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Fibromyalgia: HELP
Articles from Iowa
Based on 39 articles published since 2009
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These are the 39 published articles about Fibromyalgia that originated from Iowa during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. 2017

Lima, Lucas V / Abner, Thiago S S / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, Iowa City, IA, 52242, USA. ·J Physiol · Pubmed #28369946.

ABSTRACT: Exercise is an integral part of the rehabilitation of patients suffering a variety of chronic musculoskeletal conditions, such as fibromyalgia, chronic low back pain and myofascial pain. Regular physical activity is recommended for treatment of chronic pain and its effectiveness has been established in clinical trials for people with a variety of pain conditions. However, exercise can also increase pain making participation in rehabilitation challenging for the person with pain. Animal models of exercise-induced pain have been developed and point to central mechanisms underlying this phenomena, such as increased activation of NMDA receptors in pain-modulating areas. Meanwhile, a variety of basic science studies testing different exercise protocols, show exercise-induced analgesia involves activation of central inhibitory pathways. Opioid, serotonin and NMDA mechanisms acting in rostral ventromedial medulla promote analgesia associated with exercise. This review explores and discusses current evidence on central mechanisms underlying exercised-induced pain and analgesia.

2 Review Interdisciplinary Approaches to Managing Pain in Older Adults. 2016

Wickson-Griffiths, Abigail / Kaasalainen, Sharon / Herr, Keela. ·Faculty of Nursing, University of Regina, 3737 Wascana Parkway, Regina, Saskatchewan S4S 0A2, Canada. Electronic address: Abigail.Wickson-Griffiths@uregina.ca. · School of Nursing, McMaster University, 1280 Main Street West, HSC 3N25F, Hamilton, Ontario L8S 4K1, Canada. · College of Nursing, University of Iowa, 101 College of Nursing Building, 50 Newton Road, Iowa City, IA 52242-1121, USA. ·Clin Geriatr Med · Pubmed #27741964.

ABSTRACT: An interdisciplinary approach to managing pain has been widely used in managing specific pain conditions (eg, lower back and fibromyalgia) but not reviewed specifically for older adults. Interdisciplinary approaches have been used in primary, residential long-term, and acute care settings, where a variety of health care professionals work on pain teams to manage pain in older adults. Given the multidimensional nature of pain in older adults, interdisciplinary approaches to managing pain are recommended in practice. This article reviews the rationale supporting an interdisciplinary approach to managing pain in older adults and summarizes studies that have evaluated this approach.

3 Review Neurobiology of fibromyalgia and chronic widespread pain. 2016

Sluka, Kathleen A / Clauw, Daniel J. ·Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, United States. Electronic address: kathleen-sluka@uiowa.edu. · Anesthesiology, Medicine (Rheumatology) and Psychiatry, University of Michigan, United States. ·Neuroscience · Pubmed #27291641.

ABSTRACT: Fibromyalgia is the current term for chronic widespread musculoskeletal pain for which no alternative cause can be identified. The underlying mechanisms, in both human and animal studies, for the continued pain in individuals with fibromyalgia will be explored in this review. There is a substantial amount of support for alterations of central nervous system nociceptive processing in people with fibromyalgia, and that psychological factors such as stress can enhance the pain experience. Emerging evidence has begun exploring other potential mechanisms including a peripheral nervous system component to the generation of pain and the role of systemic inflammation. We will explore the data and neurobiology related to the role of the CNS in nociceptive processing, followed by a short review of studies examining potential peripheral nervous system changes and cytokine involvement. We will not only explore the data from human subjects with fibromyalgia but will relate this to findings from animal models of fibromyalgia. We conclude that fibromyalgia and related disorders are heterogenous conditions with a complicated pathobiology with patients falling along a continuum with one end a purely peripherally driven painful condition and the other end of the continuum is when pain is purely centrally driven.

4 Review Implications of forgiveness enhancement in patients with fibromyalgia and chronic fatigue syndrome. 2010

Toussaint, Loren / Overvold-Ronningen, Mary / Vincent, Ann / Luedtke, Connie / Whipple, Mary / Schriever, Tina / Luskin, Frederic. ·Department of Psychology, Luther College, Decorah, Iowa 52101, USA. touslo01@luther.edu ·J Health Care Chaplain · Pubmed #20658426.

ABSTRACT: The purpose of this review is to examine forgiveness as a means to enhance coping with the emotional sequelae of two disorders, fibromyalgia and chronic fatigue. As with many chronic illnesses, fibromyalgia and chronic fatigue often result in a host of negative emotions including, anger, stress, fear, and depression. We contend that learning to become more forgiving may be a complementary treatment to cope with the ongoing stress, frustration, and negative emotions that result from these two conditions. Our review includes descriptive information on fibromyalgia and chronic fatigue, a brief review of the literature on anger and its influence on health, a review of the connections between forgiveness and well-being, and methods to enhance forgiveness in patients' lives. We conclude with a conceptual model that we hope will be useful to design and/or evaluate work on forgiveness in these patients.

5 Clinical Trial Reliability and Construct Validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments in Women with Fibromyalgia. 2017

Merriwether, Ericka N / Rakel, Barbara A / Zimmerman, Miriam B / Dailey, Dana L / Vance, Carol G T / Darghosian, Leon / Golchha, Meenakshi / Geasland, Katherine M / Chimenti, Ruth / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science. · College of Nursing. · College of Public Health, University of Iowa, Iowa City, Iowa. · Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, Tennessee, USA. ·Pain Med · Pubmed #27561310.

