Nocturnal heart rate variability parameters as potential fibromyalgia biomarker: correlation with symptoms severity (original) (raw)
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Scandinavian journal of rheumatology, 2013
To investigate heart rate variability (HRV) in fibromyalgia (FM) patients and healthy controls (HCs) during different sleep stages, and to examine the association of HRV with pain and sleep quality. Polysomnography was recorded from 23 female FM patients and 22 age- and sex-matched HCs. HRV was recorded from bedtime until awakening including the standard deviation of normal-to-normal intervals (SDNN), the root mean square successive difference (RMSSD), and the low (LF; 0.04-0.15 Hz) and high (HF; 0.15-0.4 Hz) frequency power. Subjective scores of neck/shoulder pain and sleep quality were obtained at bedtime and awakening. Both patients and HCs showed high incidence of arousals per hour (FM: 16 ± 9.7; HCs: 17 ± 11). RMSSD was lower in patients than HCs during non-rapid eye movement (non-REM) stage 2 (N2) sleep (mean ± SD; 30 ± 12 ms vs. 42 ± 13 ms, p < 0.002) and during REM sleep (23 ± 11 ms vs. 37 ± 16 ms, p < 0.003). HRV did not differ between groups during N3 sleep (p > 0...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2009
It is known that increased sympathetic activity and decreased parasympathetic activity are present in patients with fibromyalgia syndrome (FMS). This study aims to investigate the correlations of autonomic dysfunction and differences in autonomic circadian activity with arrhythmia prevalence in women with FMS. Fifty female patients with FMS and 30 healthy female controls were included in this cross-sectional, case-controlled study. A 12-lead electrocardiogram and 24-hour Holter monitoring were performed in all patients to evaluate arrhythmias and autonomic function tests. Heart rate variability (HRV) parameters were utilized to detect autonomic dysfunction in patients with FMS. HRV measurements were performed in total 24-hour, day time (06:00-22:59), night time (23:00-05:59) periods and during autonomic tests (stand - supine, inspiration-expiration and Valsalva tests) using 24-hour Holter monitoring recordings. Student t-test , Mann-Whitney U and Pearson Chi-square tests were used f...
Heart rate variability as a biomarker of fibromyalgia syndrome
Future Rheumatology, 2008
Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread mechanical tenderness, fatigue, nonrefreshing sleep and depressed mood. Several biological abnormalities have been described in FM patients, including elevated substance P in the cerebrospinal fluid, increased CNS sensitivity to painful and nonpainful stimuli and pervasive dysfunction of the autonomic nervous system (ANS). Such ANS abnormalities include, but are not limited to: tachycardia, postural intolerance, Raynaud's phenomenon, and diarrhea or constipation. Heart rate variability (HRV) analysis of FM patients can be used to assess ANS dysfunction, specifically related to sympathovagal balance, which has provided evidence for nonabating sympathetic hyperactivity in this chronic pain population. Although not specific for FM, ANS dysfunction can be readily determined by HRV analysis requiring only computer analysis of electrocardiogram recordings by commercially available software. HRV has been shown to correlate with FM pain and is sensitive to change; in particular, pain related to physical and mental stressors. Thus, ANS dysfunction as assessed by HRV analysis may serve as a useful biomarker, and may become part of future FM diagnostic criteria and serve as a surrogate end point in clinical trials.
Chronobiology International, 2019
Patients with fibromyalgia (FM) report high levels of sleep disturbance and chronic diffuse musculoskeletal pain. These patients experience diminished quality of life (QoL) due to pain and other comorbidities. Chronotype preferences have been suggested as a potential factor connecting increased severity of FM, sleep disturbances, and poor overall QoL. The present study is the first study examining the possible association between chronotype preferences, sleep disturbance, severity of FM, and QoL in patients with FM. One hundred drug-free patients diagnosed with FM participated in this cross-sectional study. Of them, 79 (79%) were females and 21 (21%) were males. The mean age was 41.65 ± 9.17 years (range: 21-62 years). The severity of FM symptoms, chronotype preferences, and QoL was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), Morningness-Eveningness Questionnaire (MEQ), and World Health Organization Questionnaire on Quality of Life: Short Form (WHOQOL-BREF). The participants' anxiety/depressive symptoms and sleep problems were assessed using the Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI). The participants were classified according to their MEQ scores as evening type (score: 16-41), neither type (score: 42-58), and morning type (score: 59-86). It was found that there were significant differences in the FIQ score between the three groups (p < .001). It was determined that the total PSQI score was significantly higher in the evening type than the other two types (p < .05). It was found that there were significant differences in the general health, physical health, psychological, and environmental domain scores of the WHOQOL-BREF between the three groups (p < .05). It was detected that there were significant correlations between MEQ scores, WHOQOL-BREF subscale scores, FIQ scores, HADS-A and HADS-D scores, and PSQI scores. According to hierarchical regression analysis, eveningness preference explained an additional 21.9% of the variation in FM severity, thereby causing a statistically significant change in R-squared. Our results indicated that eveningness preference was directly related to increased FM symptom severity and poorer QoL. Based on these findings, neglecting to take chronotype preference into account may not result in optimal response to standard treatment for some patients with FM.
