TY - JOUR
T1 - Psychological Factors Modulate Quantitative Sensory Testing Measures in Fibromyalgia Patients
T2 - A Systematic Review and Meta-Regression Analysis
AU - Carneiro, Adriana Munhoz
AU - Pacheco-Barrios, Kevin
AU - Andrade, Maria Fernanda
AU - Martinez-Magallanes, Daniela
AU - Pichardo, Elly
AU - Caumo, Wolnei
AU - Fregni, Felipe
N1 - Publisher Copyright:
© 2024 Lippincott Williams & Wilkins.
PY - 2024/11/1
Y1 - 2024/11/1
N2 - Objective Considering the growing evidence that psychological variables might contribute to fibromyalgia syndrome (FMS), our study aims to understand the impact of psychological factors in quantitative sensory testing (QST) in FMS patients by performing a systematic review with meta-analysis. Methods A systematic search was carried out in PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO databases for records up until January 2024. We included 20 studies (n = 1623, 16 randomized controlled trials, and 4 nonrandomized controlled trials) with low or moderate risk of bias included. Results From nonrandomized evidence, our meta-analysis found a baseline relationship between anxiety, depression, and pain catastrophizing and QST measures in FMS patients. Higher pain catastrophizing levels were associated with less efficient conditioned pain modulation. Higher anxiety and depression were associated with lower pain threshold (PT). Randomized evidence showed a statistically significant increase in PT after fibromyalgia treatments (effect size = 0.29, 95% confidence interval = 0.03-0.56). The effect was not influenced by treatment type. Moreover, we found that only anxiety levels before treatment negatively influenced the PT improvements after treatment. Conclusion FMS patients with higher anxiety levels at baseline showed a smaller increase in PT after the intervention. Depression factor was not significant in either changes in anxiety or depression. Baseline anxiety levels should be monitored as possible confounders of QST measurements. Understanding how psychological factors and QST are related in FMS patients is critical for improving the syndrome's management and treatment.
AB - Objective Considering the growing evidence that psychological variables might contribute to fibromyalgia syndrome (FMS), our study aims to understand the impact of psychological factors in quantitative sensory testing (QST) in FMS patients by performing a systematic review with meta-analysis. Methods A systematic search was carried out in PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO databases for records up until January 2024. We included 20 studies (n = 1623, 16 randomized controlled trials, and 4 nonrandomized controlled trials) with low or moderate risk of bias included. Results From nonrandomized evidence, our meta-analysis found a baseline relationship between anxiety, depression, and pain catastrophizing and QST measures in FMS patients. Higher pain catastrophizing levels were associated with less efficient conditioned pain modulation. Higher anxiety and depression were associated with lower pain threshold (PT). Randomized evidence showed a statistically significant increase in PT after fibromyalgia treatments (effect size = 0.29, 95% confidence interval = 0.03-0.56). The effect was not influenced by treatment type. Moreover, we found that only anxiety levels before treatment negatively influenced the PT improvements after treatment. Conclusion FMS patients with higher anxiety levels at baseline showed a smaller increase in PT after the intervention. Depression factor was not significant in either changes in anxiety or depression. Baseline anxiety levels should be monitored as possible confounders of QST measurements. Understanding how psychological factors and QST are related in FMS patients is critical for improving the syndrome's management and treatment.
KW - CPM = conditioned pain modulation
KW - FMS = fibromyalgia syndrome
KW - PT = pain threshold
KW - QST = quantitative sensory testing
KW - RCT = randomized controlled trial
KW - TS = temporal summation
KW - anxiety
KW - depression
KW - fibromyalgia
KW - pain catastrophizing
KW - psychological factors
KW - quantitative sensory testing
UR - http://www.scopus.com/inward/record.url?scp=85203256383&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000001343
DO - 10.1097/PSY.0000000000001343
M3 - Artículo
C2 - 39225326
AN - SCOPUS:85203256383
SN - 0033-3174
VL - 86
SP - 781
EP - 789
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
IS - 9
ER -