ABSTRACT: Objective: The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to standardize measurement of clinically relevant patient-reported outcomes. This study evaluated the reliability and construct validity of select PROMIS static short-form (SF) instruments in women with fibromyalgia. Design: Analysis of baseline data from the Fibromyalgia Activity Study with TENS (FAST), a randomized controlled trial of the efficacy of transcutaneous electrical nerve stimulation. Setting: Dual site, university-based outpatient clinics. Subjects: Women aged 20 to 67 years diagnosed with fibromyalgia. Methods: Participants completed the Revised Fibromyalgia Impact Questionnaire (FIQR) and 10 PROMIS static SF instruments. Internal consistency was calculated using Cronbach alpha. Convergent validity was examined against the FIQR using Pearson correlation and multiple regression analysis. Results: PROMIS static SF instruments had fair to high internal consistency (Cronbach α = 0.58 to 0.94, P  < 0.05). PROMIS 'physical function' domain score was highly correlated with FIQR 'function' score (r = -0.73). The PROMIS 'total' score was highly correlated with the FIQR total score (r = -0.72). Correlations with FIQR total score of each of the three PROMIS domain scores were r = -0.65 for 'physical function,' r = -0.63 for 'global,' and r = -0.57 for 'symptom' domain. PROMIS 'physical function,' 'global,' and 'symptom' scores explained 58% of the FIQR total score variance. Conclusions: Select PROMIS static SF instruments demonstrate convergent validity with the FIQR, a legacy measure of fibromyalgia disease severity. These results highlight the potential utility of select PROMIS static SFs for assessment and tracking of patient-reported outcomes in fibromyalgia.

6 Clinical Trial Effect of transcutaneous electrical nerve stimulation on pain, function, and quality of life in fibromyalgia: a double-blind randomized clinical trial. 2015

Noehren, Brian / Dailey, Dana L / Rakel, Barbara A / Vance, Carol G T / Zimmerman, Miriam B / Crofford, Leslie J / Sluka, Kathleen A. ·B. Noehren, PT, PhD, Division of Physical Therapy, College of Health Sciences University of Kentucky, Lexington, Kentucky. · D.L. Dailey, PT, PhD, Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, Iowa. · B.A. Rakel, RN, PhD, College of Nursing, University of Iowa. · C.G.T. Vance, PT, PhD, Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa. · M.B. Zimmerman, PhD, Biostatistics, University of Iowa. · L.J. Crofford, MD, Department of Medicine, Vanderbilt University, Nashville, Tennessee. · K.A. Sluka, PT, PhD, FAPTA, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52422-1089 (USA). kathleen-sluka@uiowa.edu. ·Phys Ther · Pubmed #25212518.

ABSTRACT: BACKGROUND: Fibromyalgia is a common chronic pain condition that has a significant impact on quality of life and often leads to disability. To date, there have been few well-controlled trials assessing the utility of nonpharmacological treatment modalities such as transcutaneous electrical nerve stimulation (TENS) in the management of pain and improvement in function in individuals with fibromyalgia. OBJECTIVES: The purpose of this study will be to complete a long-term, multicenter study to assess the effects of TENS in women with fibromyalgia. DESIGN: This will be a phase II randomized, double-blind, placebo-controlled, multicenter clinical trial. PARTICIPANTS: Three hundred forty-three participants with fibromyalgia will be recruited for this study. INTERVENTION: Participants will be randomly assigned to 1 of 3 groups: the intervention (TENS), placebo, or no treatment. After completing the randomized period, all participants will receive the intervention for 1 month. The participants will be asked to use TENS at the highest tolerable level for at least 2 hours daily during physical activity. MEASUREMENTS: The primary outcome will be pain with movement, with secondary outcomes assessing functional abilities, patient-reported outcomes, and quantitative sensory testing. LIMITATIONS: Because having participants refrain from their typical medications is not practical, their usage and any change in medication use will be recorded. CONCLUSIONS: The results of this study will provide some of the first evidence from a large-scale, double-blind, placebo-controlled trial on the effectiveness of TENS on pain control and quality-of-life changes in patients with fibromyalgia.

7 Article Infertility and Health-Related Quality of Life in United States Women Veterans. 2019

Mancuso, Abigail C / Summers, Karen M / Mengeling, Michelle A / Torner, James C / Ryan, Ginny L / Sadler, Anne G. ·Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa. · Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. · Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veteran Affairs Health Care System, Iowa City, Iowa. · VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City Veterans Affairs Health Care System, Iowa City, Iowa. · Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa. · Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa. ·J Womens Health (Larchmt) · Pubmed #31755818.

ABSTRACT:

8 Article A Randomized Controlled Trial of TENS for Movement-Evoked Pain in Women with Fibromyalgia. 2019

Dailey, Dana L / Vance, Carol Gt / Rakel, Barbara A / Zimmerman, M Bridget / Embree, Jennie / Merriwether, Ericka N / Geasland, Katharine M / Chimenti, Ruth / Williams, Jon M / Golchha, Meenakshi / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA. · Department of Physical Therapy St, Ambrose University, Davenport, IA. · College of Nursing, University of Iowa, Iowa City, IA. · College of Public Health, University of Iowa, Iowa City, IA. · Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, Department of Medicine, School of Medicine, New York University, New York, NY. · Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, TN. ·Arthritis Rheumatol · Pubmed #31738014.

ABSTRACT: OBJECTIVE: Fibromyalgia (FM) is characterized by pain and fatigue, particularly during physical activity. Transcutaneous electrical nerve stimulation (TENS) activates endogenous pain inhibitory mechanisms. We evaluated if using TENS during activity would improve movement-evoked pain and other patient-reported outcomes in women with FM. METHODS: Participants were randomly assigned to receive active-TENS (n=103), placebo-TENS (n=99) or no-TENS (n=99) and instructed to use it at home 2h/day during activity for 4- weeks. TENS was applied to the lumbar and cervicothoracic regions using a modulated frequency (2-125Hz) at the highest tolerable intensity. Participants rated movement-evoked pain (primary outcome) and fatigue on an 11-point scale before and during application of TENS. Primary and secondary patient-reported outcomes were assessed at randomization and 4weeks. RESULTS: After 4-weeks, the active-TENS group reported a greater reduction in movement-evoked pain and fatigue than placebo-TENS (Pain, Group mean difference(95% CI): -1.0(-1.8, -0.2), p=0.008; Fatigue: -1.4(-2.4, -0.4), p=0.001) and no-TENS groups (Pain: -1.8(-2.6. -1.0), p<0.0001; Fatigue: -1.9(-2.9, -0.9), p=<0.0001). A greater percentage of the active-TENS group reported improvement on the global impression of change when compared to placebo-TENS (70% vs. 31%, p<0.0001) and no-TENS (9%, p<0.0001). There were no TENS-related serious adverse events and less than 5% of participants experienced minor adverse events from TENS. CONCLUSION: Among women with FM and stable medication, 4-weeks of active-TENS use compared with placebo-TENS or no-TENS resulted in a significant improvement in movement-evoked pain and other clinical outcomes. Further research is needed to examine effectiveness in a real world, pragmatic setting to establish clinical importance of these findings.

