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- Ensaio Clínico NCT07640607
Investigation of Pain Modulation Phenotypes in Female Patients With Fibromyalgia
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Fibromyalgia is characterized by altered pain processing mechanisms, including impaired descending pain inhibition and central sensitization. Although both mechanisms have been independently associated with symptom severity and functional impairment, their interrelationship and relative contributions to disease impact are not fully understood.
This study aims to examine the associations between conditioned pain modulation, central sensitization symptoms, and fibromyalgia impact. In particular, the study evaluates whether central sensitization symptoms act as a mediator in the relationship between impaired pain modulation and clinical disease burden. Participants with fibromyalgia are assessed using standardized clinical and psychological measures, including the Fibromyalgia Impact Questionnaire, Central Sensitization Inventory, and Hospital Anxiety and Depression Scale. Quantitative sensory testing is performed to evaluate conditioned pain modulation, pressure pain threshold, and temporal summation.Statistical analyses are conducted to explore bivariate associations and to identify independent predictors of fibromyalgia impact. A mediation framework is applied to assess whether central sensitization symptoms explain the relationship between pain modulation and clinical outcomes.
Tipo de estudo
Inscrição (Estimado)
Contactos e Locais
Contato de estudo
- Nome: Feyza Nur Yücel, Assoc. Prof.
- Número de telefone: +90 (0216) 542 20 00
- E-mail: dr.fny28@gmail.com
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
Inclusion Criteria:
- Having received a diagnosis of fibromyalgia according to the 2016 ACR diagnostic criteria
- Female patients aged 18-65
- Being literate
- Having signed the informed consent form upon agreeing to participate in the study
Exclusion Criteria:
- Being under 18 or over 65 years of age
- Having any condition that may lower the pain threshold or cause chronic pain (Rheumatoid Arthritis, Ankylosing Spondylitis, systemic inflammatory diseases, malignancies, etc.)
- Any neurological condition (stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease, central nervous system malignancies…)
- Peripheral artery disease
- Severe cardiopulmonary insufficiency (stage 3-4)
- Uncontrolled systemic diseases such as hypertension and diabetes
- Presence of an active infection
- Pregnancy
- Presence of cognitive impairment, hearing loss, or communication difficulties that would prevent understanding of questionnaires and protocols
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
|---|---|
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Patient
Women with Fibromyalgia
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including PPT Measurement with an Algometer, CPM and the Slow-Repeated Stimulated Pain Assessment Protocol
Central Sensitization Inventory, Revised Fibromyalgia Impact Questionnaire, S-LANSS, Tampa Kinesiophobia Scale, Hospital Anxiety and Depression Scale, SF-12 Quality of Life Scale and Fatigue Severity Scale
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Conditioned Pain Modulation
Prazo: Baseline
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Objective determination of the pain modulation phenotype and the severity of central sensitization.
Scores above 100 are considered a normal CPM response; higher scores indicate greater pain inhibition.
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Baseline
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Pressure Pain Threshold
Prazo: Baseline
|
Lower values are associated with pain sensitization
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Baseline
|
|
Slowly Repeated Evoked Pain Assessment Protocol
Prazo: Baseline
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The SREP protocol consists of 9 painful stimuli above the pain threshold, each applied to the nail for 5 seconds at approximately 30-second intervals.
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Baseline
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Central Sensitization Inventory
Prazo: Baseline
|
It is preferred for investigating pain sensitivity through symptoms associated with CS and related comorbidities.
CS severity can be classified into 5 different groups based on the score obtained from Section A of the scale: scores of 0-21 indicate a subclinical level, 22-30 indicate a mild level, 31-37 indicate a moderate level, 38-51 indicate a severe level, and scores above 51 indicate a very severe level of CS .
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Baseline
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Revised Fibromyalgia Impact Questionnaire
Prazo: Baseline
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It consists of three sections-daily physical activities, general condition, and symptoms-and a total of 21 questions.
It assesses limitations and functional disability in patients with fibromyalgia.
All questions are rated on a 0-10-point Visual Analog Scale (VAS).
A higher total score indicates an increase in disability associated with fibromyalgia.
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Baseline
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Self-administered Leeds Assessment of Neuropathic Symptoms and Signs
Prazo: Baseline
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The Neuropathic Symptoms and Signs Questionnaire is a 7-item self-report questionnaire completed by the individual, scored on a scale of 0 to 24.
A score of 12 or higher indicates the likelihood of neuropathic pain .
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Baseline
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Tampa Kinesiophobia Scale
Prazo: Baseline
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A 17-item questionnaire developed to measure the fear of movement and re-injury .