Medical Science Monitor, 2020
Departmental sources Background: Fibromyalgia syndrome (FMS) is a rheumatic disease characterized by diffuse body pain and decreased muscle function. The aim of the present study was to compare the biological rhythms of patients with fibromyalgia syndrome with the biological rhythms of healthy controls. Material/Methods: This was a cross-sectional, single blind, and single center case-control study. The patients with fibromyalgia were evaluated using a Fibromyalgia Impact Questionnaire (FIQ), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) Scale, Visual Analog Scale (VAS), Pittsburg Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI). Results: The study included 77 female patients with FMS, and 32 healthy female individuals as the control group. We found that the patients in the FMS group achieved higher scores in VAS, BDI, PSQI, and the BRIAN scale than the patients in the control group (P<0.001). An evaluation of the relationship between FMS evaluation parameters and biological rhythm scores in patients with FMS revealed a significant positive correlation between total BRAIN and VAS, FIQ, BDI, and PSQI scores. When the relationship between FMS evaluation parameters and biological rhythm scores was evaluated in patients with FMS, a significant positive correlation was found between total BRAIN and VAS, FIQ, BDI, and PSQI scores (r=0.555, P<0.001; r=0.461, P<0.001; r=0.630, P<0.001; and r=0.551, P<0.001 respectively). Conclusions: We consider that an evaluation of the biological rhythm of female patients with FMS, and appropriate treatment when required, would contribute significantly to the treatment and follow-up process of the patients.
Fibromyalgia and nondipper circadian blood pressure variability
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2014
Aberrant circadian rhythm with persistent nocturnal sympathetic hyperactivity has pointed out malfunctioning autonomic nervous system in fibromyalgia (FM) patients. This is a common pathogenesis shared also by patients with nondipping blood pressure (BP) pattern. Therefore, we aimed to investigate the frequency of nondipping BP pattern in normotensive women with newly diagnosed FM compared with healthy women. Sixty-seven normotensive women with new diagnosis of FM and 38 age-matched healthy volunteer women were recruited into the study. All subjects underwent 24-hour ambulatory BP monitoring on a usual working day. Individuals were defined as "dippers" if their nocturnal BP values decreased by more than 10% compared with daytime values; defined as "nondippers" in case of a decline less than 10%. Serum creatinine, fasting blood glucose, cholesterol levels, albumin, and thyroid-stimulating hormone levels were assessed. Ambulatory measurements showed significantly h...
Catecholamines and heart rate in female fibromyalgia patients
Journal of Psychosomatic Research, 2012
Background: Fibromyalgia syndrome is a disease of unknown pathogenesis characterised by widespread chronic musculoskeletal pain. Fibromyalgia has been associated with dysregulation of the stress systems, but results are inconsistent. Purpose: To investigate autonomic nervous system activity (urinary noradrenaline, adrenaline, dopamine, and heart rate) of fibromyalgia patients and healthy controls. Methods: Urinary catecholamines and heart rate were assessed for a 24-hour period in a controlled hospital setting (including relaxation, a test with prolonged mental stress, and sleep), and during daily activity in 29 female fibromyalgia patients and 29 age-matched female healthy controls. Results: With repeated measures ANOVAs, catecholamine levels were lower in patients than controls (P = .035 for noradrenaline; P = .005 for adrenaline; P = .001 for dopamine). One-way ANOVAs for the single periods showed that patients compared to controls had significantly lower adrenaline levels during the night (P = .010) and the second day (P = .010), significantly lower dopamine levels during the first day (P = .008), the night (P = .001), and the second day (P = .004). However, single time point noradrenaline levels were not significantly different between the groups. Overall, heart rate was significantly higher in patients than controls (P = .014). Specifically, significant differences emerged during relaxation (P = .016) and sleep (P = .011), but not during stress provocation or daily activities.
Objective Measures of Disordered Sleep in Fibromyalgia
The Journal of Rheumatology, 2009
Objective.Patients with fibromyalgia syndrome (FM) complain of inadequate sleep, which could contribute to common symptoms including sleepiness, fatigue, or pain. However, measures that consistently and objectively distinguish FM patients remain elusive.Methods.Fifteen women with FM and 15 age- and gender-matched controls underwent 3 nights of polysomnography; Multiple Sleep Latency Tests to assess sleepiness; testing of auditory arousal thresholds during non-REM stage 2 and stage 4 sleep; overnight assessment of urinary free cortisol; and analysis of 24-hour heart rate variability.Results.On the second night of polysomnography, women with FM in comparison to controls showed more stage shifts (p = 0.04) but did not differ significantly on any other standard polysomnographic measure or on the Multiple Sleep Latency Tests. Alpha EEG power during deep non-REM sleep, alone or as a proportion of alpha power during remaining sleep stages, also failed to distinguish the groups, as did audi...
Journal of Basic and Clinical Physiology and Pharmacology, 2021
Objectives Fibromyalgia, a painful musculoskeletal disorder is associated with sleep disturbances as well as autonomic dysfunction. Pathophysiology of fibromyalgia is yet not clear and neuroanatomical proximity of sleep and autonomic centre prompts probable involvement of the two impacting the quality of life of fibromyalgia patients. Present study was done with the objective to explore the extent of sleep disturbances and/or autonomic dysfunction in fibromyalgia and asses their impact on quality of life of fibromyalgia patients. Method and materials Thirty consecutive fibromyalgia patients (diagnosed by ACR 2010) from out-patient department and 30 age-gender matched controls were enrolled after the ethical clearance. All participants were evaluated for: (1) sleep using Pittsburgh sleep quality index and medical outcomes study sleep scale-12 Revised, (2) Quality of life by 36 item short-form health survey-36v2TM and revised fibromyalgia impact questionnaire (only patients). Autonomi...