Perception of induced dyspnea in fibromyalgia and chronic fatigue syndrome

Houte, Maaike Van Den; Bogaerts, Katleen; Diest, Ilse Van; Bie, Jozef De; Persoons, Philippe; Oudenhove, Lukas Van; Bergh, Omer Van den

doi:10.1016/j.jpsychores.2018.01.007

Cited by 25 publications

(31 citation statements)

References 34 publications

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“…While we had detailed data available on many important potential predictors, residual confounding from unmeasured variables is always possible in an observational study. For example, presence of fibromyalgia and other conditions may be non-physiologic conditions that increase the likelihood of reporting dyspnea(22). However, we were unable to analyze this since fibromyalgia was not systematically collected for the entire study.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Dyspnea on Exertion in a Prospective Cohort of Patients With Rheumatoid Arthritis

Doyle

Pan

et al. 2019

ACR Open Rheumatology

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Objective. To investigate the incidence and predictors of dyspnea on exertion among subjects with rheumatoid arthritis (RA).Methods. We investigated dyspnea on exertion using a prospective cohort, the Brigham RA Sequential Study (BRASS). Clinically significant dyspnea on exertion was defined as a score of ≥ 3 (unable to ambulate without breathlessness or worse) on the validated Medical Research Council (MRC) scale (range 0-5). We analyzed subjects with MRC score < 3 at BRASS baseline and at ≥ 1 year of follow-up. The MRC scale was administered annually. We determined the incidence rate (IR) of dyspnea on exertion. We used Cox regression to estimate the hazard ration (HR) for dyspnea on exertion occurring one year after potential predictors were assessed.Results. We analyzed 829 subjects with RA and no clinically significant dyspnea on exertion during a mean follow-up period of 3.0 years (SD 1.9). At baseline, mean age was 55.7 years (SD 13.6), 82.4% of subjects were female, and median RA duration was 8 years. During follow-up, 112 subjects (13.5%) developed incident dyspnea on exertion during 2476 person-years of follow-up (incidence rate 45.2 per 1000 person-years). Independent predictors of incident dyspnea on exertion were older age (HR 1.03 per year, 95% CI, 1.01-1.04), female sex (HR 2.22, 95% CI, 1.14-4.29), mild dyspnea (HR 2.62, 95% CI, 1.60-4.28), and worsened Multi-Dimensional Health Assessment Questionnaire score (HR 2.36 per unit, 95% CI, 1.54-3.60). Methotrexate use, RA disease activity, and seropositivity were not associated with incident dyspnea on exertion after accounting for other dyspnea risk factors.Conclusion. Dyspnea on exertion occurred commonly in patients with RA. Older women with impaired physical function were especially vulnerable to developing dyspnea on exertion.

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Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Dyspnea on Exertion in a Prospective Cohort of Patients With Rheumatoid Arthritis

Doyle

Pan

et al. 2019

ACR Open Rheumatology

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“…Only the results of the counter-irritation paradigm are described here. A detailed description of the methods and results of the picture viewing paradigm and the rebreathing paradigm can be found elsewhere ( Van Den Houte et al, 2017a , 2018 ).…”

Section: Methodsmentioning

confidence: 99%

Negative Affectivity, Depression, and Resting Heart Rate Variability (HRV) as Possible Moderators of Endogenous Pain Modulation in Functional Somatic Syndromes