The total score ranges from 17 to 68.
Higher scores are associated with an increase in kinesiophobia.
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Baseline
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Hospital Anxiety and Depression Scale
Prazo: Baseline
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It consists of a total of 14 items, with 7 items each for anxiety and depression.
Scores for the anxiety and depression subscales range from 0 to 21. Scores between 8 and 10 indicate moderate symptom presence, while a score greater than 11 indicates anxiety and depression symptoms that likely correspond to a clinical diagnosis.
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Baseline
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SF-12 Quality of Life Scale
Prazo: Baseline
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It was developed to assess health-related quality of life.
Two separate scores are obtained: the Physical Component Summary (PCS) and the Mental Component Summary (MCS).
The physical score reflects the individual's perception of overall health, physical limitations, and pain levels.
The mental score, on the other hand, reflects the individual's emotional problems, energy levels, and social activities.
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Baseline
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Fatigue Severity Scale
Prazo: Baseline
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This is a 9-item questionnaire in which each item is rated on a scale of 1 to 7; it assesses the severity, frequency, and impact of fatigue on daily life.
The total score ranges from 7 to 63.
As the score decreases, fatigue decreases.
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Baseline
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Colaboradores e Investigadores
Investigadores
- Investigador principal: Feyza Nur Yücel, Assoc. Prof., Saglik Bilimleri Universitesi
Publicações e links úteis
Publicações Gerais
- Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL, Mease PJ, Russell AS, Russell IJ, Walitt B. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016 Dec;46(3):319-329. doi: 10.1016/j.semarthrit.2016.08.012. Epub 2016 Aug 30.
- Yarnitsky D, Bouhassira D, Drewes AM, Fillingim RB, Granot M, Hansson P, Landau R, Marchand S, Matre D, Nilsen KB, Stubhaug A, Treede RD, Wilder-Smith OH. Recommendations on practice of conditioned pain modulation (CPM) testing. Eur J Pain. 2015 Jul;19(6):805-6. doi: 10.1002/ejp.605. Epub 2014 Oct 20.
- Maquet D, Croisier JL, Demoulin C, Crielaard JM. Pressure pain thresholds of tender point sites in patients with fibromyalgia and in healthy controls. Eur J Pain. 2004 Apr;8(2):111-7. doi: 10.1016/S1090-3801(03)00082-X.
- Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, Barton DL, St Sauver J. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013 May;65(5):786-92. doi: 10.1002/acr.21896.
- Siracusa R, Paola RD, Cuzzocrea S, Impellizzeri D. Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int J Mol Sci. 2021 Apr 9;22(8):3891. doi: 10.3390/ijms22083891.
- Nijs J, George SZ, Clauw DJ, Fernandez-de-Las-Penas C, Kosek E, Ickmans K, Fernandez-Carnero J, Polli A, Kapreli E, Huysmans E, Cuesta-Vargas AI, Mani R, Lundberg M, Leysen L, Rice D, Sterling M, Curatolo M. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. Lancet Rheumatol. 2021 May;3(5):e383-e392. doi: 10.1016/S2665-9913(21)00032-1. Epub 2021 Mar 30.
- Jurado-Priego LN, Cueto-Urena C, Ramirez-Exposito MJ, Martinez-Martos JM. Fibromyalgia: A Review of the Pathophysiological Mechanisms and Multidisciplinary Treatment Strategies. Biomedicines. 2024 Jul 11;12(7):1543. doi: 10.3390/biomedicines12071543.
- Ruschak I, Monteso-Curto P, Rossello L, Aguilar Martin C, Sanchez-Monteso L, Toussaint L. Fibromyalgia Syndrome Pain in Men and Women: A Scoping Review. Healthcare (Basel). 2023 Jan 11;11(2):223. doi: 10.3390/healthcare11020223.
- de la Coba P, Bruehl S, Del Paso GAR. Addition of Slowly Repeated Evoked Pain Responses to Clinical Symptoms Enhances Fibromyalgia Diagnostic Accuracy. Pain Med. 2020 Dec 25;21(12):3479-3487. doi: 10.1093/pm/pnz346.
Datas de registro do estudo
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Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
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Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
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Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças musculoesqueléticas
- Doenças do Sistema Nervoso
- Doenças Musculares
- Doenças Neuromusculares
- Doenças Reumáticas
- Fibromialgia
- Qualidade, acesso e avaliação da assistência médica
- Terapêutica
- Mecanismos de avaliação de saúde
- Qualidade de assistência médica
- Características do estudo epidemiológico
- Protocolos clínicos
Outros números de identificação do estudo
- 222222
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