Mory Lliure-Naima, de Oliveira Fernandes Daniel, Mancini Christian, Mouthon Michael, Chabwine Joelle Nsimire
Neurology Unit, Medicine Section, Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.
Division of Neurorehabilitation, Fribourg Cantonal Hospital, 1700 Fribourg, Switzerland.
J Clin Med. 2022 Jun 8;11(12):3296. doi: 10.3390/jcm11123296.
Fibromyalgia (FM) is a chronic pain disease characterized by multiple symptoms whose interactions and implications in the disease pathology are still unclear. This study aimed at investigating how pain, sleep, and mood disorders influence each other in FM, while discriminating between the sensory and affective pain dimensions.
Sixteen female FM patients were evaluated regarding their pain, while they underwent-along with 11 healthy sex- and age-adjusted controls-assessment of mood and sleep disorders. Analysis of variance and correlations were performed in order to assess group differences and investigate the interactions between pain, mood, and sleep descriptors.
FM patients reported the typical widespread pain, with similar sensory and affective inputs. Contrary to controls, they displayed moderate anxiety, depression, and insomnia. Affective pain (but neither the sensory pain nor pain intensity) was the only pain indicator that tendentially correlated with anxiety and insomnia, which were mutually associated. An affective pain-insomnia-anxiety loop was thus completed. High ongoing pain strengthened this vicious circle, to which it included depression and sensory pain.
Discriminating between the sensory and affective pain components in FM patients disclosed a pathological loop, with a key role of affective pain; high ongoing pain acted as an amplifier of symptoms interaction. This unraveled the interplay between three of most cardinal FM symptoms; these results contribute to better understand FM determinants and pathology and could help in orienting therapeutic strategies.
纤维肌痛（FM）是一种慢性疼痛疾病，其特征为多种症状，这些症状在疾病病理学中的相互作用和影响仍不明确。本研究旨在调查疼痛、睡眠和情绪障碍在纤维肌痛中如何相互影响，同时区分感觉性疼痛和情感性疼痛维度。
对16名女性纤维肌痛患者进行疼痛评估，同时对11名年龄和性别匹配的健康对照者进行情绪和睡眠障碍评估。进行方差分析和相关性分析，以评估组间差异，并研究疼痛、情绪和睡眠指标之间的相互作用。
纤维肌痛患者报告了典型的广泛性疼痛，感觉性和情感性输入相似。与对照组不同，他们表现出中度焦虑、抑郁和失眠。情感性疼痛（而非感觉性疼痛或疼痛强度）是唯一与焦虑和失眠有潜在相关性的疼痛指标，而焦虑和失眠相互关联。因此形成了情感性疼痛-失眠-焦虑循环。持续的高强度疼痛强化了这个恶性循环，其中还包括抑郁和感觉性疼痛。
区分纤维肌痛患者的感觉性和情感性疼痛成分揭示了一个病理循环，情感性疼痛起关键作用；持续的高强度疼痛是症状相互作用的放大器。这揭示了纤维肌痛最主要的三种症状之间的相互作用；这些结果有助于更好地理解纤维肌痛的决定因素和病理，并有助于指导治疗策略。