9 Article Risk factors for opioid use after total shoulder arthroplasty. 2019

Khazi, Zain M / Lu, Yining / Patel, Bhavik H / Cancienne, Jourdan M / Werner, Brian / Forsythe, Brian. ·Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. · Division of Sports Medicine, Midwest Orthopedics at Rush, Rush University Medical Center, Chicago, IL, USA. · Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, USA. · Division of Sports Medicine, Midwest Orthopedics at Rush, Rush University Medical Center, Chicago, IL, USA. Electronic address: brian.forsythe@rushortho.com. ·J Shoulder Elbow Surg · Pubmed #31495704.

ABSTRACT: HYPOTHESIS: The purpose was to assess opioid use before and after anatomic and reverse total shoulder arthroplasty (TSA) and determine patient factors associated with prolonged postoperative opioid use. METHODS: Patients undergoing primary TSA (anatomic or reverse) were identified within the Humana database from 2007 to 2015. Patients were categorized as opioid-naive patients who did not fill a prescription prior to surgery or those who filled opioid prescriptions within 3 months preoperatively (OU); the OU cohort was subdivided into those filling opioid prescriptions within 1 month preoperatively and those filling opioid prescriptions between 1 and 3 months preoperatively. The incidence of opioid use was evaluated preoperatively and longitudinally tracked for each cohort. Multivariate analysis was used to identify factors associated with opioid use at 12 months after surgery, with statistical significance defined as P < .05. RESULTS: Overall, 12,038 patients (5180 in OU cohort, 43%) underwent primary TSA during the study period. Opioid use declined after the first postoperative month; however, the incidence of opioid use was significantly higher in the OU cohort than in the opioid-naive cohort at 1 year (31.4% vs. 3.1%, P < .0001). Subgroup analysis revealed a similar decline in postoperative opioid use for anatomic and reverse TSA (P < .0001 for both). Multivariate analysis identified chronic preoperative opioid use (ie, filling an opioid prescription between 1 and 3 months prior to surgery) as the strongest risk factor for opioid use at 12 months after anatomic and reverse TSA (P < .0001). CONCLUSION: More than 40% of patients undergoing TSA received opioid medications within 3 months before surgery. Preoperative opioid use, age younger than 65 years, and fibromyalgia were independent risk factors for opioid use 1 year following anatomic and reverse TSA. Chronic preoperative opioid use conferred the highest risk of prolonged postoperative opioid use.

10 Article Influence of pain anticipation on brain activity and pain perception in Gulf War Veterans with chronic musculoskeletal pain. 2019

Lindheimer, Jacob B / Stegner, Aaron J / Ellingson-Sayen, Laura D / Van Riper, Stephanie M / Dougherty, Ryan J / Falvo, Michael J / Cook, Dane B. ·William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. · Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin. · Department of Kinesiology, Iowa State University, Ames, Iowa. · Department of Veterans Affairs, NJ Health Care System, War Related Illness and Injury Study Center, East Orange, New Jersey. · New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey. ·Psychophysiology · Pubmed #31429944.

ABSTRACT: Anticipation of a painful experience can influence brain activity and increase sensitivity to experimental somatosensory stimuli in healthy adults, but this response is poorly understood among individuals with chronic musculoskeletal pain (CMP). Studies of brain and perceptual responses to somatosensory stimuli are used to make inferences about central nervous system dysfunction as a potential mechanism of symptoms. As such, we sought to (a) determine the influence of pain anticipation on pain-relevant brain regions and pain perception, and (b) characterize potential differences in these responses between Gulf War Veterans with CMP and matched healthy control (CO) Veterans. CMP (N = 30) and CO Veterans (N = 31) were randomized to conditions designed to generate expectations that either painful (pain) or nonpainful (no pain) stimuli would be administered. Brain responses to five nonpainful thermal stimuli were measured during fMRI, and each stimulus was rated for pain intensity and unpleasantness. In the pain condition, an incremental linear decrease in activity across stimuli was observed in the posterior cingulate cortex, cingulate cortex, and middle temporal gyrus. Further, in the pain condition, differential responses were observed between CMP and CO Veterans in the middle temporal gyrus. These findings indicate that brain responses to nonpainful thermal stimuli in Veterans with CMP are sensitive to pain anticipation, and we recommend accounting for the influence of pain anticipation in future investigations of central nervous system dysfunction in CMP.

11 Article Opioid use following shoulder stabilization surgery: risk factors for prolonged use. 2019

Khazi, Zain M / Lu, Yining / Shamrock, Alan G / Duchman, Kyle R / Westermann, Robert W / Wolf, Brian R. ·Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. · Division of Sports Medicine, Midwest Orthopedics at Rush, Rush University Medical Center, Chicago, IL, USA. · Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. Electronic address: brian-wolf@uiowa.edu. ·J Shoulder Elbow Surg · Pubmed #31401129.

