Category: Fibromyalgia

Fibromylagia, chronic fatigue, and adult attention deficit hyperactivity disorder in the adult: a case study

Abstract:

Adult attention deficit hyperactivity disorder (ADHD) may share common features with fibromyalgia syndrome (FMS) and chronic fatigue syndrome(CFS). In an outpatient psychiatric clinic, a number of adult patients who presented primarily with symptoms of ADHD, predominately inattentive type, also reported unexplained fatigue, widespread musculoskeletal pain or a pre-existing diagnosis of CFS or FMS.

As expected, ADHD pharmacotherapy usually attenuated the core ADHD symptoms of inattention, distractibility, hyperactivity, and impulsivity. Less expected was the observation that some patients also reported amelioration of pain and fatigue symptoms. The utility of ADHD medications in FMS and CFS states may be their innate arousal and enhanced filtering properties.

This model supposes that FMS and CFS are central processing problems rather than peripheral disorders of muscles and joints.

 

Source: Young JL, Redmond JC. Fibromylagia, chronic fatigue, and adult attention deficit hyperactivity disorder in the adult: a case study. Psychopharmacol Bull. 2007;40(1):118-26. https://www.ncbi.nlm.nih.gov/pubmed/17285103

 

Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome

Abstract:

In addition to the debilitating fatigue, the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. These pain complaints show the greatest overlap between CFS and fibromyalgia (FM). Although the literature provides evidence for central sensitization as cause for the musculoskeletal pain in FM, in CFS this evidence is currently lacking, despite the observed similarities in both diseases. The knowledge concerning the physiological mechanism of central sensitization, the pathophysiology and the pain processing in FM, and the knowledge on the pathophysiology of CFS lead to the hypothesis that central sensitization is also responsible for the sustaining pain complaints in CFS.

This hypothesis is based on the hyperalgesia and allodynia reported in CFS, on the elevated concentrations of nitric oxide presented in the blood of CFS patients, on the typical personality styles seen in CFS and on the brain abnormalities shown on brain images. To examine the present hypothesis more research is required. Further investigations could use similar protocols to those already used in studies on pain in FM like, for example, studies on temporal summation, spatial summation, the role of psychosocial aspects in chronic pain, etc.

 

Source: Meeus M, Nijs J. Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clin Rheumatol. 2007 Apr;26(4):465-73. Epub 2006 Nov 18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820749/ (Full article)

 

Cognitive dysfunction in fibromyalgia and chronic fatigue syndrome: new trends and future directions

Abstract:

Fibromyalgia (FM) and chronic fatigue syndrome (CFS) patients often have memory and cognitive complaints. Objective cognitive testing demonstrates long-term and working memory impairments. In addition, CFS patients have slow information-processing, and FM patients have impaired control of attention, perhaps due to chronic pain. Neuroimaging studies demonstrate cerebral abnormalities and a pattern of increased neural recruitment during cognitive tasks. Future work should focus on the specific neurocognitive systems involved in cognitive dysfunction in each syndrome.

 

Source: Glass JM. Cognitive dysfunction in fibromyalgia and chronic fatigue syndrome: new trends and future directions. Curr Rheumatol Rep. 2006 Dec;8(6):425-9. https://www.ncbi.nlm.nih.gov/pubmed/17092441

 

Menopausal transition symptoms in midlife women living with fibromyalgia and chronic fatigue

Abstract:

We aimed to determine how menopausal transition symptoms cluster across 216 midlife women with fibromyalgia, chronic fatigue syndromes (FMS/CFS), or both and subsequently to compare symptom factor severity scores by menopausal status among these women and compare symptom reporting with prior community-based samples of women without obvious illness.

We designed a cross-sectional telephone survey of 216 women aged 35 to 55, diagnosed with FMS/CFS, symptomatic in the prior 6 months, and without hysterectomy. Thirty-six of 61 symptoms loaded on five factors: aroused/anxious mood, depressed mood/withdrawal, musculoskeletal, gastrointestinal (GI), and vasomotor. Peri- and postmenopausal women had higher symptom severity scores for musculoskeletal, GI, and vasomotor factors but not mood factors.

Symptoms for the women we studied who had FMS/CFS clustered similar to those in previous community-based samples of midlife women without major illness; however, the number of women experiencing symptoms was much higher among our sample.

 

Source: Wilbur J, Shaver J, Kogan J, Buntin M, Wang E. Menopausal transition symptoms in midlife women living with fibromyalgia and chronic fatigue. Health Care Women Int. 2006 Aug;27(7):600-14. https://www.ncbi.nlm.nih.gov/pubmed/16844673

 

Fibromyalgia and chronic fatigue syndrome: an update for athletic trainers

Abstract:

OBJECTIVE: Primary fibromyalgia syndrome (PFS) and chronic fatigue syndrome (CFS) are clinical conditions characterized by a variety of symptoms, including prominent fatigue, myalgia, and sleep disturbances. Although the incidence of these syndromes is infrequent, when manifested, they can completely disrupt the life and career of those affected. When they are manifested within the physically active population, they can jeopardize the futures of the most promising athletes.

