The Fibromyalgia Research Blog

[Guest guest]

FYI: Some good studies are

summarized on the Fibromyalgia Research blog. My favorite – one that I can

personally attest to, is the 3rd one down called:

Online Support Groups Empowering for Patients

with Fibromyalgia & Other Conditions

Shari

Ferbert

www.affter.org

The Fibromyalgia Research Blog

Immunological

Changes in Fibromyalgia & Other Chronic Pain Conditions?

Posted:

04 Feb 2008 12:46 PM CST

The newest issue of the medical journal Neuroimmunomodulation [2008

Feb 1;14(5):272-280] includes the results of a study conducted by Department

of Anesthesiology of Ludwig Maximilians University,

Munich, Germany. The study address

immunological changes in chronic pain patients, specifically complex regional

pain syndrome (CRPS) and fibromyalgia (FMS), both of which the researchers

describe as " chronic pain syndromes occurring in highly stressed

individuals. "

Despite the known connection between the nervous system and immune cells,

information on distribution of lymphocyte subsets under stress and pain

conditions is limited. Lymphocytes are white blood cells that play a

critical role in the body's defenses. They include T cells, B cells, and

natural killer cells. They also modulate the activities of other cells.

The researchers performed a comparative study of 15 patients with CRPS, 22

patients with FMS and 37 age- and sex-matched healthy controls. Their aim was

to investigate the influence of pain and stress on lymphocyte number,

subpopulations and the Th1/Th2 cytokine ratio in T lymphocytes.

Lymphocyte numbers did not differ between the groups studied. However, when

the subtypes of lymphocytes were studied using quantitative analyses, it

became evident that there was " a significant reduction of cytotoxic CD8+

lymphocytes in both CRPS... and [fibromyalgia]... patients as compared with

healthy controls. Additionally, CRPS patients were characterized by a lower

percentage of IL-2-producing T cell subpopulations reflecting a diminished

Th1 response in contrast to no changes in the Th2 cytokine profile. "

The article concludes that future studies are necessary in order to answer

" whether such immunological changes play a pathogenetic role in CRPS and

[FMS] or merely reflect the consequences of a pain-induced neurohumoral

stress response, and whether they contribute to immunosuppression in stressed

chronic pain patients. "

Effects

of the Drug Pyridostigmine Along with Exercise in Treatment of Fibromyalgia

Posted:

04 Feb 2008 12:26 PM CST

A subset of fibromyalgia patients are known to have a

dysfunctional hypothalamic-pituitary-insulin-like growth factor 1 (IGF-1)

axis, which is diagnosed by low blood serum levels of IGF-1 and a reduced

growth hormone (GH) response to physiologic stimuli. There is evidence that

the drug pyridostigmine (PYD) can improve the acute

response of growth hormone to exercise in fibromyalgia patients. Researchers

at Oregon Health

& Science University

in Portland, OR, conducted a 6-month randomized

controlled trial of pyridostigmine in conjunction with exercise, in order to

evaluate the effectiveness of this treatment on fibromyalgia treatment.

The purpose of this study was to evaluate the clinical

effectiveness of 6 months of PYD and group exercise on [fibromyalgia]

symptoms. The researchers randomized patients into one of four groups: PYD

PYD plus exercise, PYD without exercise but with diet recall, placebo plus exercise,

and placebo plus diet recall but no exercise. To assess the results of the

treatments, they used the visual analog scale (VAS) score for pain, tender

point count, and total myalgic score. They also used other secondary outcome

measures including the Fibromyalgia Impact Questionnaire (FIQ) and scores for

individual symptoms (fatigue, poor sleep, stiffness, and anxiety), as well as

quality of life (QOL) evluation and level of physical fitness (lower body

strength/endurance, upper and lower body flexibility, balance, and time on

the treadmill).

A total of 165 [fibromyalgia] patients completed baseline

measurements; 154 (93.3%) completed the study. The combination of PYD and

exercise did not improve pain scores. PYD groups showed a significant

improvement in sleep and anxiety in those who completed the study and in QOL

in those who complied with the therapeutic regimen as compared with the

placebo groups. Compared with the nonexercise groups, the 2 exercise groups

demonstrated improvement in fatigue and fitness. PYD was generally well

tolerated.

The research team concluded that " neither the combination of PYD plus

supervised exercise nor either treatment alone yielded improvement in most

fibromyalgia symptoms. " However, they noted that pyridostigmine (PYD)

did improve anxiety and sleep, and exercise improved fatigue and fitness.

They speculate that pyridostigmine (PYD) " may have improved vagal tone,

thus benefiting sleep and anxiety; this notion warrants further study. "

Online

Support Groups Empowering for Patients with Fibromyalgia & Other

Conditions

Posted:

04 Feb 2008 12:13 PM CST

In an article in the journal Qualitative Health Research [2008

Mar;18(3):405-17] researchers at the University of Twente in the Netherlands

present the results of their research into the effects of online support

groups on the wellbeing of fibromyalgia, breast cancer and arthritis

patients.

Ever since the rise of online support

groups it has been presumed that there is an empowering effect from patients'

participating in these groups, despite a lack of evidence to back up this

assumption. In this study we explored if, and in which ways, patients feel

empowered by participation. Additionally, we studied which empowering and

disempowering processes occur as a result of taking part in these groups.

Their study consisted of interviewing 32 participants of online

support groups. Analyzing this interviews showed empowering processes that

fell into the following categories: exchanging information, encountering

emotional support, finding recognition, sharing experiences, helping others,

and amusement. They found that few people mentioned disempowering processes.

Empowering outcomes mentioned were being better informed; feeling confident

in the relationship with their physician, their treatment, and their social

environment; improved acceptance of the disease; increased optimism and

control; enhanced self-esteem and social well-being; and collective action.

The researchers concluded that participation in online support

groups " can make a valuable contribution to the emergence of empowered

patients. "

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