ABSTRACT: HYPOTHESIS: The purpose of this study was to determine the rate of opioid use before and after shoulder stabilization surgery for instability due to recurrent dislocation and assess patient factors associated with prolonged opioid use postoperatively. METHODS: Patients undergoing primary shoulder stabilization procedures for shoulder instability due to recurrent dislocation were accessed from the Humana administrative claims database. Patients were categorized as those who filled 1 or more opioid prescriptions within 1 month, those who filled opioid prescriptions between 1 and 3 months, and those who never filled opioid prescriptions before surgery. Rates of opioid use were evaluated preoperatively and longitudinally tracked for each group. Multiple binomial logistic regression analysis was used to identify factors associated with opioid use at 3 months and 1 year after surgery. RESULTS: Overall, 4802 patients (45.9% opioid naive) underwent shoulder stabilization surgery for shoulder instability during the study period. Rates of opioid use significantly declined after the first postoperative month; however, at 1 year, the rate of opioid use was significantly greater in patients who filled opioid prescriptions preoperatively (13.4% vs. 1.9%, P < .0001). Filling opioid prescriptions 1 to 3 months prior to surgery was the strongest risk factor for opioid use at 1 year after surgery. CONCLUSIONS: Patients who were prescribed opioids 1 to 3 months before surgery had the highest risk of prolonged opioid use following surgery. Obesity, tobacco use, and a preoperative diagnosis of fibromyalgia were independently associated with prolonged opioid use following surgery.

12 Article Anger rumination mediates differences between fibromyalgia patients and healthy controls on mental health and quality of life. 2019

Toussaint, Loren / Sirois, Fuschia / Hirsch, Jameson / Kohls, Niko / Weber, Annemarie / Schelling, Joerg / Vajda, Christian / Offenbäecher, Martin. ·Department of Psychology, Luther College, Decorah, IA, USA. · Department of Psychology, University of Sheffield, Sheffield, UK. · Department of Psychology, East Tennessee State University, Johnson City, TN, USA. · Department of Health Promotion, University of Applied Sciences and Arts Coburg, Coburg, Germany. · Institute for General Practice, University of Munich, Munich, Germany. · Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria. · Institute of General Practice and Family Medicine, University Hospital, University of Munich, Munich, Germany and Gasteiner Heilstollen Hospital, Bad Gastein-Böckstein, Austria. ·Personal Ment Health · Pubmed #31169367.

ABSTRACT: The present study examined differences between fibromyalgia patients and healthy controls on anger rumination, mental health and quality of life and tested anger rumination as a mediator of patient-control differences in mental health and quality of life. Participants were a propensity score-matched sample of 58 fibromyalgia patients and 58 healthy controls. Participants completed measures of anger rumination, depression and anxiety and quality of life. Patients were higher than controls on all anger rumination scales and depression and anxiety and lower on quality of life. All anger rumination scales were related to poorer mental health and quality of life. Patient-control differences on mental health and quality of life were mediated by anger rumination. In multiple mediator models, the only subscale with unique mediating effects was anger memories. Anger rumination has potent associations with mental health and quality of life, and differences between patients and controls on mental health and quality of life are partially mediated by differences in anger rumination. Addressing tendencies to ruminate on anger experiences in the care of fibromyalgia patients may offer an important avenue to improved health and quality of life. © 2019 John Wiley & Sons, Ltd.

13 Article Development of a method to maximize the transcutaneous electrical nerve stimulation intensity in women with fibromyalgia. 2018

Vance, Carol Gt / Chimenti, Ruth L / Dailey, Dana L / Hadlandsmyth, Katherine / Zimmerman, M Bridget / Geasland, Katharine M / Williams, Jonathan M / Merriwether, Ericka N / Alemo Munters, Li / Rakel, Barbara A / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science, The University of Iowa Carver College of Medicine, Iowa City, IA, USA, carol-vance@uiowa.edu. · Department of Anesthesia, College of Medicine, University of Iowa, Iowa City, IA, USA. · Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA. · Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, TN, USA. · Department of Physical Therapy, New York University, New York, NY, USA. · College of Nursing, University of Iowa, Iowa City, IA, USA. ·J Pain Res · Pubmed #30349353.

ABSTRACT: Introduction: Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological intervention clinically used for pain relief. The importance of utilizing the adequate stimulation intensity is well documented; however, clinical methods to achieve the highest possible intensity are not established. Objectives: Our primary aim was to determine if exposure to the full range of clinical levels of stimulation, from sensory threshold to noxious, would result in higher final stimulation intensities. A secondary aim explored the association of pain, disease severity, and psychological variables with the ability to achieve higher final stimulation intensity. Methods: Women with fibromyalgia (N=143) were recruited for a dual-site randomized controlled trial - Fibromyalgia Activity Study with TENS (FAST). TENS electrodes and stimulation were applied to the lumbar area, and intensity was increased to sensory threshold (ST), then to "strong but comfortable" (SC1), then to "noxious" (N). This was followed by a reduction to the final stimulation intensity of "strong but comfortable" (SC2). We called this the Setting of Intensity of TENS (SIT) test. Results: There was a significant increase from SC1 (37.5 mA IQR: 35.6-39.0) to SC2 (39.2 mA IQR: 37.1-45.3) ( Conclusion: The SC2-SC1 increase was significantly associated with age and anxiety, with greater mean increases associated with older age and higher anxiety. Thus, although all patients may benefit from this protocol, older women and women with elevated anxiety receive the greatest benefit.

14 Article Physical activity is related to function and fatigue but not pain in women with fibromyalgia: baseline analyses from the Fibromyalgia Activity Study with TENS (FAST). 2018

Merriwether, Ericka N / Frey-Law, Laura A / Rakel, Barbara A / Zimmerman, Miriam B / Dailey, Dana L / Vance, Carol G T / Golchha, Meenakshi / Geasland, Katherine M / Chimenti, Ruth / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA. · Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA. · College of Nursing, University of Iowa, Iowa City, IA, USA. · College of Public Health, University of Iowa, Iowa City, IA, USA. · Department of Medicine/Rheumatology & Immunology, Vanderbilt University, Nashville, TN, USA. · Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA. kathleen-sluka@uiowa.edu. · College of Nursing, University of Iowa, Iowa City, IA, USA. kathleen-sluka@uiowa.edu. · Department of Physical Therapy and Rehabilitation Science, 1-242 MEB, University of Iowa Carver College of Medicine, Iowa City, IA, 52422-1089, USA. kathleen-sluka@uiowa.edu. ·Arthritis Res Ther · Pubmed #30157911.

