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