Blunted short-term autonomic cardiovascular reactivity to orthostatic and clinostatic challenges in fibromyalgia..., 2022, Contreras-Merinoa et al

Full title: Blunted short-term autonomic cardiovascular reactivity to orthostatic and clinostatic challenges in fibromyalgia as an indicator of the severity of chronic pain

Highlights

• Fibromyalgia (FM) has been related to autonomic cardiovascular disturbances.
• Short-term cardiovascular responses to gravitational stress were assessed in FM.
• FM sufferers showed blunted cardiovascular responses in the first 30 s.
• Cardiovascular reactivity correlated to pain, quality of life and affect in FM.
• High temporal resolution measures are encouraged in postural stress research in FM.

Abstract

Fibromyalgia is a long-term pain disorder that has been related to autonomic dysfunctions and reduced cardiovascular reactivity. We aimed to assess the dynamic short-term cardiovascular responses to postural changes in fibromyalgia. Thirty-eight women with fibromyalgia and thirty-six healthy women underwent the “Chronic Pain Autonomic Stress Test”. Electrocardiogram, blood pressure and impedance cardiography were continuously recorded during active standing and lying down. Second-by-second values were derived over the first 30 s of each posture.

Lower reactivity during the beginning of each position was observed in fibromyalgia sufferers compared to healthy women, with smaller responses seen during stand up in heart rate, blood pressure, cardiac output, total peripheral resistance, and pre-ejection period, and smaller changes during lying down in heart rate, cardiac output and total peripheral resistance. The magnitude of the autonomic adjustments to postural changes was inversely associated with the severity of clinical pain. These findings indicate an early impaired autonomic cardiovascular response to orthostatic and clinostatic challenges in fibromyalgia, suggesting less autonomic flexibility and adaptability to situational demands and challenges. Short-term second-by-second cardiovascular measures may be useful in the clinical assessment of fibromyalgia.

Open access, https://www.sciencedirect.com/science/article/pii/S0167876022000599

 

From the preprint:

"Positive affectivity is reduced in FM (Finan et al., 2009; Galvez-Sánchez et al., 2018),
which is associated with higher levels of loneliness and less enjoyment of interpersonal events (Wolf and
Davis, 2014). In this context, FM sufferers less able to adjust to environmental demands would be more
likely to experience less positive affect. Thus, reduced autonomic reactivity could help explain the
affective difficulties and distress commonly observed in FM (Galvez-Sánchez et al., 2020). Future studies
are needed to assess how cardiovascular reactivity may relate to different sociodemographic
characteristics (e.g., race/ethnicity, culture, etc.)"

All this autonomic micro- dyfunction may intrigue the researchers in the psychology dept. at the Univ.of Jaen,however, it is the noxious experience of FM pain itself via peripherals-spinal cord-brain and lack of descending tract modulation that should be studied.

Remember: the pain of FM is like the muscle aches during the worst flu you have ever had, or a Shingles vaccine.