This study assessed the cognitive brain function measured by the cognitive P300 auditory event-related potentials (ERPs) in female fibromyalgia (FM) patients and compared the results with those from healthy age and education-matched controls. The relationship of the P300 potentials to the pain threshold of patients was also investigated. The P300 component of the auditory ERPs were studied in 11 female FM patients and 10 age and education-matched healthy controls. None of the patients were taking antidepressants such as amitriptyline or serotonin-reuptake inhibitors. The P300 latencies of the patients were not significantly different whereas the N2P3 amplitudes were significantly lower than the controls. The P300 latencies in the patients negatively correlated with the total myalgic scores (TMS) (r= -0.73) and the control point scores (CPS) (r=-0.85). On the other hand, the P300 amplitudes showed a significant correlation with the TMS (r=0.61) and the CPS (r=0.60). There was no significant correlation between the anxiety and depression scores with the P300 latency or amplitudes. These results showed cognitive impairment, which was mainly expressed by the lower N2P3 amplitudes in patients with FM, and its clinical relevance requires further research.
Adult ; Brain/physiopathology ; Cognition ; *Evoked Potentials, Auditory ; Female ; Fibromyalgia/*physiopathology/psychology ; Human ; Middle Aged ; Pain Threshold

PURPOSE: The purpose of this research was to provide basic data in the control of depression found in patients with fibromyalgia by analysing the main factors that affect them. METHOD: The subjects were 207 out-patients in three university medical centers diagnosed with fibromyalgia according to the conditions by American College of Rheumatology (1990). Depression was measured by the CES-D Scale. Dependant variables, such as stress and anxiety were measured by the VAS Scale and physical activity was measured using 10(4-point-scale) questions developed by the researcher. The number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al.(1989) for arthritis patients. RESULT: The main factors that affect depression of patients with fibromyalgia were self-efficacy, anxiety, physical activity, tender points fatigue, and family support, which explained 49% of the depression. CONCLUSION: It has been confirmed that the regression equation model of this research may serve as a predictor of depression in patients with fibromyalgia.
Self Efficacy ; Middle Aged ; Humans ; Fibromyalgia/*psychology ; Female ; Fatigue ; Family ; Exercise ; Depression/*etiology ; Anxiety ; Adult

BACKGROUNDFibromyalgia (FMS) is a syndrome characterized by chronic widespread musculoskeletal pain, whose etiology is not completely understood. Different therapeutic approaches have been used with inconsistent results. This observation does not invalidate the continued search for alternative treatments aimed at improving quality of life (QoL) in FMS.

OBJECTIVEThis study compared three classical traditional Chinese medicine (TCM) therapies: acupuncture (AC), electroacupuncture (EAC) and moxibustion (MX) in the management of pain and promotion of QoL in FMS patients.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSA preliminary, group-assigned, comparative study enrolled 30 women, mean age (46.90±9.24) years (range 20-60 years), who met the 1990 American College of Rheumatology criteria for FMS diagnosis and a pain-pressure threshold (PPT) < 4 kg/cm(2). The study was conducted in a teaching tertiary-care medical institution from May 2010 through April 2012. AC, EAC and MX were delivered for 30 min, once a week, for 8 weeks, bilaterally at Neiguan (PC6), Hegu (LI4), Yanglingquan (GB34), Sanyinjiao (SP6) and Taichong (LR3) acupoints.

MAIN OUTCOME MEASURESEach week, immediately before treatment and after treatment, subjects were tested for PPTs, Wong-Baker Faces Pain Scale (WBFPS; for pain intensity) and Medical Outcomes Study 36-item Short Form Health Survey (SF-36: for QoL).

RESULTSThere was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session. Significant improvement of QoL was perceived in vitality (after AC treatment) and in mental health (after EAC and MX treatments).

CONCLUSIONTCM therapies (AC, EAC and MX) promoted an improvement in the QoL in two areas (vitality and mental health) in FMS women. Further large-scale clinical trials are required to confirm this effect.

Acupuncture Therapy ; Adult ; Complementary Therapies ; Female ; Fibromyalgia ; psychology ; therapy ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Moxibustion ; Quality of Life

BACKGROUNDJuvenile Fibromyalgia Syndrome (JFMS) is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points (TP). The objective of this study was to determine the prevalence of JFMS in the urban population of Samsun and to determine the impact of JFMS on depression symptoms, school performance and quality of life (QOL).

