Background:
Fibromyalgia is caused by various elements, such as hereditary, physical, and psychological, along with social influences. Alterations to the neurological system, including in the brain's circuitry and cognitive-emotional regions, are associated with chronic pain. According to the neurovisceral integration paradigm, there is a complicated interaction between visceral structures and autonomic dysfunction.
Aim:
This study aims to assess autonomic reactivity in both healthy controls and fibromyalgia patients.
Methods:
Out of 60 individuals, 30 were classified as having fibromyalgia by the medicine department, while 30 were healthy controls. Each subject underwent and recorded cardiovascular reflex tests, such as the Valsalva maneuver, deep breathing examinations (DBT), handgrip examinations, cold pressor tests, and lying-to-stand tests (LST). SPSS edition 21 was used for the statistical analysis. The unpaired t-test was applied to parameters with normal distributions.
Results:
Patients with fibromyalgia showed a significant decrease in their delta HR during DBT (13.11 ± 1.19 versus 15.26 ± 1.34, p < 0.001) as compared to the controlled group. The expiration:inspiration (E:I) ratio during DBT in fibromyalgia patients was significantly decreased (1.19 ± 0.21 versus 1.30 ± 0.49, p < 0.001) as compared to the controlled group, and the Valsalva ratio in fibromyalgia patients was also substantially reduced (1.17 ± 0.65 versus 1.48 ± 0.78, p < 0.001) as compared to the controlled group. The fibromyalgia patients exhibited a significant fall in the systolic blood pressure during LST (11.93 ± 4.84 versus 3.89 ± 2.12, p < 0.001) as compared to the control group. The 30:15 ratio during LST in fibromyalgia patients was significantly reduced (1.13 ± 0.22 versus 1.24 ± 0.37, p < 0.001) in comparison to the healthy control group. The rise in heart rate during LST was substantially greater in patients with fibromyalgia (13.32 ± 5.28 versus 8.34 ± 3.71, p < 0.001) compared to the control group. The cold pressor test was significantly decreased in fibromyalgia patients (9.29 ± 4.01 versus 15.92 ± 5.64, p < 0.001) when compared to the control group. The handgrip test findings were statistically insignificant.
Conclusion:
Revealing autonomic dysfunction, the parasympathetic tone was lower as well as sympathetic impairment was observed in fibromyalgia patients as compared to the healthy control group. Future studies should concentrate on ANS dysfunction as a biomarker for early warning signals for drug intake and fibromyalgia treatment.
Key words: Autonomic dysfunction, Fibromyalgia, Cardiovascular autonomic reactivity, Sympathetic tone, Parasympathetic tone
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