Some highlights for November:
Fibromyalgia symptoms and medication requirements respond to parathyroidectomy http://bit.ly/14RFSH6
What they found: 80% of 2,184 patients with primary hyperparathyroidism (PHP) had also been diagnosed with fibromyalgia. Fibromyalgia symptoms, quality of life and medication use improved for patients with both conditions who were surgically treated with parathyroidectomy. The authors recommend that PHP be ruled out in suspected cases of fibromyalgia.
Why it matters: Surgery is an effective treatment for PHP and may reduce the burden of suffering in those with concomitant fibromyalgia.
Daily Social Enjoyment Interrupts the Cycle of Same-Day and Next-Day Fatigue in Women with Fibromyalgia http://bit.ly/1HqCQZc
What they found: Enjoyment of social activities reduces fatigue and has a bigger impact on fatigue levels than stress.
Why it matters: Social enjoyment may counteract the effects of stress, which are known to worsen fibromyalgia symptoms. Many people with fibromyalgia find fatigue to be as problematic as pain or more so; social enjoyment may constitute a free remedy for a debilitating symptom.
Cytokine and chemokine profiles in fibromyalgia... http://bit.ly/1AnREG1
What they found: Chemokine and cytokine assays were conducted on 477 patients with diagnoses of fibromyalgia, rheumatoid arthritis or systemic lupus erythematosus. Cytokine/chemokine composite test scores for each group revealed diagnosis-specific signatures that could have clinical relevance.
Why it matters: Chemokines and cytokines are messenger molecules that can be detected in the blood. A chemokine/cytokine profile that is unique to fibromyalgia would help to differentiate it from other potential diagnoses.
Exploring the Role of Perceived Stress in a Patient’s Experience of Fibromyalgia http://bit.ly/1x3WFCo
What they found: 705 patients meeting Fibromyalgia Research Survey Criteria who completed a series of self-report measures that revealed that the total effect of stress on fibromyalgia symptoms was statistically significant, that perceived stress worsened symptoms and that the relationship between perceived stress and symptom intensity correlated with day-to-day changes in fibromyalgia's impact.
Why it matters: Stress is a modifiable factor that can influence symptom severity. The use of effective stress management techniques may improve quality of life for people with fibromyalgia.
The Gut Microbiome and the Brain bit.ly/1vFwMcl
What they found: "Gut bacteria directly stimulate afferent neurons of the enteric nervous system to send signals to the brain via the vagus nerve. Through these varied mechanisms, gut microbes shape the architecture of sleep and stress reactivity of the hypothalamic-pituitary-adrenal axis. They influence memory, mood, and cognition and are clinically and therapeutically relevant to a range of disorders, including alcoholism, chronic fatigue syndrome, fibromyalgia, and restless legs syndrome."
Why it matters: Therapeutic manipulation of the gut micro-organisms may lead to symptomatic improvements in conditions such as fibromyalgia.
Central Pain Sensitization, COMT Val158Met Polymorphism, and Emotional Factors in Fibromyalgia http://bit.ly/1vFKqM5
What they found: "Enzymes like catechol-O-methyl-transferase (COMT) are involved in the elimination of catecholamines playing a possible role in central sensitization and pain... A total of 137 fibromyalgia patients were assessed and compared to 99 matched controls. Central sensitization (nociceptive flexion reflex <27 mA) was present in 95/134 (71%) patients. Among them, COMT p.Val158Met polymorphism displayed a significant linear “genotype effect” (P = .033), with the Met/Met (mean = 17.8 ± 4.8 mA) and Val/Val (mean = 21.4 ± 4.6 mA) subgroups at the opposite ends of the nociceptive flexion reflex threshold (Met/Met vs Val/Val P = .015) and the Val/Met subgroup (mean = 19 ± 4.9 mA) in between (Val/Met vs Val/Val P = .041). Spontaneous moderate to severe pain was more likely to be associated with COMT Met/Met genotype. Patients showed important emotional distress compared to controls. In sensitized patients, the COMT Met/Met subgroup showed systematically—though not significantly—worse scores for all psychological variables."
Why it matters: Understanding the association between genotype polymorphism and central sensitization in fibromyalgia is essential because it may determine the severity of central sensitization and be a risk factor in treatment.
Altered White Matter Integrity in Corpus Callosal Area in Fibromyalgia Identified with Tract Based Spatial Statistical Analysis http://bmj.co/1zzvU6j
What they found: "Nineteen FM patients and age-, and gender-, and education-matched 21 healthy controls (HCs) were included and underwent diffusion-weighted imaging. Group difference in white matter integrity, assessed via fractional anisotropy (FA), was investigated by applying tract-based spatial statistics. FM group showed a single cluster with lower FA in the left body of corpus callosum, which was found to be connected with the bilateral sensorimotor cortices, compared with HCs corrected for multiple comparisons (P<0.05). Furthermore, FA values in the resulting cluster were negatively associated with sensory pain as measured by the short-form McGill Pain Questionnaire, and also with relative magnitude of sensory pain vs. affective pain (calculated by sensory score/affective score)."
Why it matters: The study showed that people with FM had disruptions in the tissues of the body of corpus callosum in the brain and that these were associated with clinical pain intensity. The findings suggest abnormal transfer processes between the brain's hemispheres might contribute to heightened pain perception and further strengthen the hypothesis of centrally augmented pain processing.