METHODSA cross-sectional study was conducted in 1109 children (mean age (14.8 ± 2.0) years old). A questionnaire was applied to the children and a medical examination including TP was performed. Yunus and Masi's criteria were used for diagnosis of JFMS. The children with JFMS were compared with an age and sex matched non-JFMS group. Depression was assessed with Children's Depression Inventory (CDI) and QOL was evaluated with Pediatric Quality of Life Inventory 4.0 (PedsQL4.0).

RESULTSSixty-one (5.5%) (13 boys and 48 girls) of 1109 children met the diagnostic criteria of JFMS. While PedsQL scores of children with JFMS were lower than the non-JFMS group for physical, emotional, social, school functioning and total score (P = 0.001), CDI total score was higher in the JFMS group than in the non-JFMS group (P = 0.001). The JFMS group reported more school absences (P = 0.001) and the average school grade was lower in the JFMS group than in the non-JFMS group (P = 0.03).

CONCLUSIONThe prevalence of JFMS is high in school age children. Since JFMS is a common problem of childhood, early diagnosis and identification of the disorder and more comprehensive and successful treatment approaches with appropriate psychological assistance may prevent more complex and severe problems in adulthood.

Adolescent ; Cross-Sectional Studies ; Depression ; etiology ; Female ; Fibromyalgia ; epidemiology ; psychology ; Humans ; Male ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Syndrome ; Turkey ; epidemiology ; Urban Population

BACKGROUNDFibromyalgia is a syndrome characterized by chronic pain, fatigue, depression, and sleep disturbances. Its primary cause is unclear. Several studies have reported decreased intracellular magnesium levels in patients with fibromyalgia and have found negative correlation between magnesium levels and fibromyalgia symptoms.

OBJECTIVETo gather preliminary data on whether transdermal magnesium can improve quality of life for women who have fibromyalgia.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSThis is a patient questionnaires and survey in a fibromyalgia clinic at a tertiary medical center. Forty female patients with the diagnosis of fibromyalgia were enrolled. Each participant was provided a spray bottle containing a transdermal magnesium chloride solution and asked to apply 4 sprays per limb twice daily for 4 weeks. Participants were asked to complete the Revised Fibromyalgia Impact Questionnaire, SF-36v2 Health Survey, and a quality-of-life analog scale at baseline, week 2, and week 4.

MAIN OUTCOME MEASUREQuestionnaire and survey scores, evaluated through intent-to-treat and per-protocol analyses.

RESULTSTwenty-four patients completed the study (mean [SD] age, 57.2 [7.6] years; white, 95%; mean body mass index, 31.3 kg/m2). With intention-to-treat analysis, Revised Fibromyalgia Impact Questionnaire subscale and total scores were significantly improved at week 2 and week 4 (total score, P=0.001). Per-protocol analysis results were similar: all subscales of the Revised Fibromyalgia Impact Questionnaire were significantly improved at week 2 and week 4 (total score, P=0.001).

CONCLUSIONThis pilot study suggests that transdermal magnesium chloride applied on upper and lower limbs may be beneficial to patients with fibromyalgia.

TRIAL REGISTRATIONClinicalTrials.gov.ldentifier NCT01968772.

Administration, Cutaneous ; Aged ; Feasibility Studies ; Female ; Fibromyalgia ; drug therapy ; psychology ; Humans ; Magnesium Chloride ; administration & dosage ; adverse effects ; Middle Aged ; Pilot Projects ; Quality of Life

