Leça Salomé, Tavares Isaura
Unit of Experimental Biology, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal.
Institute of Molecular and Cell Biology, University of Porto, Porto, Portugal.
Front Integr Neurosci. 2022 Jul 28;16:920271. doi: 10.3389/fnint.2022.920271. eCollection 2022.
Fibromyalgia is one of the most common causes of widespread chronic pain. It has a huge impact on the quality of life, namely because it appears earlier in life than most of the chronic pain conditions. Furthermore, emotional-cognitive distress factors, such as depression and anxiety, are a common feature in patients with fibromyalgia. The neurobiological mechanisms underlying fibromyalgia remain mostly unknown. Among non-pharmacological treatments, cognitive-behavioral therapy has been used during the last decade, namely with the enrolment of patients in programs of mindfulness-based stress reduction (MBSR) and in mindfulness-based interventions (MBI). We critically analyzed the literature to search for scientific evidence for the use of MBI in fibromyalgia. The studies were evaluated as to several outcomes of fibromyalgia improvement along with aspects of the study design which are currently considered relevant for research in mindfulness. We conclude that despite the sparsity of well-structured longitudinal studies, there are some promising results showing that the MBI are effective in reducing the negative aspects of the disease. Future design of studies using MBI in fibromyalgia management should be critically discussed. The importance of active controls, evaluation of sustained effects along with investigation of the subserving neurobiological mechanisms and detailed reports of possible adverse effects should be considered.
纤维肌痛是广泛慢性疼痛最常见的病因之一。它对生活质量有巨大影响,这主要是因为它比大多数慢性疼痛疾病在生命中出现得更早。此外,诸如抑郁和焦虑等情绪认知困扰因素是纤维肌痛患者的常见特征。纤维肌痛潜在的神经生物学机制大多仍不为人知。在非药物治疗中,认知行为疗法在过去十年中得到应用,即让患者参与基于正念减压(MBSR)和基于正念干预(MBI)的项目。我们批判性地分析了文献,以寻找在纤维肌痛中使用MBI的科学证据。对这些研究就纤维肌痛改善的几个结果以及目前认为与正念研究相关的研究设计方面进行了评估。我们得出结论,尽管结构良好的纵向研究较少,但有一些有前景的结果表明MBI在减轻该疾病的负面影响方面是有效的。未来关于在纤维肌痛管理中使用MBI的研究设计应进行批判性讨论。应考虑积极对照的重要性、对持续效果的评估、对潜在神经生物学机制的研究以及对可能不良反应的详细报告。