ABSTRACT: BACKGROUND: Although exercise is an effective treatment for fibromyalgia, the relationships between lifestyle physical activity and multiple symptomology domains of fibromyalgia are not clear. Thus, the purpose of this study was to comprehensively examine the relationships between lifestyle physical activity with multiple outcome domains in women with fibromyalgia, including pain, fatigue, function, pain-related psychological constructs, and quality of life. METHODS: Women (N = 171), aged 20 to 70 years, diagnosed with fibromyalgia, recruited from an ongoing two-site clinical trial were included in this prespecified subgroup analysis of baseline data. Physical activity was assessed using self-report and accelerometry. Symptomology was assessed using questionnaires of perceived physical function, quality of life, fatigue, pain intensity and interference, disease impact, pain catastrophizing, and fear of movement. In addition, quantitative sensory testing of pain sensitivity and performance-based physical function were assessed. Correlation coefficients, regression analyses and between-group differences in symptomology by activity level were assessed, controlling for age and body mass index (BMI). RESULTS: Lifestyle physical activity was most closely associated with select measures of physical function and fatigue, regardless of age and BMI. Those who performed the lowest levels of lifestyle physical activity had poorer functional outcomes and greater fatigue than those with higher physical activity participation. No relationships between lifestyle physical activity and pain, pain sensitivity, or pain-related psychological constructs were observed. CONCLUSIONS: Lifestyle physical activity is not equally related to all aspects of fibromyalgia symptomology. Lifestyle physical activity levels have the strongest correlations with function, physical quality of life, and movement fatigue in women with fibromyalgia. No relationships between lifestyle physical activity and pain, pain sensitivity, or psychological constructs were observed. These data suggest that physical activity levels are more likely to affect function and fatigue, but have negligible relationships with pain and pain-related psychological constructs, in women with fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01888640 . Registered on 28 June 2013.

15 Article Transition to chronic pain: opportunities for novel therapeutics. 2018

Price, Theodore J / Basbaum, Allan I / Bresnahan, Jacqueline / Chambers, Jan F / De Koninck, Yves / Edwards, Robert R / Ji, Ru-Rong / Katz, Joel / Kavelaars, Annemieke / Levine, Jon D / Porter, Linda / Schechter, Neil / Sluka, Kathleen A / Terman, Gregory W / Wager, Tor D / Yaksh, Tony L / Dworkin, Robert H. ·The University of Texas at Dallas, Richardson, TX, USA. Theodore.price@utdallas.edu. · University of California, San Francisco, San Francisco, CA, USA. · National Fibromyalgia and Chronic Pain Association, Logan, UT, USA. · Laval University & CERVO Brain Research Centre, Québec, QC, Canada. · Harvard University, Boston, MA, USA. · Duke University, Durham, NC, USA. · York University, Toronto, ON, Canada. · University of Texas MD Anderson Cancer Center, Houston, TX, USA. · National Institutes of Health, Bethesda, MD, USA. · University of Iowa, Iowa City, IA, USA. · University of Washington, Seattle, WA, USA. · University of Colorado, Boulder, CO, USA. · University of California, San Diego, San Diego, CA, USA. · University of Rochester, Rochester, NY, USA. ·Nat Rev Neurosci · Pubmed #29765159.

ABSTRACT: -- No abstract --

16 Article Catastrophizing Interferes with Cognitive Modulation of Pain in Women with Fibromyalgia. 2018

Ellingson, Laura D / Stegner, Aaron J / Schwabacher, Isaac J / Lindheimer, Jacob B / Cook, Dane B. ·William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. · Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin. · Department of Kinesiology, Iowa State University, Ames, Iowa, USA. ·Pain Med · Pubmed #29474665.

ABSTRACT: Background: Pain modulation is a critical function of the nociceptive system that includes the ability to engage descending pain control systems to maintain a functional balance between facilitation and inhibition of incoming sensory stimuli. Dysfunctional pain modulation is associated with increased risk for chronic pain and is characteristic of fibromyalgia (FM). Catastrophizing is also common in FM. However, its influence on pain modulation is poorly understood. Objective: To determine the role of catastrophizing on central nervous system processing during pain modulation in FM via examining brain responses and pain sensitivity during an attention-distraction paradigm. Methods: Twenty FM patients and 18 healthy controls (CO) underwent functional magnetic resonance imaging while receiving pain stimuli, administered alone and during distracting cognitive tasks. Pain ratings were assessed after each stimulus. Catastrophizing was assessed with the Pain Catastrophizing Scale (PCS). Results: The ability to modulate pain during distraction varied among FM patients and was associated with catastrophizing. This was demonstrated by significant positive relationships between PCS scores and pain ratings (P < 0.05) and brain responses in the dorsolateral prefrontal cortex (P < 0.01). Relationships between catastrophizing and pain modulation did not differ between FM and CO (P > 0.05). Conclusions: FM patients with higher levels of catastrophizing were less able to distract themselves from pain, indicative of catastrophizing-related impairments in pain modulation. These results suggest that the tendency to catastrophize interacts with attention-resource allocation and may represent a mechanism of chronic pain exacerbation and/or maintenance. Reducing catastrophizing may improve FM symptoms via improving central nervous system regulation of pain.