DATA SOURCES: Public documents available from the U. S. Department of Health and Human Services, Public Health Services, and the National Institutes of Health were researched. MEDLINE and CINAHL were researched back to 1988 with the following key words: chronic fatigue syndrome, primary fibromyalgia syndrome, sports participant, physically active, mononucleosis, myalgia, rehabilitation, reconditioning, athlete, and sports medicine.

DATA SYNTHESIS: The definition of CFS in 1988 included disabling fatigue of unknown case of at least 6 months’ duration. Primary fibromyalgia syndrome was once considered a subsyndrome of CFS. PFS is diagnostically characterized as a nonarticular rheumatism. The “yuppie flu” was a catch phrase of the 1980s for CFS, which was then named chronic Epstein-Barr virus syndrome. Initially the condition was thought of as simple infectious mononucleosis, but we now have a medically defined set of symptoms to describe what are called CFS and PFS. Training interruptions, feelings of loss of control, and concerns over possible psychologic or psychiatric referral can occur. Relaxation therapy, exercise, image therapy, serotonin supplementation, and antiviral therapy are in clinical trials now as the best options for management of CFS and PFS.

CONCLUSIONS/RECOMMENDATIONS: Current statistics on those affected by CFS and PFS in the general population are less than 2% for CFS and 2% for PFS. Comprehensive documentation of signs, symptoms, and complaints, along with judicious physician follow-up, are important during the course of treatment leading up to and following a diagnosis of CFS or PFS. Professional evaluation of the affected player’s neuropsychological status is important and necessary as a care plan is developed.

 

Source: Cramer CR. Fibromyalgia and chronic fatigue syndrome: an update for athletic trainers. J Athl Train. 1998 Oct;33(4):359-61. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320588/ (Full article)

 

The association between experimental and clinical pain measures among persons with fibromyalgia and chronic fatigue syndrome

Abstract:

Evoked or experimental pain is often used as a model for the study of clinical pain, yet there are little data regarding the relationship between the two. In addition, there are few data regarding the types of stimuli and stimulus intensities that are most closely related to clinical pain. In this study, 36 subjects with fibromyalgia (FM), chronic fatigue syndrome (CFS), or both syndromes were administered measures of clinical pain and underwent a dolorimetry evaluation. Subjects also underwent experimental pain testing utilizing heat and pressure stimulation.

Stimulation levels evoking low, moderate and high sensory intensity, and comparable levels of unpleasantness, were determined for both types of stimuli using random staircase methods. Clinical pain was assessed using visual analogue ratings and the short form of the McGill Pain Questionnaire (MPQ). Ratings of heat pain sensation were not significantly associated with clinical pain ratings, with the exception of unpleasantness ratings at high stimulus intensities. Pain threshold and tolerance as assessed by dolorimetry were significantly associated with average measures of clinical pain.

Both intensity and unpleasantness ratings of pressure delivered using random staircase methods were significantly associated with clinical pain at low, moderate and high levels, and the strength of the association was greater at increasingly noxious stimulus intensities. These findings suggest that random pressure stimulation as an experimental pain model in these populations more closely reflects the clinical pain for these conditions. These findings merit consideration when designing experimental studies of clinical pain associated with FM and CFS.

 

Source: Geisser ME, Gracely RH, Giesecke T, Petzke FW, Williams DA, Clauw DJ. The association between experimental and clinical pain measures among persons with fibromyalgia and chronic fatigue syndrome. Eur J Pain. 2007 Feb;11(2):202-7. Epub 2006 Mar 20. https://www.ncbi.nlm.nih.gov/pubmed/16546424

 

The Spanish version of the FibroFatigue Scale: validation of a questionnaire for the observer’s assessment of fibromyalgia and chronic fatigue syndrome

Abstract:

OBJECTIVE: To examine some of the psychometric properties of the Spanish version of the FibroFatigue Scale (FFS).

METHODS: FFS was administered to 120 patients diagnosed with fibromyalgia and chronic fatigue syndrome. Internal consistency was evaluated by using Cronbach’s alpha, test-retest reliability with weighted kappa and construct validity by correlations among FFS, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQol 5D (EQ-5D) and the Hospital Anxiety and Depression Scale (HADS). The interrater reliability was tested using analysis of variance with patients and raters as independent factors.

RESULTS: Internal consistency (alpha) was .88, test-retest reliability was .91, and interrater reliability was .93. Significant correlations were obtained between overall FFS and the FIQ (.55, P<.01), the EQ-5D (-.48, P<.01) and the HADS depression subscale (.25, P<.01), but not with the HADS anxiety subscale.

CONCLUSION: These results support the reliability and validity of the data obtained with the Spanish version of the FSS.

