Background & Aims
Fibromyalgia syndrome (FMS) is a complex condition, characterized by both somatic and psychological symptoms (1,2). Due to its nature and absence of clear biomarkers, diagnosing FMS is challenging. In this sense, Quantitative Sensory Testing (QST) emerges as a promising method for understanding neuropathic pain in FMS(3). It has satisfactory validity and reliability over time, but psychological factors like depression and anxiety might affect its reliability due to the subject’s perception (4,5,6). This way, our study aims to present the results from a systematic review and metanalysis related to the role of depression and anxiety on quantitative sensory testing- QST results.
Methods
The systematic search was carried out in Pubmed/MEDLINE, EMBASE, Web of Science, and PsycINFO databases until May, 2023. We included 20 studies (n=1623, 16 RCTs, and four non-RCTs) with low or moderate risk of bias.
Results
Anxiety and depression symptoms were negatively associated with CPM (Pearson’s correlation of -0.42 and -0.43, respectively) and PTs (Pearson’s correlation ranged from -0.24 to -0.40), indicating that high punctuation in depression and anxiety scales were related to a lower pain threshold.
Conclusions
The study revealed that patients with Fibromyalgia Syndrome (FMS) exhibiting higher levels of anxiety at baseline demonstrated a less pronounced increase in Pain Threshold (PT) following the intervention. Interestingly, the depression factor did not significantly influence changes in either anxiety or depression levels. These findings underscore the importance of monitoring baseline anxiety levels as they may act as potential confounders in QST measurements. A comprehensive understanding of the interplay between psychological factors and QST in FMS patients is crucial. Research highlights the importance of integrating psychological and physiological factors in FMS treatment.
References
Registration: CRD42023429397
References
1.Clauw DJ. Fibromyalgia: a clinical review. Jama. 2014;311:1547-55.
2.Wolfe F, Clauw DJ, Fitzcharles M-A, Goldenberg DL, Häuser W, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. The Journal of rheumatology. 2011;38:1113-22.
3.Favretti M, Iannuccelli C, Di Franco M. Pain Biomarkers in Fibromyalgia Syndrome: Current Understanding and Future Directions. International Journal of Molecular Sciences. 2023;24:10443.
4.Treede R-D. The role of quantitative sensory testing in the prediction of chronic pain. Pain. 2019;160:S66-S9.
5.Weaver KR, Griffioen MA, Klinedinst NJ, Galik E, Duarte AC, Colloca L, Resnick B, Dorsey SG, Renn CL. Quantitative sensory testing across chronic pain conditions and use in special populations. Frontiers in Pain Research. 2022;2:779068.
6.Castelo-Branco L, Cardenas-Rojas A, Rebello-Sanchez I, Pacheco-Barrios K, de Melo PS, Gonzalez-Mego P, Marduy A, Vasquez-Avila K, Costa Cortez P, Parente J. Temporal Summation in Fibromyalgia Patients: Comparing Phasic and Tonic Paradigms. Frontiers in Pain Research. 2022;3:881543.
Presenting Author
Adriana Munhoz Carneiro
Poster Authors
ADRIANA Carneiro
DSc
University of Sao Paulo
Lead Author
Kevin Pacheco-Barrios
MD
Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School
Lead Author
Maria Fernanda Andrade
Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School
Lead Author
Daniela Martinez-Magallanes ,MD
Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School
Lead Author
Elly Pichardo
MD
Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School
Lead Author
Wolnei Caumo
PhD
Post-Graduate Program in Medical Sciences, School of Medicine, Univ. Federal do Rio Grande do Sul
Lead Author
Felipe Fregni
MD
Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School
Lead Author
Topics
- Assessment and Diagnosis