17 Article Mindfulness as a protective factor against depressive symptoms in people with fibromyalgia. 2017

Brooks, Jessica M / Muller, Veronica / Sánchez, Jennifer / Johnson, Eboneé T / Chiu, Chung-Yi / Cotton, Brandi P / Lohman, Matthew C / Catalano, Denise / Bartels, Stephen / Chan, Fong. ·a Department of Psychiatry , Dartmouth College , Lebanon , NH , USA. · b Department of Rehabilitation and Health Services , University of North Texas , Denton , TX , USA. · c Department of Educational Foundation and Counseling Programs , Hunter College, City University of New York , New York , NY , USA. · d Department of Rehabilitation and Counselor Education , The University of Iowa , Iowa City , IA , USA. · e Department of Kinesiology and Community Health , The University of Illinois at Urbana-Champaign , Champaign , IL , USA. · f Dartmouth College , Lebanon, NH , USA , and. · g Department of Rehabilitation Psychology and Special Education , University of Wisconsin-Madison , Madison, WI , USA. ·J Ment Health · Pubmed #29271273.

ABSTRACT: BACKGROUND: Depressive symptoms complicate pain management for people with FM, with adverse consequences such as a greater need for pain medications and limited pain coping strategies. Determining risks and protective factors associated with depressive symptoms in persons with FM could inform the development and implementation of mental health interventions. AIMS: To formulate and test a behavioral activation model of depression with mindfulness as a protective factor for people with FM. METHODS: We conducted an online cross-sectional survey with 117 adults with FM from community and clinic networks. Path analysis was used to assess the relationships of pain intensity, perceived stress, activity interference, pain catastrophizing and mindfulness with depressive symptoms. RESULTS: Mindfulness has a negative direct association with depressive symptoms and a negative indirect association with depressive symptoms through perceived stress, activity interference and pain catastrophizing. Perceived stress, activity interference and pain catastrophizing had direct associations with depressive symptoms. Finally, perceived stress, activity interference and pain catastrophizing had indirect associations with depressive symptoms through pain intensity. CONCLUSIONS: Mindfulness seems to play an important role as a protective factor against the negative effects of stress and depression among people with FM and should be included in mental health interventions for chronic pain.

18 Article Somatic symptom presentations in women with fibromyalgia are differentially associated with elevated depression and anxiety. 2017

Hadlandsmyth, Katherine / Dailey, Dana L / Rakel, Barbara A / Zimmerman, M Bridget / Vance, Carol Gt / Merriwether, Ericka N / Chimenti, Ruth L / Geasland, Katharine M / Crofford, Leslie J / Sluka, Kathleen A. ·1 Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, USA. · 2 Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, USA. · 3 College of Nursing, University of Iowa, Iowa City, USA. · 4 College of Public Health, University of Iowa, Iowa City, USA. · 5 College of Medicine, Vanderbilt University, Nashville, USA. ·J Health Psychol · Pubmed #29076404.

ABSTRACT: This study examined whether depression and anxiety differentially relate to fatigue, sleep disturbance, pain catastrophizing, fear of movement, and pain severity in women with fibromyalgia. Baseline data from the Fibromyalgia Activity Study with Transcutaneous Electrical Nerve Stimulation were analyzed. Of 191 participants, 50 percent reported high anxiety and/or depression (17% high anxiety, 9% high depression, and 24% both). Fatigue and sleep impairment were associated with high depression ( p < 0.05). Pain severity, pain catastrophizing, and fear of movement were associated with high anxiety and high depression ( p < 0.05). Possible implications for underlying mechanisms and the need for targeted treatments are discussed.

19 Article Longitudinal Perioperative Pain Assessment in Head and Neck Cancer Surgery. 2017

Buchakjian, Marisa R / Davis, Andrew B / Sciegienka, Sebastian J / Pagedar, Nitin A / Sperry, Steven M. ·1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA. · 2 Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA. · 3 University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. ·Ann Otol Rhinol Laryngol · Pubmed #28770621.

ABSTRACT: OBJECTIVE: To evaluate perioperative pain in patients undergoing major head and neck cancer surgery and identify associations between preoperative and postoperative pain characteristics. METHODS: Patients undergoing head and neck surgery with regional/free tissue transfer were enrolled. Preoperative pain and validated screens for symptoms (neuropathic pain, anxiety, depression, fibromyalgia) were assessed. Postoperatively, patients completed a pain diary for 4 weeks. RESULTS: Twenty-seven patients were enrolled. Seventy-eight percent had pain prior to surgery, and for 38%, the pain had neuropathic characteristics. Thirteen patients (48%) completed at least 2 weeks of the postoperative pain diary. Patients with moderate/severe preoperative pain report significantly greater pain scores postoperatively, though daily pain decreased at a similar linear rate for all patients. Patients with more severe preoperative pain consumed greater amounts of opioids postoperatively, and this correlated with daily postoperative pain scores. Patients who screened positive for neuropathic pain also reported worse postoperative pain. CONCLUSION: Longitudinal perioperative pain assessment in head and neck patients undergoing surgery suggests that patients with worse preoperative pain continue to endorse worse pain postoperatively and require more narcotics. Patients with preoperative neuropathic pain also report poor pain control postoperatively, suggesting an opportunity to identify these patients and intervene with empiric neuropathic pain treatment.

20 Article Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study. 2017

Kutch, Jason J / Ichesco, Eric / Hampson, Johnson P / Labus, Jennifer S / Farmer, Melissa A / Martucci, Katherine T / Ness, Timothy J / Deutsch, Georg / Apkarian, A Vania / Mackey, Sean C / Klumpp, David J / Schaeffer, Anthony J / Rodriguez, Larissa V / Kreder, Karl J / Buchwald, Dedra / Andriole, Gerald L / Lai, H Henry / Mullins, Chris / Kusek, John W / Landis, J Richard / Mayer, Emeran A / Clemens, J Quentin / Clauw, Daniel J / Harris, Richard E / Anonymous3040912. ·aDivision of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USAbDepartment of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USAcOppenheimer Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USAdDepartment of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USAeDepartment of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University Medical Center, Stanford, CA, USAfDepartments of Radiology and Anesthesiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USAgDepartment of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USAhDepartment of Urology, University of Southern California, Los Angeles, CA, USAiDepartment of Urology, University of Iowa, Iowa City, IA, USAjCollege of Medicine, Washington State University, Seattle, WA, USAkDepartment of Urology, Washington University, Saint Louis, MO, USAlNational Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USAmDepartment of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USAnDepartment of Urology, University of Michigan, Ann Arbor, MI, USA. ·Pain · Pubmed #28692006.

