Hierarchical Cluster Analysis Based on Clinical and Neuropsychological Symptoms Reveals Distinct Subgroups in FM..., 2023, Maurel et al

Full title: Hierarchical Cluster Analysis Based on Clinical and Neuropsychological Symptoms Reveals Distinct Subgroups in Fibromyalgia: A Population-Based Cohort Study

Abstract

Fibromyalgia (FM) is a condition characterized by musculoskeletal pain and multiple comorbidities. Our study aimed to identify four clusters of FM patients according to their core clinical symptoms and neuropsychological comorbidities to identify possible therapeutic targets in the condition. We performed a population-based cohort study on 251 adult FM patients referred to primary care according to the 2010 ACR case criteria. Patients were aggregated in clusters by a K-medians hierarchical cluster analysis based on physical and emotional symptoms and neuropsychological variables.

Four different clusters were identified in the FM population. Global cluster analysis reported a four-cluster profile (cluster 1: pain, fatigue, poorer sleep quality, stiffness, anxiety/depression and disability at work; cluster 2: injustice, catastrophizing, positive affect and negative affect; cluster 3: mindfulness and acceptance; and cluster 4: surrender). The second analysis on clinical symptoms revealed three distinct subgroups (cluster 1: fatigue, poorer sleep quality, stiffness and difficulties at work; cluster 2: pain; and cluster 3: anxiety and depression). The third analysis of neuropsychological variables provided two opposed subgroups (cluster 1: those with high scores in surrender, injustice, catastrophizing and negative affect, and cluster 2: those with high scores in acceptance, positive affect and mindfulness).

These empirical results support models that assume an interaction between neurobiological, psychological and social factors beyond the classical biomedical model. A detailed assessment of such risk and protective factors is critical to differentiate FM subtypes, allowing for further identification of their specific needs and designing tailored personalized therapeutic interventions.

Open access, https://www.mdpi.com/2227-9059/11/10/2867

 

One author is from the Division of Rheumatology, Clinical Unit in ME/CFS and Long COVID, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain, while another is from the Division of Rheumatology, Research Unit in ME/CFS and Long COVID, Vall d’Hebron Research Institute.

 

The hell is this judgmental BS? Not even trying to make sense, says a lot more about whoever did this research than anything to do with the patients.

 

251 Spanish FM patients, of which 21% are disabled by FM.

Pain is not something the brain interprets positively. Chronic pain has no purpose.

The brain doesn't really "accept" chronic pain.

And psychological "surrender" is not effective. Drugs that knock the pain off the awareness map are helpful, the only true remedy.

Mindfulness will make you catastrophize, because one of the brain's main functions is to make predictions based on the past, in order to assure survival.

How do other mammals act when they are experiencing chronic pain. Are they jolly and wagging their tails? Up to their usual charming antics? Fetching nuts, hunting, carrying on as usual?

 

Prior classification of subgroups in FM boiled down recently to those patients with prominent anxiety and depression symptoms and those without. Hmm, you could classify the human race as a whole that way.

But in any case, unless there is a research pathway regarding the relationship in the CNS between FM and anxiety/depression, if any, what is the purpose of exploring the categorization of psychological symptoms?

Oh, I forgot; these symptoms make rheumatologists and others uncomfortable.