The Fibromyalgia Research Blog

[Guest guest]

shari ferbert

Subject: The Fibromyalgia

Research Blog

FYI: Some of these studies have already been posted… just

passing along the whole update from the fibromyalgia research blog…

The Fibromyalgia Research Blog

Are

Fibromyalgia Patients More Sensitive to Sound?

Posted: 29 Feb 2008 11:04

AM CST

Fibromyalgia is characterized by widespread tenderness, including

sensitivity to touch. But do fibromyalgia patients also more sensitive to other

stimuli, such as sound? In their article A Psychophysical Study of Auditory

and Pressure Sensitivity in

Patients With Fibromyalgia and Healthy Controls, researchers at the Chronic

Pain and Fatigue Research Center at the University of Michigan, Ann Arbor,

discuss their recent research into this question [Journal of Pain, 2008 Feb 14]. Because past studies reported

that people with fibromyalgia are sensitive to other stimuli, such as auditory

tones, they hypothesized " that subjects with [fibromyalgia] would display

greater sensitivity to both pressure and auditory tones and report greater

sensitivity to sounds encountered in daily activities " and that

fibromyalgia involves a global central nervous system amplification of sensory

information.

The study administered auditory tones and physical pressure to 30 fibromyalgia

patients and 28 healthy controls. They used the same psychophysical methods to

deliver the stimuli and a similar way of scaling responses. Subjects also

completed a self-report questionnaire regarding sensitivity to everyday sounds.

Participants with [fibromyalgia] displayed significantly greater sensitivity to

all levels of auditory stimulation (Ps < .05). The magnitude of difference

between [fibromyalgia] patients' lowered auditory sensitivity (relative to

control subjects) was similar to that seen with pressure, and pressure and

auditory ratings were significantly correlated in both control subjects and

subjects with [fibromyalgia]... patients also were more sensitive to everyday

sounds (t = 8.65, P < .001).

The research team suggests that these findings support the concept that

fibromyalgia is " associated with a global central nervous system

augmentation in sensory processing. " They suggest further research to

examine which neural substrates are associated with this abnormality of sensory

processing and its role in the etiology of fibromyalgia. The research findings

may also help explain why fibromyalgia patients frequently display a number of

other physical symptoms besides pain.

Cost-Effectiveness

of Aquatic Training for Women with Fibromyalgia

Posted: 29 Feb 2008 10:50

AM CST

The results of a randomized controlled trial were published in the

most recent issue of Arthritis Research and

Therapy [2008 Feb 22;10(1):R24]. Knowing that physical therapy in

warm water has been shown to be highly effective for fibromyalgia patients, the

study was designed to evaluate whether it is an efficient investment for

patients or health care managers. The research aimed to " assess the

cost-utility of adding an aquatic exercise programme to the usual care of women

with fibromyalgia. "

The study evaluated costs to the health care system and to society. It included

33 participants, all women with fibromyalgia. Seventeen participants were

randomly assigned to an experimental group and sixteen to a control group.

The intervention in the experimental group consisted of a one-hour, supervised,

water-based exercise sessions, three times per week for 8 months. The main

outcome measures were the health care costs and the number of quality-adjusted

life-years (QALYs) using the time trade-off elicitation technique from the

EQ-5D. Sensitivity analyses was performed for variations in the staff salary,

number of women attending sessions and time spent going to the pool. The

cost-effectiveness acceptability curves were created using a non-parametric

bootstrap technique.

The mean incremental treatment costs for fibromyalgia patients

participating in this aquatic therapy program exceeded those for usual care per

patient by 517 Euros for health care costs and 1032 Euros for societal costs.

The researchers conclude that " the addition of an aquatic exercise programme

to the usual care for fibromyalgia in women, is cost-effective in terms of both

health care costs and societal costs. " However, the fact that appropriate

facilities (warm water pools) are often far from patients' homes and cannot

accommodate many patients per session is something that must be considered

before investing in such a program.

Study

Suggests Fibromyalgia Pain is Neuropathic

Posted: 29 Feb 2008 10:50

AM CST

In the March issue of the journal Pain

Medicine [2008 Mar;9(2):149-160] researchers at three

institutions in Florida conducted a study to determine whether the neuropathic

pain scale (NPS) can be used to classify chronic pain patients (CPPs) as having

primarily neuropathic vs non-neuropathic pain, as well as to determine whether

there is a cut-off score that can be used reliably to make this distinction

between types of pain. This study evaluated 305 chronic pain patients (CPPs)

admitted to The Rosomoff Pain Center (Miami, FL). All were administered the

NPS, a diagnostic tool designed to assess the distinct pain

qualities associated with neuropathic pain, and were given a diagnosis on the

basis of a physical examination and all available test results.

Using patients known to have neuropathic or non-neuropathic pain conditions as

a reference, esearchers were able to derive " an NPS cut-off score above

which CPPs would be classified as having neuropathic pain. " Patients who

had diagnoses of myofascial pain syndromes, spinal stenosis, epidural fibrosis,

fibromyalgia, complex regional pain syndromes, and failed back surgery

syndrome, a predicted NPS score was calculated and compared with the cut-off

score.

The NPS appeared to be able to separate CPPs into neuropathic pain vs

non-neuropathic pain subtypes. The cut-off score the researchers derived was

5.53 on the NPS. Myofascial pain syndrome and spinal stenosis had scores lower

than this cut-off score at 3.81 and 4.26, respectively - Therefore they did not

meet the criteria for neuropathic pain. Epidural fibrosis, fibromyalgia,

complex regional pain syndromes, and failed back surgery syndrome had

predictive scores higher than the cut-off score at 6.15, 6.35, 6.87, 9.34, and

7.19, respectively. Thus, these syndromes did meet the qualifications for

neuropathic pain according to this study's criteria. The researchers conclude

that the NPS does appear to be able to discriminate between patients

experiencing neuropathic and non-neuropathic pain.

A debate is currently raging as to whether diagnoses, such as fibromyalgia and

complex regional pain syndrome 1, can be classified as neuropathic. Our NPS

cut-off score results suggest that these diagnoses may have a neuropathic pain

component. The reliability and validity of our NPS method will need to be

tested further in other neuropathic pain models, such as diabetic peripheral

neuropathic pain.