Resting state connectivity correlates with drug and placebo response in fibromyalgia patients

Schmidt‐Wilcke, Tobias; Ichesco, Eric; Hampson, Johnson P.; Kairys, Anson; Peltier, Scott; Harte, Steven E.; Clauw, Daniel J.; Harris, Richard E.

doi:10.1016/j.nicl.2014.09.007

Cited by 107 publications

(85 citation statements)

References 61 publications

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“…Together, these three levels of processing accounted for 71 % of the variance in pain severity [283]. There are data suggesting that decreased resting state functional connectivity between areas involved in pain perception and pain modulation may be useful in predicting pharmacological treatment responses [284,286].…”

Section: Connectivity At Restmentioning

confidence: 99%

Fibromyalgia: A Critical and Comprehensive Review

Borchers

Gershwin

2015

Clinic Rev Allerg Immunol

229

217

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Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients.

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Section: Connectivity At Restmentioning

confidence: 99%

Fibromyalgia: A Critical and Comprehensive Review

Borchers

Gershwin

2015

Clinic Rev Allerg Immunol

229

217

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“…The MAST device is a small portable device designed for research as well as potential point-of-care applications. 14,24,25 It applies discrete pressure stimuli to the thumbnail bed. Our group has extensive experience using thumbnail pressure as an evoked pain stimulus, and its validity in the measurement of pain sensitivity has been discussed extensively.…”

Section: Quantitative Sensory Testingmentioning

confidence: 99%

Pressure Pain Sensitivity in Patients With Suspected Opioid-Induced Hyperalgesia

Wasserman

Hassett

Harte

et al. 2015

Regional Anesthesia and Pain Medicine

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Background and Objectives This study was designed to test whether a brief quantitative sensory testing (QST) assessment could be used to detect hyperalgesia in patients with suspected opioid-induced hyperalgesia. Methods Twenty patients on long-term opioid therapy with suspected opioid-induced hyperalgesia were recruited along with and 20 healthy controls. Pressure pain threshold, Pain50, a measure of intermediate suprathreshold pressure pain sensitivity, and tolerance levels, were evaluated. As a secondary outcome, changes in pressure pain sensitivity following intravenous administration of placebo (saline) and fentanyl (1.5 μg/kg) were assessed. Results There were no significant differences in pain measures between healthy controls and patients. However, there was an association between higher doses of opioids and having a lower pain tolerance (r= -0.46, P=0.041) and lower Pain50 (r=-0.46, P = 0.044), which was consistent with the hypothesis. Patients on >100 mg oral morphine equivalents (OME) displayed decreased pressure pain tolerance compared to patients taking <100 mg OME (P = 0.042). In addition, male patients showed a hyperalgesic response to fentanyl administration, which was significant for the Pain50 measure (P=0.002). Conclusions Whereas there were no differences between patients suspected of having opioid-induced hyperalgesia and the healthy controls, the finding that higher doses of opioids were associated with more sensitivity suggests that dose might be an important factor in the development of hyperalgesia. In addition, male patients demonstrated a hyperalgesic response after a bolus of fentanyl. Future studies are needed to develop better diagnostics for detecting hyperalgesia in the clinical setting.

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“…Specifically, we wonder whether results would be similar if: a) the authors had included a PET study by Juengling et al (Juengling et al 2003), which studied brain metabolism at baseline in 12 medication-free BPD, without current substance abuse or depression, compared to 12 HC and b) had excluded the study by Soloff et al (Soloff et al 2005), given that its inclusion as a resting-state study might be thought by some readers to be limited by the fact that this was an experimentation of fenfluramine vs placebo and some evidence shows that placebo can alter the resting state (e.g. (Sikora et al 2016;Schmidt-Wilcke et al 2014)). …”

mentioning

confidence: 99%