Fibromyalgia and facial expression

Eye contact and eye gaze behaviors within communication contexts are considered vital to clear linguistic transmission. Although much research has been done on eye contact and gaze behaviors, surprisingly little literature exists in this area concerning deaf populations. Due to linguistic necessity, certain factors influencing gaze behaviors during communication will differ between hearing and deaf groups. The present article explains a sequential model of eye gaze and eye contact behaviors (Patterson, 1982) developed and researched among hearing populations and explores possible similarities and differences in these behaviors in deaf people. It is found that characterizations of eye contact and eye gaze behaviors applied to hearing populations are not completely applicable to deaf groups. Empirical research is needed to validate the ideas presented here, and future research directions are indicated.

THU0615-HPR FORCE-TIME CURVE ANALYSIS OF HANDGRIP STRENGTH IN PATIENTS WITH FIBROMYALGIA: COMPARISON WITH HEALTHY SUBJECTS

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 higher diastolic BP values in patients with FM for both average of 24-hour recordings. Patients with FM had significantly lower systolic (9.1 ± 3.9 vs 11.5 ± 4.9, P = 0.010) and diastolic dipping ratios (12.3 ± 6.1 vs 16.1 ± 6.4, P = 0.004). The number of nondippers in the FM group was significantly higher than that of controls for both systolic (66% vs 34%, P = 0.002) and diastolic BP measurements (42% vs 21%, P=0.031). Patients with FM were 3.68 times more likely to be systolic nondipper and 2.69 times more likely to be diastolic nondipper. We have demonstrated a significant relationship between FM and nondipping BP pattern, and we suggest that nondipping profile, which has been closely associated with cardiovascular morbidity, may appear as an additional risk factor in patients with FM.

Immersive virtual reality (IVR) can induce an experience of “social presence” which can, in turn, increase social influence. Non-verbal behavior such as eye contact is an important component of human communication and, therefore, an important factor in creating social presence. This paper presents an experimental study that elaborates social influence through conformity with a group of virtual agents within an immersive virtual environment (IVE). Specifically, it investigates the impact of the agents’ gaze behavior on social presence and influence. An experiment based on the Asch (1951) paradigm using two levels of agents’ gaze behavior (Eye Contact condition vs. No-Eye Contact condition) was conducted. The results showed that participants conformed with the agents as they gave significantly more incorrect responses to the trials that the agents also gave an incorrect response, compared to those trials that the agents gave correct answers. However, no impact of the agents’ gaze behavior on conformity was observed, even if the participants in the Eye Contact condition reported a higher sense of social presence. In addition, self-reported measures showed a number of social effects that occurred only in the eye contact condition, indicating that the agents’ gaze behavior has an impact on participants’ experience.

Sex Hormones and Pain in Regularly Menstruating Women With Fibromyalgia Syndrome

Objective: To compare the heart rate variability (HRV) before and after a sub-maximal exercise test in women with fibromyalgia (FM) and to compare the result to matched controls. Additionally, to compare heart rate (HR) before, during and after the sub-maximal exercise test. Methods: Twenty-four women with FM and 26 controls performed a sub-maximal exercise test. HRV was registered for 5 minutes at rest before and after the exercise test. HR was registered at baseline, during the exercise test and at recovery. Results: The HRV of the healthy group was statistically different from the exercise test but the women with FM showed no such difference. HR was significantly higher among the women with FM than in the healthy group at baseline and up to 75W but lower at peak (138/152 bpm, p<0.008). In women with FM HR during exercise (HR2) was predicted by heart rate recovery (HRR20) and physical exertion (RPE2). HRR20 and RPE2 accounted for 0.465 of the variance (p=0.006) in HR2. In healthy women HR2 correlated with HRR20 and negatively with physical activity (PhA). In the reference group HRR20 and PhA accounted for 0.448 (p=0.002) of the variance HR. Conclusion:The HRV in women with FM show less adjustment of the ANS while not being significantly affected by submaximal exercise as healthy women. In healthy women heart rate during the test was negatively related to PhA. In women with FM exertion seems to replace an effect from exercise on physiological adaptation. FM may entail imperceptible extraction of power from PhA while under load. Links to FM pain will be discussed. Women with FM seem to rate exertion “Very hard” on lower workload and HR than healthy women. The physiotherapeutic methodology for measuring HRV with basic HR monitors should be improved before it can be recommended for clinical use.

Background: The present study aims at analyzing the nonverbal affective behavior of female fibromyalgia (FM) inpatients in comparison to healthy women. Methods: Videotaped psychodynamic interviews of each of 15 female FM inpatients and healthy women were analyzed. Afterwards the analyses of facial expression were related to gazing behavior and emotional experience. Results: FM patients exhibited neither a reduction in total activity of facial expression nor in absolute frequency of primary affects in comparison to healthy women, who, however, (also in eye contact) also exhibited a significantly higher proportion of ‘genuine joy’ and a lower one of ‘contempt’. No congruence between the patient’s emotional experience and affective expression was found. Conclusions: The absence of reduced total activity of facial expression is in contrast to the elaborate descriptions of complaints provided by the patients. Nevertheless, our detailed analysis shows a lack of elements that stabilize the relationship and the presence of dissociating elements in the interactions.

