Fibromyalgia and centralized pain in the rheumatoid arthritis patient

Minhas, Deeba; Murphy, Anne; Clauw, Daniel J.

doi:10.1097/bor.0000000000000929

Cited by 13 publications

(6 citation statements)

References 46 publications

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“…One potential contributor to fibromyalgia is dysfunctional pain processing in the nervous system [ 2 ]. People with fibromyalgia appear to have an increased sensitivity to pain, and they may experience pain in response to stimuli that would not typically cause pain in others [ 2 , 98 , 99 , 100 , 101 ]. This sensitivity may be due to alterations in the way that pain signals are processed in the central nervous system.…”

Section: Discussionmentioning

confidence: 99%

REAC Neurobiological Modulation as a Precision Medicine Treatment for Fibromyalgia

Silva,

Barcessat,

Gonçalves

et al. 2023

JPM

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Fibromyalgia syndrome (FS) is a disorder characterized by widespread musculoskeletal pain and psychopathological symptoms, often associated with central pain modulation failure and dysfunctional adaptive responses to environmental stress. The Radio Electric Asymmetric Conveyer (REAC) technology is a neuromodulation technology. The aim of this study was to evaluate the effects of some REAC treatments on psychomotor responses and quality of life in 37 patients with FS. Tests were conducted before and after a single session of Neuro Postural Optimization and after a cycle of 18 sessions of Neuro Psycho Physical Optimization (NPPO), using evaluation of the functional dysmetria (FD) phenomenon, Sitting and Standing (SS), Time Up and Go (TUG) tests for motor evaluation, Fibromyalgia Impact Questionnaire (FIQ) for quality of life. The data were statistically analyzed, and the results showed a statistically significant improvement in motor response and quality of life parameters, including pain, as well as reduced FD measures in all participants. The study concludes that the neurobiological balance established by the REAC therapeutic protocols NPO and NPPO improved the dysfunctional adaptive state caused by environmental and exposomal stress in FS patients, leading to an improvement in psychomotor responses and quality of life. The findings suggest that REAC treatments could be an effective approach for FS patients, reducing the excessive use of analgesic drugs and improving daily activities.

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Section: Discussionmentioning

confidence: 99%

REAC Neurobiological Modulation as a Precision Medicine Treatment for Fibromyalgia

Silva,

Barcessat,

Gonçalves

et al. 2023

JPM

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“…Long COVID research focusing on neuroimmune changes parallels similar research in FM and ME/CFS and adds to a greater appreciation of the complicated relationship between the central nervous system, pain, and fatigue. For example, one-third of patients with rheumatoid arthritis (RA) and osteoarthritis have FM, and clinicians must determine if chronic pain and fatigue are related to active rheumatic disease or to concurrent FM (68). Furthermore, there is a bidirectional association of pain and immune-induced inflammation.…”

Section: Impact On Future Research and Patient Managementmentioning

confidence: 99%

“…Furthermore, there is a bidirectional association of pain and immune-induced inflammation. For example, in patients with RA and FM, nociplastic pain increases with inflammation, as demonstrated by the correlation of acute phase reactant elevations with functional connectivity between the insula and left inferior parietal lobe (68,69). Inflammatory conditions like RA or SARS-CoV-2 may trigger chronic pain, exhaustion, cognitive disturbances, and sleep disturbances that persist long after the inflammation or infection has subsided.…”

