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Updated: Sep 25, 2026
A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
Published on: January 5, 2024
Disability stratification in fibromyalgia: symptom burden, centrally acting medication exposure, and functional
Hayes W Miller1, Roba B Abousaway1, Minh N Luong1
1Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Purpose:
To determine whether disability stratification identifies clinically meaningful differences in symptom burden, centrally acting medication exposure, and health-related functioning in fibromyalgia, and to identify independent clinical correlates of physical functioning.
Materials And Methods:
We analyzed a harmonized multisite cohort of 1,126 adults with physician-confirmed fibromyalgia from two U.S. academic centers. Among 976 participants with FIQR/SIQR-equivalent disability scores, high disability was defined as the upper quartile (≥65.92; n = 244). Symptom burden included CSI, BDI-II, and MPQ measures. Physical functioning was assessed using a four-domain SF-36 physical health composite. Multivariable regression identified independent correlates of physical functioning.
Results:
High disability was associated with greater pain, central sensitization-associated symptoms, depressive symptoms, body mass index, and centrally acting medication burden, with worse functioning across all SF-36 domains (all p < 0.001). Pain showed the strongest correlation with disability (ρ = 0.72), followed by CSI (ρ = 0.59) and BDI-II (ρ = 0.48). In 875 complete cases, pain, CSI, BDI-II, body mass index, and medication burden were independently associated with worse physical functioning (adjusted R2=0.445).
Conclusions:
Disability stratification captures clinically meaningful fibromyalgia heterogeneity beyond pain alone and may support rehabilitation-oriented assessment and future precision rehabilitation research.