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纤维肌痛中的疼痛敏化。疼痛敏化定量感觉测试与纤维肌痛疾病负担之间的横断面关联。

Pain sensitization in fibromyalgia. Cross-sectional associations between quantitative sensory testing of pain sensitization and fibromyalgia disease burden.

作者信息

Pettersen Pernille Steen, Haugmark Trond, Berg Inger Jorid, Hammer Hilde Berner, Neogi Tuhina, Zangi Heidi, Haugen Ida K, Provan Sella Aarrestad

机构信息

Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.

Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA.

出版信息

Eur J Pain. 2025 Jan;29(1):e4771. doi: 10.1002/ejp.4771.


DOI:10.1002/ejp.4771
PMID:39670546
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11639049/
Abstract

BACKGROUND: Whether fibromyalgia burden is related to measures of sensitization, assessed by quantitative sensory testing (QST), is not clear. We examine the associations between sensitization and fibromyalgia disease burden as measured by the polysymptomatic sistress scale (PDS) and the fibromyalgia impact questionnaire (FIQ) (range 0-100). MATERIALS AND METHODS: Participants were recruited from referrals to a rheumatology outpatient clinic and the fibromyalgia diagnosis was verified by a rheumatologist. They completed the PDS and FIQ and underwent QST of pressure pain threshold (PPT) at five sites, temporal summation (TS), and conditioned pain modulation (CPM) estimated as post-stimuli/pre-stimuli PPT. The associations between QST and disease burden were analysed in linear regression models adjusted for age, sex, and body mass index. RESULTS: A total of 78 individuals with clinically verified fibromyalgia (90% women, mean age 40.9 years (SD 7.3)) were recruited. Overall mean PPT was associated with the FIQ total score (β-2.1, 95% CI-4.3, -0.0) and the function component (β-2.1, (-4.3, -0.0)). When examining the associations between PPT at individual sites and fibromyalgia disease severity, PPTs at the distal interphalangeal joint and tibialis anterior muscle were associated with both FIQ total score and the FIQ fatigue component. All associations were weak and insignificant after Bonferroni corrections. CONCLUSION: In this cohort of individuals with fibromyalgia, sensitization was not significantly associated with self-reported disease burden. Our results point to the multifactorial nature of fibromyalgia disease severity. SIGNIFICANCE: In patients with fibromyalgia, commonly used measures of sensitization do not explain the symptom burden or the functional impact.

摘要

背景:纤维肌痛负担是否与通过定量感觉测试(QST)评估的敏化测量指标相关尚不清楚。我们研究了通过多症状困扰量表(PDS)和纤维肌痛影响问卷(FIQ)(范围0 - 100)测量的敏化与纤维肌痛疾病负担之间的关联。 材料与方法:参与者从转介至风湿病门诊诊所的患者中招募,纤维肌痛诊断由风湿病学家核实。他们完成了PDS和FIQ,并在五个部位进行了压力痛阈(PPT)的QST、时间总和(TS)以及以刺激后/刺激前PPT估计的条件性疼痛调制(CPM)。在针对年龄、性别和体重指数进行调整的线性回归模型中分析QST与疾病负担之间的关联。 结果:共招募了78名经临床证实患有纤维肌痛的个体(90%为女性,平均年龄40.9岁(标准差7.3))。总体平均PPT与FIQ总分(β - 2.1,95%置信区间 - 4.3, - 0.0)和功能分量(β - 2.1,( - 4.3, - 0.0))相关。在检查各个部位的PPT与纤维肌痛疾病严重程度之间的关联时,远端指间关节和胫骨前肌的PPT与FIQ总分和FIQ疲劳分量均相关。在进行Bonferroni校正后,所有关联均较弱且无统计学意义。 结论:在这个纤维肌痛个体队列中,敏化与自我报告的疾病负担无显著关联。我们的结果表明纤维肌痛疾病严重程度具有多因素性质。 意义:在纤维肌痛患者中,常用的敏化测量指标无法解释症状负担或功能影响。

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本文引用的文献

[1]
Delay in fibromyalgia diagnosis and its impact on the severity and outcome: a large cohort study.

Clin Exp Rheumatol. 2024-6

[2]
Correlation of Fibromyalgia Survey Questionnaire and Quantitative Sensory Testing Among Patients With Active Rheumatoid Arthritis.

J Rheumatol. 2022-9

[3]
Algometry for the assessment of central sensitisation to pain in fibromyalgia patients: a systematic review.

Ann Med. 2022-12

[4]
Central sensitisation in chronic fatigue syndrome and fibromyalgia; a case control study.

J Psychosom Res. 2021-11

[5]
Effects of a mindfulness-based and acceptance-based group programme followed by physical activity for patients with fibromyalgia: a randomised controlled trial.

BMJ Open. 2021-6-29

[6]
Pain matters for central sensitization: sensory and psychological parameters in patients with fibromyalgia syndrome.

Pain Rep. 2021-3-10

[7]
Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment.

Nat Rev Rheumatol. 2020-11

[8]
Pain acceptance and its impact on function and symptoms in fibromyalgia.

Scand J Pain. 2020-10-25

[9]
Fibromyalgia 2016 criteria and assessments: comprehensive validation in a Norwegian population.

Scand J Pain. 2020-10-25

[10]
Modified 2016 American College of Rheumatology Fibromyalgia Criteria, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy, and the Prevalence of Fibromyalgia.

Arthritis Care Res (Hoboken). 2021-5

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