The Link between Endogenous Pain Modulation Changes and Clinical Improvement in Fibromyalgia Syndrome: A Meta-Regression Analysis

Conditioned pain modulation (CPM) and temporal summation (TS) tests can measure the ability to inhibit pain in fibromyalgia syndrome (FMS) patients and its level of pain sensitization, respectively. However, their clinical validity is still unclear. We studied the association between changes in the...

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Vydané v:Biomedicines Ročník 12; číslo 9; s. 2097
Hlavní autori: Pacheco-Barrios, Kevin, Filardi, Rafaela Machado, González-González, Luis Fernando, Park, Nayeon, Petrus, Fernanda Queiroz, Navarro-Flores, Alba, Di-Bonaventura, Silvia, Alves, Luana Gola, Queiroz, Fernanda, Fregni, Felipe
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland MDPI AG 01.09.2024
MDPI
Predmet:
Bias
biomarker
Biomarkers
Care and treatment
Chronic pain
Clinical outcomes
Clinical trials
conditioned pain modulation
Fibromyalgia
Health aspects
Health care
Intervention
Neuromodulation
Pain
Regression analysis
Systematic Review
temporal summation
Therapeutic applications
chronic pain
temporal summation
biomarker
fibromyalgia
conditioned pain modulation
ISSN:2227-9059, 2227-9059
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Shrnutí:Conditioned pain modulation (CPM) and temporal summation (TS) tests can measure the ability to inhibit pain in fibromyalgia syndrome (FMS) patients and its level of pain sensitization, respectively. However, their clinical validity is still unclear. We studied the association between changes in the CPM and TS tests and the clinical improvement of FMS patients who received therapeutic intervention. We systematically searched for FMS randomized clinical trials with data on therapeutic interventions comparing clinical improvement (pain intensity and symptom severity reduction), CPM, and TS changes relative to control interventions. To study the relationship between TS/CPM and clinical measures, we performed a meta-regression analysis to calculate odds ratios. We included nine studies (484 participants). We found no significant changes in TS or CPM by studying all the interventions together. Our findings show that this lack of difference is likely because pharmacological and non-pharmacological interventions resulted in contrary effects. Non-pharmacological interventions, such as non-invasive neuromodulation, showed the largest effects normalizing CPM/TS. Meta-regression was significantly associated with pain reduction and symptom severity improvement with normalization of TS and CPM. We demonstrate an association between clinical improvement and TS/CPM normalization in FMS patients. Thus, the TS and CPM tests could be surrogate biomarkers in FMS management. Recovering defective endogenous pain modulation mechanisms by targeted non-pharmacological interventions may help establish long-term clinical recovery in FMS patients.
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These authors contributed equally to this work.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines12092097