Fibromyalgia (FM) is a contested illness with ill-defined boundaries. There is no clearly defined cut-point that separates FM from non-FM. Diagnosis of FM has been faced with several challenges that occur, including patients' health care-seeking behavior, symptoms recognition, and FM labeling by physicians. This review focuses on important but less visible factors that have a profound influence on under- or over-diagnosis of FM. FM shows different phenotypes and disease expression in patients and even in one patient over time. Psychosocial and cultural factors seem to be a contemporary ferment in FM which play a major role in physician diagnosis even more than having severe symptom levels in FM patients. Although the FM criteria are the only current methods which can be used for classification of FM patients in surveys, research, and clinical settings, there are several key pieces missing in the fibromyalgia diagnostic puzzle, such as invalidation, psychosocial factors, and heterogeneous disease expression. Regarding the complex nature of FM, as well as the arbitrary and illusory constructs of the existing FM criteria, FM diagnosis frequently fails to provide a clinical diagnosis fit to reality. A physicians' judgment, obtained in real communicative environments with patients, beyond the existing constructional scores, seems the only reliable way for more valid diagnoses. It plays a pivotal role in the meaning and conceptualization of symptoms and psychosocial factors, making diagnoses and labeling of FM. It is better to see FM as a whole, not as a medical specialty or constructional scores.
Chronic Pain ; Classification ; Diagnosis ; Dyssomnias ; Fatigue Syndrome, Chronic ; Fibromyalgia ; Headache ; Humans ; Judgment ; Musculoskeletal Diseases ; Patient Selection ; Phenotype ; Psychology ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVE: The rheumatic disease is a chronic disease, which can result in a functional disability and impaired health-related quality of life (HRQOL). Recently, the concerns about the HRQOL have been increasing especially in chronic diseases, but there has been no report with Korean patients with rheumatic disease. The objective of this study is to assess HRQOL and the correlation among each measurement and to identify the predictors for HRQOL in Korean patients with rheumatic disease. METHODS: A cross-sectional study with 100 patients with rheumatoid arthritis (RA), 103 patients with osteoarthritis (OA), 111 patients with systemic lupus erythematosus (SLE), 104 patients with fibromyalgia (FM), 90 patients with ankylosing spondylitis (AS), and 228 healthy persons as control was done. We measured the HRQOL (with 36 item Short Form Health Survey (SF-36), EuroQol5 Dimensions (EQ-5D), time trade off (TTO), standard gamble (SG) method), the disease specific health state (with Korean Health Assessment Questionnaire (KHAQ) for RA, Korean Western Ontario and McMaster Universities (KWOMAC) for OA, SLE Disease Activity Index (SLEDAI) & Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) for SLE, Korean Fibromyalgia Impact Questionnaire (KFIQ) for FM, Korean Bath Ankylosing Spondylitis Functional Index (KBASFI) for AS), the psychosocial factors (with Centers for Epidemiologic Studies-Depression (CES-D), social support, social network, self-efficacy scale), and clinical features. We compared the means of each group by Student's t-test and ANOVA test, analyzed the correlation among HRQOL and other variables with Pearson and/or Spearman coefficient, and performed the multiple regression analysis with SF-36 as a dependent variable. RESULTS: There were significant differences in sociodemographic and clinical features among groups. Therefore these differences were compensated later in multiple regression analysis. The HRQOL of disease group was significantly lower than that of healthy control. Among disease groups, the SF-36 global score was highest in SLE and lowest in FM. The SF-36 physical component summary was highest in SLE and lowest in OA and FM. The SF-36 mental component summary was lowest in FM. The EQ-5D utility was highest in SLE and lowest in OA, RA, and FM. The EQ-5D visual analog scale was highest in SLE and lowest in OA, AS, and FM. The CES-D was highest in FM and the self-efficacy scale was lowest in FM. The social support and social network was highest in SLE and lowest in OA and FM. In correlation analysis, the SF-36 and EQ-5D were well correlated with each other, but SG and TTO were not. In general, the disease specific health state (except SLEDAI & SDI), CES-D, and self-efficacy scale were well correlated with SF-36 & EQ-5D. In multivariate models, in a point of view of 5 diseases as a whole, the statistically significant variables of SF-36 global were age, income, the disease specific health state, and self-efficacy scale. The statistically significant variables of SF-36 PCS were age, income, the disease specific health state, and self-efficacy scale, and the statistically significant variables of SF-36 MCS were age, the disease specific health state, social support, and self-efficacy scale. The disease type itself was a statistically significant variable with all SF-36 scores in multiple regression analysis. CONCLUSION: These results suggest that HRQOL in Korean patients with rheumatic disease is significantly lower than healthy control and there is a difference in HRQOL among disease types. Among variables, age, disease type, the disease specific health state, CES-D, self-efficacy were most constant meaningful variables correlated with HRQOL. Therefore, the efforts to improve HRQOL for Korean patients with rheumatic disease should be designed to improve the self-efficacy and to alleviate the depression in addition to conventional treatment. In addition, to define the more definite feature of HRQOL in Korean patients with rheumatic disease, the study with more and larger epidemiological controlled disease group and detailed variable adjustment should be done.
Arthritis, Rheumatoid ; Baths ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Fibromyalgia ; Health Surveys ; Humans ; Lupus Erythematosus, Systemic ; Ontario ; Osteoarthritis ; Psychology ; Quality of Life* ; Surveys and Questionnaires ; Rheumatic Diseases* ; Rheumatology ; Spondylitis, Ankylosing ; Visual Analog Scale