Fibromyalgia (FM) is characterized by generalized chronic pain and reduced pain thresholds. Disturbed neuroendocrine function and impairment of growth hormone/insulin-like growth factor-1 is common. However, the pathophysiology of FM is not clear. MicroRNAs are important regulatory factors reflecting interface of genes and environment. Our aim was to identify characteristic microRNAs in FM and relations of specific microRNAs with characteristic symptoms. A total of 374 circulating microRNAs were measured in women with FM (n = 20; median 52.5 years) and healthy women (n = 20; 52.5 years) by quantitative PCR. Pain thresholds were examined by algometry. Pain [fibromyalgia impact questionnaire (FIQ) pain] levels were rated (0-100 mm) using FIQ. Fatigue (FIQ fatigue) was rated (0-100 mm) using FIQ and multidimensional fatigue inventory general fatigue. Sleep quantity and quality (1-4) rated from satisfactory to nonsatisfactory. Higher scores indicate more severe symptoms. Eight microRNAs differed significantly between FM and healthy women. Seven microRNAs, miR-103a-3p, miR-107, let-7a-5p, miR-30b-5p, miR-151a-5p, miR-142-3p and miR-374b-5p, were lower in FM. However, levels of miR-320a were higher in FM. MiR-103a-3p correlated with pain (r = 0.530, p = 0.016) and sleep quantity (r = 0.593, p = 0.006) in FM. MiR-320a correlated inversely with pain (r = -0.468, p = 0.037). MiR-374b-5p correlated inversely with pain threshold (r = -0.612, p = 0.004). MiR-30b-5p correlated with sleep quantity (r = 0.509, p = 0.022), and let-7a-5p was associated with sleep symptoms. When adjusted for body mass index, the correlation of sleep quantity with miR-103a and miR-30b was no longer significant. To our knowledge, this is the first study of circulating microRNAs in FM. Levels of several microRNAs differed significantly in FM compared to healthy women. Three microRNAs were associated with pain or pain threshold in FM.

ObjectivesThis study aims to evaluate the coexistence of metabolic syndrome (MetS) and fibromyalgia syndrome (FMS) and determine the effects of this coexistence on neuroendocrine levels and clinical features of FMS.Patients and methodsOne-hundred female FMS patients (mean age 40.1±7.8 years; range, 24 to 58 years) and 38 healthy females (mean age 40.4±5.8 years; range, 30 to 55 years) were included in this cross-sectional study. MetS was identified by using the criteria from the Adult Treatment Panel III. Widespread pain index, symptom severity score and number of tender points were determined. Visual analog scale, Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Beck Depression Inventory, and pain pressure threshold were used as the outcome measures. The severity of FMS was assessed with total myalgic score (TMS) and control point score.ResultsTwenty-four (24%) of the 100 FMS patients and three (7.9%) of the 38 control patients fulfilled the MetS criteria (p=0.047). The coexistence of FMS and MetS was associated with higher symptom severity score (p=0.004), widespread pain index (p=0.001), number of tender points (p=0.039), and lower total myalgic score (p=0.029) values. There was a significant association between the occurrence of FMS and MetS (odds ratio=3.76; 95% confidence interval: 1.04-13.4; p=0.043).ConclusionWe found that patients with FMS had a nearly four times higher risk for MetS and the coexisting MetS may increase the severity of FMS. In clinical practice, when evaluating a patient with FMS, metabolic characteristics should also be evaluated.

This study aims to assess the relationship between fibromyalgia syndrome (FMS) and vitiligo in Iraqi patients and evaluate the predictors of this relationship, if present. The case-control study included 100 Iraqi patients (46 males, 54 females; mean age 30.4±14 years; range 15 to 65 years) with vitiligo and 200 age- and sex-matched healthy controls (74 males, 126 females; mean age 30.3±9.4 years; range 15 to 62 years). Baseline characteristics of patients and controls were recorded. The 2012 Canadian Guidelines criteria were used for the diagnosis of FMS and applied to all patients and controls. Prevalence of FMS in vitiligo patients and controls was 12% and 7%, respectively (p=0.15, odds ratio=1.8, 95% confidence interval=0.8-4.08). FMS symptoms in vitiligo patients were fatigue (46%), diffuse body pain (34%), sleep disturbance (33%), cognitive dysfunction (30%), and mood disorders (23%), while visceral involvements were central nervous system (52%), skin (35%), gastrointestinal tract (32%), cardiovascular system- respiratory system (16%), genitourinary tract (8%), and ear nose throat (7%). Of vitiligo patients, FMS was significantly more common among females (22.2%) compared to none among males (0%) (p<0.05). Prevalence of FMS was restricted to female sex only and a significantly higher prevalence rate of FMS was found among female vitiligo patients (22.2%) compared to controls (9.5%). Receiving phototherapy significantly increased the risk of having FMS by 5 times compared to female patients not receiving phototherapy. Use of any steroid reduced the risk of having FMS by 2.5 times (inverse of odds ratio=0.4) among females patients (p>0/05). No significant association was found between FMS in vitiligo patients and age, disease duration, type of vitiligo, use of any immunosuppressant and body mass index (p>0.05). Fibromyalgia syndrome was more prevalent in vitiligo patients compared to controls, which was clinically important but statistically not significant. There was a significant association between FMS in vitiligo patients and female sex, severe form of vitiligo, and receiving phototherapy. This may suggest that early diagnosis of FMS in vitiligo patients may help in early treatment and subsequently improve patients' quality of life.

