Hypervigilance for innocuous tactile stimuli in patients with fibromyalgia: An experimental approach

Abstract

Background: Hypervigilance, i.e., excessive attention, is often invoked as a potential explanation for the observation that many individuals with fibromyalgia show a heightened sensitivity to stimulation in various sensory modalities, such as touch and hearing. Compelling evidence for this assumption is, however, lacking. The aim of the present study was to investigate the presence of somatosensory hypervigilance in patients with fibromyalgia. Methods: Fibromyalgia patients (n = 41) and a matched control group (n = 40) performed a tactile change detection task in which they had to detect whether there was a change between two consecutively presented patterns of tactile stimuli presented to various body locations. The task was performed under two conditions: in the unpredictable condition, tactile changes occurred equally often at all possible body locations; in the predictable condition, the majority of tactile changes occurred at one specific body location. Results: It was hypothesized that the fibromyalgia group would show better tactile change detection in the unpredictable condition and when changes ocurred at unexpected locations in the predictable condition. The results did not support this hypothesis. In neither condition was the fibromyalgia group better than the control group in detecting tactile changes. Conclusions: No evidence was found to support the claim that patients with fibromyalgia display somatosensory hypervigilance. This finding challenges the idea of hypervigilance as a static feature of fibromyalgia and urges for a more dynamic view in which hypervigilance emerges in situations when bodily threat is experienced.

Generalized hypervigilance in fibromyalgia: Normal interoceptive accuracy, but reduced self-regulatory capacity

“…Although the small CI indicates robustness of the finding that the accuracy of detecting heart beats does not differ between FM patients and healthy controls, it is opposed to previous results showing increased pain sensitivity and amplified perception of painful and non-painful stimuli in FM patients (2,3,(7)(8)(9). The present finding, however, is in line with a number of studies, which failed to demonstrate prioritization of external innocuous stimuli in FM patients (4,41). In the study by Van Damme and colleagues (41), participants performed a tactile change detection task in which they had to detect whether there was a change between two consecutively presented patterns of tactile stimuli presented to various body locations.…”

“…In line with this assumption, subsequent studies aimed to investigate the GHH with innocuous stimuli (e.g. 4,41). Other studies, however, interpreted the GHH as referring to aversive stimuli only (e.g.…”

Attentional bias modification for acute experimental pain: A randomized controlled trial of retraining early versus later attention on pain severity, threshold and tolerance

“…It also has a large evidence-base that spans the emotion and pain literature (see e.g. Reduced pain threshold has been reported in individuals with persistent pain (Herren-Gerber et al, 2004) and is indicative of somatosensory hypervigilance (Van Damme et al, 2015). Second, each attentional bias test comprised 96 trials, which is arguably low and may have compromised the sensitivity of the test to detect bias change, but we think this is unlikely as other studies have successfully used similar trials per condition (e.g.…”

“…In terms of clinical implications, the findings concerning threshold and tolerance are noteworthy. Reduced pain threshold has been reported in individuals with persistent pain (Herren-Gerber et al, 2004) and is indicative of somatosensory hypervigilance (Van Damme et al, 2015). This hypervigilance may lead to increased avoidance of pain-causing activities, deconditioning and depression, and increased likelihood of pain, creating a vicious circle Linton, 2000, 2012).…”

Symptoms and the body: Taking the inferential leap

“…Studies comparing fibromyalgia patients and healthy controls found no difference in their ability to detect innocuous tactile stimuli (Vandenbroucke et al, 2014;Van Damme et al, 2014), and/or observed that only NA predicted daily symptom reports (Mussgay et al, 1999;Schaefer et al, 2012). Other studies investigating attentional processing of bodily sensations themselves provide some evidence for a relationship between attention to the body and symptom reporting, although also implicate avoidance of bodily sensations Brown et al, 2010).…”