ABSTRACT: Chronic pain is often measured with a severity score that overlooks its spatial distribution across the body. This widespread pain is believed to be a marker of centralization, a central nervous system process that decouples pain perception from nociceptive input. Here, we investigated whether centralization is manifested at the level of the brain using data from 1079 participants in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network (MAPP) study. Participants with a clinical diagnosis of urological chronic pelvic pain syndrome (UCPPS) were compared to pain-free controls and patients with fibromyalgia, the prototypical centralized pain disorder. Participants completed questionnaires capturing pain severity, function, and a body map of pain. A subset (UCPPS N = 110; fibromyalgia N = 23; healthy control N = 49) underwent functional and structural magnetic resonance imaging. Patients with UCPPS reported pain ranging from localized (pelvic) to widespread (throughout the body). Patients with widespread UCPPS displayed increased brain gray matter volume and functional connectivity involving sensorimotor and insular cortices (P < 0.05 corrected). These changes translated across disease diagnoses as identical outcomes were present in patients with fibromyalgia but not pain-free controls. Widespread pain was also associated with reduced physical and mental function independent of pain severity. Brain pathology in patients with centralized pain is related to pain distribution throughout the body. These patients may benefit from interventions targeting the central nervous system.

21 Article Gratitude mediates quality of life differences between fibromyalgia patients and healthy controls. 2017

Toussaint, Loren / Sirois, Fuschia / Hirsch, Jameson / Weber, Annemarie / Vajda, Christian / Schelling, Jorg / Kohls, Niko / Offenbacher, Martin. ·Luther College, Decorah, Iowa, USA. touslo01@luther.edu. · University of Sheffield, Sheffield, UK. · East Tennessee State University, Johnson City, Tennessee, USA. · Coburg University, Coburg, Germany. · Medical University of Graz, Graz, Austria. · University of Munich, Munich, Germany. ·Qual Life Res · Pubmed #28584891.

ABSTRACT: PURPOSE: Despite a growing literature on the benefits of gratitude for adjustment to chronic illness, little is known about gratitude in medical populations compared to healthy populations, or the degree to which potential deficits in gratitude might impact quality of life. The purpose of the present study was to (1) examine levels of gratitude and quality of life in fibromyalgia patients and healthy controls and (2) consider the role of gratitude in explaining quality of life differences between fibromyalgia patients and healthy controls. METHODS: Participants were 173 fibromyalgia patients and 81 healthy controls. All participants completed measures of gratitude, quality of life, and socio-demographics. RESULTS: Although gratitude was positively associated with quality of life, levels of gratitude and quality of life were lower in the fibromyalgia sample relative to the healthy controls. This difference in gratitude partially mediated differences in quality of life between the two groups after controlling for socio-demographic variables. CONCLUSIONS: Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.

22 Article Struggling With Adversities of Life: The Role of Forgiveness in Patients Suffering from Fibromyalgia. 2017

Offenbaecher, Martin / Dezutter, Jessie / Kohls, Niko / Sigl, Claudia / Vallejo, Miguel A / Rivera, Javier / Bauerdorf, Felix / Schelling, Jörg / Vincent, Ann / Hirsch, Jameson K / Sirois, Fuschia M / Webb, Jon R / Toussaint, Loren L. ·*Institute of General Medicine, University Clinic, Munich ‡Division of Integrative Health Promotion, University of Applied Science and Arts, Coburg, Germany †Faculty of Psychology and Educational Sciences, KU Leuven University of Leuven, Leuven, Belgium §Psychology Faculty, UNED ∥Rheumatology Unit, Rehabilitation Provincial Institute, "Gregorio Marañón" General Hospital, Madrid, Spain ¶Division of General Internal Medicine, Mayo Clinic, Rochester, MN #Department of Psychology, East Tennessee State University, Johnson City, TN **Department of Psychology, University of Sheffield, Sheffield, UK ††Department of Psychology, Luther College, Decorah, IA. ·Clin J Pain · Pubmed #27584816.

ABSTRACT: OBJECTIVES: We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia syndrome (FM) participants and healthy controls. In addition, we compared FM and controls on mean levels of these variables. MATERIALS AND METHODS: A total of 173 individuals with FM and 81 controls completed this study. FM participants and controls were residents of Germany recruited with the support of the German Fibromyalgia Patient Association and several self-help groups. FM participants and controls were about 53 years of age, mostly married (70%), Christians (81%), with levels of education ranging from 9 to 13+ years. All participants completed assessments of forgiveness, pain, health, quality of life, and anger. RESULTS: Analyses revealed that FM participants reported higher pain and anger and poorer health and quality of life. FM participants also reported lower levels of both forgiveness of self and others. Size and direction of associations of forgiveness with pain, health, quality of life, and anger in were not significantly different between healthy individuals and individuals with FM. DISCUSSION: Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FM participants at levels that are of similar size and direction as in healthy controls. However, FM participants manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FM to better manage psychological and physical symptoms, thereby enhancing well-being.

23 Article A Randomized, Controlled Trial of Wholistic Hybrid Derived From Eye Movement Desensitization and Reprocessing and Emotional Freedom Technique (WHEE) for Self-Treatment of Pain, Depression, and Anxiety in Chronic Pain Patients. 2017

Benor, Daniel / Rossiter-Thornton, John / Toussaint, Loren. ·1 Energy Medicine University, Mill Valley, CA, USA. · 2 Toronto, Ontario, Canada. · 3 Luther College, Decorah, IA, USA. ·J Evid Based Complementary Altern Med · Pubmed #27432773.