et al. 2018

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Background: Several studies have shown that patients with functional somatic syndromes (FSS) have, on average, deficient endogenous pain modulation (EPM), as well as elevated levels of negative affectivity (NA) and high comorbidity with depression and reduced resting heart rate variability (HRV) compared to healthy controls (HC). The goals of this study were (1) to replicate these findings and (2) to investigate the moderating role of NA, depression, and resting HRV in EPM efficiency within a patient group with fibromyalgia and/or chronic fatigue syndrome (CFS). Resting HRV was quantified as the root mean square of successive differences between inter-beat intervals (RMSSD) in rest, a vagally mediated time domain measure of HRV.Methods: Seventy-eight patients with fibromyalgia and/or CFS and 33 HC completed a counter-irritation paradigm as a measure of EPM efficiency. Participants rated the painfulness of electrocutaneous stimuli (of individually calibrated intensity) on the ankle before (baseline phase), during (counter-irritation phase) and after (recovery phase) the application of a cold pain stimulus on the forearm. A larger reduction in pain in the counter-irritation phase compared to the baseline phase reflects a more efficient EPM.Results: In contrast to our expectations, there was no difference between pain ratings in the baseline compared to counter-irritation phase for both patients and HC. Therefore, reliable conclusions on the moderating effect of NA, depression, and RMSSD could not be made. Surprisingly, patients reported more pain in the recovery compared to the counter-irritation and baseline phase, while HC did not. This latter effect was more pronounced in patients with comorbid depression, patients who rated the painfulness of the counter-irritation stimulus as high and patients who rated the painfulness of the electrocutaneous stimuli as low. We did not manage to successfully replicate the counter-irritation effect in HC or FSS patients. Therefore, no valid conclusions on the association between RMSSD, depression, NA and EPM efficiency can be drawn from this study. Possible reasons for the lack of the counter-irritation effect are discussed.

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“…For example, in the picture paradigm, we observed a moderating role of difficulty identifying feelings and absorption on the affective modulation of symptom reporting (12). In the rebreathing paradigm, we found a moderating role of somatic symptom severity on the delayed recovery of symptoms despite equal recovery in physiological response (13). These individual difference variables were chosen a priori based on well-grounded hypotheses.…”

Section: Introductionmentioning

confidence: 94%

“…Perception of induced dyspnea was investigated with a rebreathing paradigm. Detailed methods are described elsewhere (13). Briefly, participants went through a breathing trial, consisting of a 60-second baseline phase (room air), a 150-second rebreathing phase (rebreathing through a bag initially filled with a gas mixture of 95% O2 and 5% CO2), causing a progressive increase in respiratory flow, PCO2 and experienced dyspnea, and a 150-second recovery phase (room air).…”

Section: Symptom Perception Measuresmentioning

confidence: 99%

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Relationship Between Different Experimental Measures of Distorted Symptom Perception in Functional Syndrome Patients

Houte

Oudenhove

Bogaerts³

et al. 2019

Psychosom Med

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Objective: Patients with functional somatic syndromes (FSS) show reduced correspondence between induced physiological changes and self-reported symptoms in a rebreathing paradigm, as well as elevated symptoms unrelated to physiological changes after induction of negative affective states in an affective picture viewing paradigm. Detailed results of both paradigms separately were published elsewhere. The main goal of the current report is to describe the relationship between the responses to these two paradigms measuring distortions in symptom perception in a well-described sample of patients with fibromyalgia and/or chronic fatigue syndrome (CFS).Methods: Patients (N=81) with fibromyalgia and/or CFS participated in a test session comprising four well-validated paradigms, including the picture viewing and rebreathing paradigm. Using mixed model analyses, it was tested whether the amount of affective modulation of symptom reporting was related to distorted perception of induced dyspnea. In an exploratory way, we assessed the role of several individual difference variables as moderators.Results: There was no relationship between patients' amount of affective modulation of symptom reporting, as assessed with the picture paradigm, and level of distortion in dyspnea perception, as assessed with the rebreathing paradigm (effect of affective modulation in the subjective recovery from induced dyspnea: F1,70 = 0.16, p = 0.70; time*affective modulation interaction effect: F4,70 = 0.14, p = 0.97). Conclusions:Biased symptom reporting in one paradigm is unrelated to biased symptom reporting in the other paradigm, indicating that distortions in symptom perception in FSS patients is not a trait-like, cross-situationally stable condition, but a versatile dysfunction that is context-dependent.

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Perception of induced dyspnea in fibromyalgia and chronic fatigue syndrome

Cited by 25 publications

References 34 publications

Incidence and Predictors of Dyspnea on Exertion in a Prospective Cohort of Patients With Rheumatoid Arthritis

Incidence and Predictors of Dyspnea on Exertion in a Prospective Cohort of Patients With Rheumatoid Arthritis

Negative Affectivity, Depression, and Resting Heart Rate Variability (HRV) as Possible Moderators of Endogenous Pain Modulation in Functional Somatic Syndromes

Relationship Between Different Experimental Measures of Distorted Symptom Perception in Functional Syndrome Patients

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