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Psychological Factors Modulate Quantitative Sensory Testing Measures in Fibromyalgia Patients: A Systematic Review
Adriana Munhoz Carneiro1, Kevin Pacheco-Barrios, Maria Fernanda Andrade
1From the Mood Disorders Unity-ProGruda and Service of Interdisciplinary Neuromodulation; Department and Institute of Psychiatry, Faculty of Medicine (Carneiro), University of São Paulo, São Paulo, Brazil; Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital (Pacheco-Barrios, Andrade, Martinez-Magallanes, Pichardo, Fregni), Harvard Medical School, Boston, Massachusetts; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud (Pacheco-Barrios), Lima, Peru; Post-Graduate Program in Medical Sciences, School of Medicine (Caumo), Universidade Federal do Rio Grande do Sul; and Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (Caumo), Porto Alegre, Rio Grande do Sul, Brazil.
Psychological factors like anxiety and depression impact fibromyalgia syndrome (FMS) pain sensitivity. Higher baseline anxiety in FMS patients correlates with smaller improvements in pain threshold after treatment.
Area of Science:
- Neuroscience
- Psychology
- Rheumatology
Background:
- Fibromyalgia syndrome (FMS) is a complex chronic pain condition.
- Growing evidence suggests psychological variables influence FMS.
- Quantitative Sensory Testing (QST) measures sensory perception in FMS.
Purpose of the Study:
- To systematically review and meta-analyze the impact of psychological factors on QST in FMS patients.
- To understand the relationship between psychological variables and pain sensitivity in FMS.
Main Methods:
- Systematic search of PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO databases.
- Inclusion of 20 studies (16 RCTs, 4 non-RCTs) with low/moderate risk of bias.
- Meta-analysis of baseline psychological factors and QST measures, and treatment effects on QST.
Main Results:
- Baseline anxiety, depression, and pain catastrophizing correlate with QST measures in FMS.
- Higher pain catastrophizing linked to reduced conditioned pain modulation.
- Higher anxiety and depression associated with lower pain threshold (PT).
- Fibromyalgia treatments significantly increased PT (effect size = 0.29).
- Baseline anxiety levels negatively influenced PT improvements post-treatment.
Conclusions:
- FMS patients with higher baseline anxiety exhibit diminished PT improvements after interventions.
- Baseline anxiety levels may confound QST measurements in FMS.
- Understanding psychological factors is crucial for optimizing FMS management and treatment strategies.
