Understanding the Psychophysiological and Sensitization Mechanisms behind Fibromyalgia Syndrome: A Network Analysis Approach, 2022, Varol et al

Abstract

Objective
Current evidence suggests that fibromyalgia syndrome (FMS) involves complex underlying mechanisms. This study aimed to quantify the multivariate relationships between clinical, psychophysical, and psychological outcomes in women with FMS by using network analysis to understand the psycho-biological mechanisms driving FMS and generating new research questions for improving treatment strategies.

Methods
Demographic (age, height, weight), clinical (pain history, pain intensity at rest and during daily living activities), psychophysical (widespread pressure pain thresholds -PPT-), sensory-related (PainDETECT, S-LANSS, Central Sensitization Inventory -CSI-) and psychological (depressive and anxiety levels) variables were collected in 126 women with FMS. Network analysis was conducted to quantify the adjusted correlations between the modelled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network).

Results
The network showed several local associations between psychophysical and clinical sensory-related variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs on the knee and tibialis anterior muscle (ρ: 0.33). PainDETECT was associated with LANSS (ρ: 0.45) and CSI (ρ: 0.24), whereas CSI was associated with HADS-A (ρ: 0.28). The most central variables were PPTs over the tibialis anterior (the highest Strength centrality) and CSI (the highest Closeness and Betweenness centrality).

Conclusion
Our findings support a model where clinical sensory-related, psychological, and psycho-physical variables are connected, albeit in separate clusters, reflecting a nociplastic condition with a relevant role of sensitization. Clinical implications of the findings, such as developing treatments targeting these mechanisms, are discussed.

Paywall, https://academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnac121/6663999

 

Researchers are physiotherapists in two centers in Spain.

What do these phrases actually mean (I don't have access to the full study): "psychophysical" and the "cllnical sensory-related" for the variables.

Many of the variables are clearly related such as pain intensity and anixety and depression---this is common sense. No need to separate them out but they miraculously find some of the variables are related in "clusters."

I don't like their terminology that psychophysical is the widespread pain-pressure threshold. Is it psyhcological because pain is perceived in the brain?

ETA: Without the full report and my looking up various terms such as network analysis and the scales used, I can't make an objective assessment of the utility of this research.

 

@shak8, I don't like these these terms, either. Alarms go off for me when I read about anxiety and depression in relation to fibromyalgia. Of course, if you have unremitting pain, you'll likely have depression and anxiety as a result. I dispute that these conditions are the cause, though. Maybe I'm reading too much into it, but the paper is really unclear.

I appreciate the effort to understand more about fibro, but I think because most of the sufferers are women, and there's a long, sorry history of dismissing women's pain, that terms like anxiety and depression tend to come up in these papers.

 

Just pure, undiluted, freebased pseudoscience. Freebased for that extra kick in the brain-nuts.

That nonsense like this is taken seriously says everything about how medicine has completely lost the plot and gave up trying a long time ago.