Section: Impact On Future Research and Patient Managementmentioning

confidence: 99%

Applying Lessons From Rheumatology to Better Understand Long COVID

Goldenberg

2023

Arthritis Care & Research

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Long COVID can sometimes be attributed to organ damage and well‐characterized pathophysiology, but more often there is no evidence of organ damage or abnormal biomarkers. This is most evident in patients with mild to moderate initial SARS‐CoV‐2 infection who were not hospitalized. Their persistent symptoms are strikingly similar to those of fibromyalgia (FM) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), including fatigue, post exertional malaise, myalgias/arthralgias, sleep and cognitive disturbances in 50‐100% of cases.Analogous pathophysiologic pathways in FM, ME/CFS and long COVID include host‐microbial interactions in the absence of direct tissue invasion, an absence of systemic autoimmunity, but evidence for immune dysregulation, as well as autonomic, peripheral, and central nervous system dysfunction. Current treatment of long COVID has been based on multidisciplinary management recommended for FM and ME/CFS but has been formalized and widely available by funding for nation‐wide long COVID clinics. Long COVID and its treatment should be distinguished by the presence or absence of organ damage. The acknowledged role of patient engagement in research and open dialogue regarding work and disability noted in long COVID may have meaningful impact on patients with FM and ME/CFS. Hopefully, advances in long COVID basic research will aid in understanding FM and ME/CFS and rheumatologists should be involved in such research and patient care.image

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“…The ACR further evolved the criterion in 2016 and now defines FM as [11] (1) generalized pain, defined as pain in ≥4 of five regions; (2) pain that lasts for ≥3 months; (3) a widespread pain index (WPI) of ≥7 and a symptom severity scale (SSS) score of ≥5 (or a WPI of 4-6 and an SSS score of ≥9); and (4) a diagnosis of FM that is irrespective of other diagnoses and does not exclude the presence of other illnesses. The International Association for the Study of Pain (IASP) also proposed a new category of chronic pain, 'nociplastic pain', which is distinct from nociceptive and neuropathic pain [2,12,13], and FM is considered a representative of this. Although the patho-physiology of FM and nociplastic pain remains to be elucidated, it is described that the pain signaling initiated in the peripheral and central nervous systems is dysregulated [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Fibromyalgia Animal Models Using Intermittent Cold and Psychological Stress

Ueda,

Neyama

2023

Biomedicines

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Fibromyalgia (FM) is a chronic pain condition characterized by widespread musculoskeletal pain and other frequent symptoms such as fatigue, sleep disturbance, cognitive impairment, and mood disorder. Based on the view that intermittent stress would be the most probable etiology for FM, intermittent cold- and intermittent psychological stress-induced generalized pain (ICGP and IPGP) models in mice have been developed and validated as FM-like pain models in terms of the patho-physiological and pharmacotherapeutic features that are shared with clinical versions. Both models show long-lasting and generalized pain and female-predominant sex differences after gonadectomy. Like many other neuropathic pain models, ICGP and IPGP were abolished in lysophosphatidic acid receptor 1 (LPAR1) knock-out mice or by LPAR1 antagonist treatments, although deciding the clinical importance of this mechanism depends on waiting for the development of a clinically available LPAR1 antagonist. On the other hand, the nonsteroidal anti-inflammatory drug diclofenac with morphine did not suppress hyperalgesia in these models, and this is consistent with the clinical findings. Pharmacological studies suggest that the lack of morphine analgesia is associated with opioid tolerance upon the stress-induced release of endorphins and subsequent counterbalance through anti-opioid NMDA receptor mechanisms. Regarding pharmacotherapy, hyperalgesia in both models was suppressed by pregabalin and duloxetine, which have been approved for FM treatment in clinic. Notably, repeated treatments with mirtazapine, an α2 adrenergic receptor antagonist-type antidepressant, and donepezil, a drug for treating Alzheimer’s disease, showed potent therapeutic actions in these models. However, the pharmacotherapeutic treatment should be carried out 3 months after stress, which is stated in the FM guideline, and many preclinical studies, such as those analyzing molecular and cellular mechanisms, as well as additional evidence using different animal models, are required. Thus, the ICGP and IPGP models have the potential to help discover and characterize new therapeutic medicines that might be used for the radical treatment of FM, although there are several limitations to be overcome.

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Fibromyalgia and centralized pain in the rheumatoid arthritis patient

Cited by 13 publications

References 46 publications

REAC Neurobiological Modulation as a Precision Medicine Treatment for Fibromyalgia

REAC Neurobiological Modulation as a Precision Medicine Treatment for Fibromyalgia

Applying Lessons From Rheumatology to Better Understand Long COVID

Fibromyalgia Animal Models Using Intermittent Cold and Psychological Stress

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