The aim of the current study was to investigate fine motor control ability and manual dexterity women with fibromyalgia syndrome (FMS) without symptoms in the upper extremity compared to healthy women. Subtests of the Purdue Pegboard Test (one-hand, bilateral and assembly) and of the Jebsen-Taylor hand-function test (writing, turning cards, picking up small, light and large heavy objects, simulated feeding and stacking checkers) were evaluated bilaterally in 20 women with FMS (aged 35-55years) without symptoms in the upper limb and 20 age- and hand dominance-matched healthy women. Differences between sides and groups were analysed with several analysis of variance (ANOVA). The ANOVA revealed significant differences between groups (P<0.001) and sides (P=0.007) for one-hand pin placement subtest: women with FMS showed bilateral worse scores than controls. Patients also exhibited significantly lower scores in bilateral pin placement and assembly subtests when compared to healthy controls (P<0.001). The ANOVA also revealed significant differences between groups for writing, turning over cards, picking up small objects, stacking checkers, picking up large light objects and picking up large heavy objects (all, P<0.001): women with FMS needed more time for these subtests than healthy women with both hands. No difference for simulated feeding was found between groups. Our findings revealed bilateral deficits in fine motor control ability and manual dexterity in patients with FMS without symptoms in the upper extremity. These deficits are not related to the clinical features of the symptoms supporting an underlying central mechanism of altered motor control.

AB0948 Proinflammatory Cytokine and OX-LDL Levels in Fibromyalgia Patients

Fibromyalgia syndrome (FMS) is a rheumatic disorder that has been observed to affect self-perception of sexuality. The study aims to assess sexual dysfunction (SD), establish possible associations with SD levels, and evaluate the impact of physical activity (PA) levels on SD in Spanish women with FMS as compared with healthy control women. The study was cross-sectional. A total of 170 women voluntarily agreed to participate between September 2019 and February 2020: 88 in the FMS group and 82 in the control group. The main outcome measures were SD, as assessed through the Female Sexual Function Index (FSFI), and PA levels, as assessed with a structured interview. There were significant differences in every domain and total SD score between the FMS and control groups (P < .05). In addition, we obtained a moderate significant direct association (χ2[1] = 37.071, P < .05, phi = 0.467) when exploring the associations between FMS and risk of SD. Results showed statistically significant differences between the FMS group and the control group when PA levels were not reached in the desire, pain, and total scores of the FSFI (P < .05). When the PA levels were reached, between-group differences were found in all domains, as well as in the total score of the FSFI (P < .05). Sexual function should be evaluated in women with FMS, while future treatments should address this clinical area with the aim of managing SD in this population. The main limitation is that the outcome measures were self-reported. We found a high prevalence of SD in Spanish women with FMS, with an impact on aspects such as desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. In addition, there is a moderate direct association between FMS and SD. Ultimately, the results showed that, irrespective of PA, women with FMS reported increased SD.

Fibromyalgia syndrome (FMS) is a chronically painful condition whose symptoms are widely reported to be exacerbated by stress. We hypothesized that female patients with FMS differ from pain-free female controls in their sympathetic responses, a fact that may unmask important biomarkers and factors that contribute to the etiology of FMS. In a pilot study, blood pressure (BP), skin temperature, thermogenic activity, circulating glucose, and pain sensitivity of 13 individuals with FMS and 11 controls at room temperature (24°C) were compared with that after exposure to cold (19°C). When measured at 24°C, BP, skin temperature, blood glucose, and brown adipose tissue (BAT) activity, measured using F-fluorodeoxyglucose positron-emission tomography/computed tomography, did not differ between controls and individuals with FMS. However, after cold exposure (19°C), BP and BAT activity increased in controls but not in individuals with FMS; skin temperature on the calf and arm decreased in controls more than in individiuals with FMS; and circulating glucose was lower in individiuals with FMS than in controls. Pain sensitivity did not change during the testing interval in response to cold. The convergence of the effect of cold on 4 relatively simple measures of thermogenic, cardiovascular, and metabolic activity, each regulated by sympathetic activity, strongly indicate that individuals with FMS have impaired sympathetic responses to stress that are observable and highly significant even when measured in extraordinarily small sample populations. If insufficient sympathetic responses to stress are linked to FMS, stress may unmask and maximize these potential clinical biomarkers of FMS and be related to its etiology.

Executive Function and Decision-Making in Women with Fibromyalgia