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Disease Phenotypes in Refractory Musculoskeletal Pain Syndromes Identified by Unsupervised Machine Learning.

作者信息

Hügle Thomas, Prétat Tiffany, Suter Marc, Lovejoy Chris, Ming Azevedo Pedro

机构信息

University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland.

出版信息

ACR Open Rheumatol. 2024 Nov;6(11):790-798. doi: 10.1002/acr2.11699. Epub 2024 Aug 29.


DOI:10.1002/acr2.11699
PMID:39210607
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11557993/
Abstract

OBJECTIVE: Overlapping chronic pain syndromes, including fibromyalgia, are heterogeneous and often treatment-resistant entities carrying significant socioeconomic burdens. Individualized treatment approaches from both a somatic and psychological side are necessary to improve patient care. The objective of this study was to identify and visualize patient clusters in refractory musculoskeletal pain syndromes through an extensive set of clinical variables, including immunologic, psychosomatic, wearable, and sleep biomarkers. METHODS: Data were collected during a multimodal pain program involving 202 patients. Seventy-eight percent of the patients fulfilled the criteria for fibromyalgia, 77% had a concomitant psychiatric-mediated disorder, and 22% a concomitant rheumatic immune-mediated disorder. Five patient phenotypes were identified by hierarchical agglomerative clustering as a form of unsupervised learning, and a predictive model for the Brief Pain Inventory (BPI) response was generated. Based on the clustering data, digital personas were created with DALL-E (OpenAI). RESULTS: The most relevant distinguishing factors among clusters were living alone, body mass index, peripheral joint pain, alexithymia, psychiatric comorbidity, childhood pain, neuroleptic or benzodiazepine medication, and response to virtual reality. Having an immune-mediated disorder was not discriminatory. Three of five clusters responded to the multimodal treatment in terms of pain (BPI intensity), one cluster responded in terms of functional improvement (BPI interference), and one cluster notably responded to the virtual reality intervention. The independent predictive model confirmed strong opioids, trazodone, neuroleptic treatment, and living alone as the most important negative predictive factors for reduced pain after the program. CONCLUSION: Our model identified and visualized clinically relevant chronic musculoskeletal pain subtypes and predicted their response to multimodal treatment. Such digital personas and avatars may play a future role in the design of personalized therapeutic modalities and clinical trials.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/03ce60160335/ACR2-6-790-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/89b4418606ee/ACR2-6-790-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/c7744203ef7c/ACR2-6-790-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/30db076964ec/ACR2-6-790-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/03ce60160335/ACR2-6-790-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/89b4418606ee/ACR2-6-790-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/c7744203ef7c/ACR2-6-790-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/30db076964ec/ACR2-6-790-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44bb/11557993/03ce60160335/ACR2-6-790-g002.jpg

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Disease Phenotypes in Refractory Musculoskeletal Pain Syndromes Identified by Unsupervised Machine Learning.

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引用本文的文献

[1]
Fibromyalgia: what are you made of and how do I tackle you? Introduction to fibromylagia special issue.

Pain Rep. 2025-5-27

[2]
Effectiveness and user experience of a virtual reality intervention in a cohort of patients with chronic musculoskeletal pain syndromes.

PLOS Digit Health. 2025-3-31

[3]
An immersive virtual reality exergame as a patient education approach in fibromyalgia: Pilot study.

Digit Health. 2025-1-9

本文引用的文献

[1]
Disentangling the relationship between depression and chronic widespread pain: A Mendelian randomisation study.

Semin Arthritis Rheum. 2023-6

[2]
Clustering analysis identifies two subgroups of women with fibromyalgia with different psychological, cognitive, health-related, and physical features but similar widespread pressure pain sensitivity.

Pain Med. 2023-7-5

[3]
Effects of a Telerehabilitation Program in Women with Fibromyalgia at 6-Month Follow-Up: Secondary Analysis of a Randomized Clinical Trial.

Biomedicines. 2022-11-23

[4]
Prevalence and Characterization of Psychological Trauma in Patients with Fibromyalgia: A Cross-Sectional Study.

Pain Res Manag. 2022

[5]
Artificial intelligence and machine learning in pain research: a data scientometric analysis.

Pain Rep. 2022-11-3

[6]
Discovering Engagement Personas in a Digital Diabetes Prevention Program.

Behav Sci (Basel). 2022-5-24

[7]
Personas for Better Targeted eHealth Technologies: User-Centered Design Approach.

JMIR Hum Factors. 2022-3-15

[8]
Effectiveness of a Multicomponent Treatment Based on Pain Neuroscience Education, Therapeutic Exercise, Cognitive Behavioral Therapy, and Mindfulness in Patients With Fibromyalgia (FIBROWALK Study): A Randomized Controlled Trial.

Phys Ther. 2021-12-1

[9]
Mortality and concurrent use of opioids and hypnotics in older patients: A retrospective cohort study.

PLoS Med. 2021-7-15

[10]
Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment.

Nat Rev Rheumatol. 2020-11

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