstract] [Hide abstract]
ABSTRACT: Fibromyalgia Highlights Causes Using brain scans on patients with fibromyalgia, researchers have discovered an abnormal increase in blood flow (called "brain perfusion") in an area of the brain that discriminates the intensity of pain, and a decrease in blood flow in areas thought to be involved in the emotional response to pain. These abnormalities were unrelated to the patients' depression and anxiety levels, reinforcing the idea that fibromyalgia is a real disorder, rather than a result of depression. Patients with fibromyalgia seem to be more sensitive to sounds than those without the condition. This increased sensitivity may be due to an abnormality in sensory processing by the central nervous system. Prognosis People with fibromyalgia experience greater psychological distress and a greater impact on quality of life than those with other conditions, such as chronic low back pain. Treatment The U.S. Food and Drug Administration (FDA) has approved the drug duloxetine (Cymbalta) for treating fibromyalgia. In studies, duloxetine reduced fibromyalgia pain by more than 30%. Lifestyle Exercising in a warm swimming pool is a cost-effective therapy that improves quality of life in women with fibromyalgia. Waon therapy --a type of treatment in which patients first sit in a dry sauna and then are placed in a warm room and wrapped in blankets --may help reduce pain in fibromyalgia patients, according to one small study. Medications The anti-epileptic drug pregabalin is effective at improving pain and sleep in three different doses (300 mg, 450 mg, and 600 mg), and the drug is well tolerated by fibromyalgia patients. A synthetic drug derived from marijuana may prove an effective addition to fibromyalgia treatment. In one study, nabilone (Cesamet), which is typically used to treat severe nausea and vomiting in chemotherapy patients, significantly relieved fibromyalgia pain compared to placebo.
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ABSTRACT: Objective We tested the hypothesis that functional somatic syndromes (FSSs) are risk factors for hysterectomy in early bladder pain syndrome/interstitial cystitis (BPS/IC). Methods In 312 women with incident BPS/IC, we diagnosed seven pre–BPS/IC syndromes: chronic pelvic pain (CPP), fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome (IBS), sicca syndrome, migraine, and panic disorder. Each was defined as present before 12 months (existing syndrome) or onset within 12 months (new syndrome) prior to BPS/IC onset. Retrospectively, we sought associations between prior hysterectomy and existing FSSs. Prospectively, we studied associations of existing and new syndromes with subsequent hysterectomy. Logistic regression analyses adjusted for age, race, menopause and education. Results The retrospective study showed prior hysterectomy (N = 63) to be associated with existing CPP and the presence of multiple existing FSSs. The prospective study revealed that 30/249 women with a uterus at baseline (12%) underwent hysterectomy in early BPS/IC. This procedure was associated with new CPP (OR 6.0; CI 2.0, 18.2), new IBS (OR 5.4; CI 1.3, 22.3), and ≥ 3 existing FSSs (OR 3.9; CI 1.1, 13.9). Conclusion Accounting for CPP and IBS, the presence of multiple FSSs (most without pelvic pain) was a separate, independent risk factor for hysterectomy in early BPS/IC. This suggests that patient features in addition to abdominopelvic abnormalities led to this procedure. Until other populations are assessed, a prudent approach to patients who are contemplating hysterectomy (and possibly other surgeries) for pain and who have IBS or numerous FSSs is first to try alternative therapies including treatment of the FSSs.Journal of Psychosomatic Research 09/2014; 77(5). DOI:10.1016/j.jpsychores.2014.09.004 · 2.84 Impact Factor