 

Source: García-Campayo J, Pascual A, Alda M, Marzo J, Magallon R, Fortes S. The Spanish version of the FibroFatigue Scale: validation of a questionnaire for the observer’s assessment of fibromyalgia and chronic fatigue syndrome. Gen Hosp Psychiatry. 2006 Mar-Apr;28(2):154-60. https://www.ncbi.nlm.nih.gov/pubmed/16516066

 

Do support groups help people with chronic fatigue syndrome and fibromyalgia? A comparison of active and inactive members

Abstract:

OBJECTIVE: To examine the benefits and problems of a chronic fatigue syndrome (CFS) and fibromyalgia (FM) support organization as reported by its participants.

METHODS: Active members (n = 32) and inactive members or dropouts (n = 135) of a regional support organization for people with CFS and FM completed a 26 item questionnaire by telephone interview or by self-completion and postal return.

RESULTS: The most frequently endorsed benefits of membership were illness legitimization (67.8%), finding out helpful new information (66.4%), and feeling understood by others (62.2%). Lower frequency endorsements were given to: helped to find (35.0%) or deal with (38.5%) doctors, and helped to improve my illness (36.4%). The most frequently reported reasons for dropping out were inconvenient location (37.8%) or time (37.0%), too much negative talk or complaining (33.3%), too sick to attend (28.8%), and illness or coping improvement (29.6% each). The active-member group showed significantly higher (p < 0.04) symptom severity scores and less illness improvement (p < 0.01) in comparison to the inactive/dropout group.

CONCLUSION: This cross-sectional study suggests that support groups for CFS are viewed as helpful by participants on a number of illness related issues. On the other hand, active members reported greater symptom severity and less illness improvement than inactive members or dropouts.

 

Source: Friedberg F, Leung DW, Quick J. Do support groups help people with chronic fatigue syndrome and fibromyalgia? A comparison of active and inactive members. J Rheumatol. 2005 Dec;32(12):2416-20. http://www.ncbi.nlm.nih.gov/pubmed/16331774

 

Exercise and cognitive performance in chronic fatigue syndrome

Abstract:

PURPOSE: To determine the effect of submaximal steady-state exercise on cognitive performance in patients with chronic fatigue syndrome (CFS) alone, CFS with comorbid fibromyalgia FM (CFS + FM), and sedentary healthy controls (CON).

METHODS: Twenty CFS-only patients, 19 CFS + FM, and 26 CON completed a battery of cognitive tests designed to assess speed of information processing, variability, and efficiency. Tests were performed at baseline, immediately before, and twice following 25 min of either cycle ergometry set at 40% of peak oxygen capacity or quiet rest.

RESULTS: There were no group differences in average percentage of peak oxygen consumption during exercise (CFS = 45%; CFS + FM = 47%; Control = 43%: P = 0.2). There were no significant effects of acute exercise on cognitive performance for any group. At baseline, one-way ANOVA indicated that CFS patients displayed deficits in speed of processing, performance variability, and task efficiency during several cognitive tests compared with healthy controls. However, the CFS + FM patients were not different than controls. Repeated measures ANOVA indicated that across all tests (pre- and postexercise) CFS, but not CFS + FM, were significantly less consistent (F2,59 = 3.7, P = 0.03) and less efficient (F2,59 = 4.6, P = 0.01) than controls.

CONCLUSION: CFS patients without comorbid FM exhibit subtle cognitive deficits in terms of speed, consistency, and efficiency that are not improved or exacerbated by light exercise. Importantly, our data suggest that CFS + FM patients do not exhibit cognitive deficits either pre- or postexercise. These results highlight the importance of disease heterogeneity in studies determining acute exercise and cognitive function in CFS.

 

Source: Cook DB, Nagelkirk PR, Peckerman A, Poluri A, Mores J, Natelson BH. Exercise and cognitive performance in chronic fatigue syndrome. Med Sci Sports Exerc. 2005 Sep;37(9):1460-7. http://www.ncbi.nlm.nih.gov/pubmed/16177595

 

Death of a lifestyle: the effects of social support and healthcare support on the quality of life of persons with fibromyalgia and/or chronic fatigue syndrome

Abstract:

PURPOSE: The purpose of this study was to investigate how social support and healthcare support affect the quality of life of persons with fibromyalgia and chronic fatigue syndrome.

METHOD: A constant comparison method was used for the qualitative portion of the research and descriptive correlational methods were used for the quantitative portion.

CONCLUSION: This mixed design research study suggested that social support, unlike healthcare support, is related to Quality of Life (QOL). It was also evident that subjects suffering from CFS and/or FMS do not experience high levels of social support.

 

Source: Schoofs N, Bambini D, Ronning P, Bielak E, Woehl J. Death of a lifestyle: the effects of social support and healthcare support on the quality of life of persons with fibromyalgia and/or chronic fatigue syndrome. Orthop Nurs. 2004 Nov-Dec;23(6):364-74. http://www.ncbi.nlm.nih.gov/pubmed/15682879