ABSTRACT: In this pilot study, a convenience sample of 24 chronic pain patients (17 with chronic fatigue syndrome/fibromyalgia) were randomized into WHEE treatment and wait-list control groups for 6 weeks. Assessments of depression, anxiety, and pain were completed before, during, and at 1 and 3 months after treatment. Wait-listed patients then received an identical course of WHEE and assessments. WHEE decreased anxiety ( P < .5) and depression ( P < .05) compared with the control group. The wait-list-turned-WHEE assessments demonstrated decreased pain severity ( P < .05) and depression ( P < .04) but not pain interference or anxiety. WHEE appears a promising method for pain, anxiety, and depression in patients with chronic pain, compared to standard medical care alone. Though a small pilot study, the present results suggest that further research appears warranted. An incidental finding was that a majority of patients with chronic pain had suffered psychological trauma in childhood and/or adulthood.

24 Article Perceived function and physical performance are associated with pain and fatigue in women with fibromyalgia. 2016

Dailey, Dana L / Frey Law, Laura A / Vance, Carol G T / Rakel, Barbara A / Merriwether, Ericka N / Darghosian, Leon / Golchha, Meenakshi / Geasland, Katharine M / Spitz, Rebecca / Crofford, Leslie J / Sluka, Kathleen A. ·Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, 1-252 MEB, 500 Newton Road, Iowa City, IA, 52242, USA. dana-dailey@uiowa.edu. · Department of Physical Therapy and Rehabilitation Science, 1-242 MEB, Carver College of Medicine, University of Iowa, 375 Newton Road, Iowa City, IA, 52422, USA. dana-dailey@uiowa.edu. · Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, 1-252 MEB, 500 Newton Road, Iowa City, IA, 52242, USA. · College of Nursing, University of Iowa, 50 Newton Road, Iowa City, IA, 52242, USA. · Department of Medicine, Division of Rheumatology & Immunology, Vanderbilt University, 1161 21st Avenue South, Nashville, TN, 37232, USA. ·Arthritis Res Ther · Pubmed #26979999.

ABSTRACT: BACKGROUND: Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue and associated with significant impairment in perceived function and reduced physical performance. The purpose of this study was to determine the degree to which pain and fatigue are associated with perceived function and physical performance in women with fibromyalgia. METHODS: Hierarchical linear regression determined the contribution of pain and fatigue (Numeric Rating Scale (NRS) for resting, movement and combined) to perceived function (Fibromyalgia Impact Questionnaire Revised - Function Subscale, FIQR-Function), Multidimensional Assessment of Fatigue - Activities of Daily Living (MAF-ADL) and SF-36 Physical Function Subscale (SF-36-PF) and physical performance (6-Minute Walk Test, 6MWT and Five Time Sit To Stand, 5TSTS) while controlling for age, body mass index, pain catastrophizing, fear of movement, anxiety, and depression in women with fibromyalgia (N = 94). RESULTS: For perceived function, movement pain and movement fatigue together better predicted FIQR-function (adjusted R(2) = 0.42, p ≤ 0.001); MAF-ADL (adjusted R(2) = 0.41, p ≤ 0.001); and SF-36-PF function (adjusted R(2) = 0.34, p ≤ 0.001). For physical performance measures, movement pain and fatigue together predicted 6MWT distance (adjusted R(2) = 0.42, p ≤ 0.001) and movement fatigue alone predicted performance time on the 5TSTS (adjusted R(2) = 0.20, p ≤ 0.001). CONCLUSIONS: Pain and fatigue are significantly associated with and explain more than one-third of the variance in perceived function and physical performance in women with fibromyalgia. TRIAL REGISTRATION: NIH Clinicaltrials.gov REGISTRATION: NCT01888640 . Registered 13 June 2013.

25 Article Perceived dyscognition reported by patients with fibromyalgia. 2016

McAllister, Samantha J / Toussaint, Loren L / Williams, David A / Hoskin, Tanya L / Whipple, Mary O / Vincent, Ann. ·Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. · Department of Psychology, Luther College, Decorah, Iowa, USA. · Chronic Pain and Fatigue Research Center, University of Michigan Health System, Ann Arbor, Michigan, USA. · Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA. · Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. vincent.ann@mayo.edu. ·Clin Exp Rheumatol · Pubmed #26941074.

ABSTRACT: OBJECTIVES: Patients with fibromyalgia often report dyscognition as a symptom; however, the literature on this symptom is sparse. Our objective for this cross-sectional study was to characterize dyscognition among patients with fibromyalgia, identify comorbid symptoms associated with dyscognition, and evaluate its relation with fibromyalgia severity. METHODS: Dyscognition was assessed with the Multiple Abilities Self-report Questionnaire (MASQ) for 681 patients with fibromyalgia. Other assessed comorbid symptoms were pain, fatigue, sleep problems, mood, physical and mental health, and autonomic function. Correlation and regression modeling were used to identify relations between the MASQ subscales and other fibromyalgia symptoms. Mixed analysis of variance was used to examine the profile of dyscognition in different levels of fibromyalgia. MASQ subscale scores from a previously described healthy normal control population were used for comparison. RESULTS: The mean (SD) age of the study patients was 55.8 (12.6) years, and most patients were female (93%) and white (91%). Perceived dyscognition was most related to depression, anxiety, and autonomic function. Across all fibromyalgia severity levels, patients had significantly higher levels of perceived dyscognition than the healthy controls. Significant differences existed for the MASQ total and most MASQ subscales among patients with mild, moderate, and severe fibromyalgia. CONCLUSIONS: Our study results provide further evidence that perceived dyscognition in fibromyalgia is influenced by various comorbid symptoms. In treating patients with fibromyalgia who have dyscognition, clinicians should consider the multiple types of dyscognition and the effects of other fibromyalgia symptoms.

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