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Auditory-evoked potentials as a tool for follow-up of fibromyalgia

Abstract

Aim of the study

In this study, we assessed the value of auditory-evoked potentials (AEPs) as objective measurable reproducible tests for the follow-up of patients with fibromyalgia (FM) in response to pharmacologic and rehabilitative therapy.

Patients and methods

This study included 30 female FM patients and 10 age-matched female controls. All participants underwent a clinical examination, a psychiatric and functional assessment (sleep score, Fibromyalgia Impact Questionnaire, and Hospital Anxiety and Depression Scale) and measurement of AEPs elicited by tones of increasing intensity (60, 70, 80, and 90 dB) known as late cortical responses and cognitive auditory potentials (P300). Patients were subdivided into three equal groups. Group 1 received pregabalin, group 2 received fluoxetine, and group 3 included patients who performed a graded aerobic exercise program. Assessment was repeated at the end of the 8-week treatment period.

Results

Patients had significantly shorter N1 latencies at 60 and 70 dB, significantly shorter P2 latencies at all the studied intensities, and significantly higher N1P2 amplitudes at 90 dB.There was a statistically significant decrease in amplitude and a significant increase in P300 latency when compared with controls. Changes in AEP values before and after treatment were closely associated with the changes in psychiatric and functional assessment parameters.

Conclusion

Improvement in the clinical assessment of the different symptoms of FM goes hand in hand with the improvement in the late cortical and cognitive components of AEPs, which provides evidence of the value of AEP as a simple, noninvasive, objective, and reproducible follow-up tool for assessment of hypervigilance and cognitive function in FM patients.

References

  1. Gauffin J, Hankama T, Kautiainen H, Hannonen P, Haanpää M Neuropathic pain and use of PainDETECT in patients with fibromyalgia: A cohort study. BMC Neurol 2013; 13:21.

    Article  Google Scholar 

  2. Maestu C, Cortes A, Vazquez JM, del Rio D, Gomez-Arguelles JM, delPozo F, Nevado A Increased brain responses during subjectively-matched mechanical pain stimulation in fibromyalgia patients as evidenced by MEG. Clin Neurophysiol 2013; 124:752–760.

    Article  Google Scholar 

  3. De Tommaso M, Federici A, Serpino C, Vecchio E, Franco G, Sardaro M, et al. Clinical features of headache patients with fibromyalgia comorbidity. J Headache Pain 2011; 12:629–638.

    Article  Google Scholar 

  4. González JL, Mercado F, Barjola P, Carretero I, López-López A, Bullones MA, et al. Generalized hypervigilance in fibromyalgia patients: An experimental analysis with the emotional Stroop paradigm. J Psychosom Res 2010; 69:279–287.

    Article  Google Scholar 

  5. Hollins M, Harper D, Maixner W Changes in pain from a repetitive thermal stimulus: The roles of adaptation and sensitization. Pain 2011; 152:1583–1590.

    Article  Google Scholar 

  6. Dadabhoy D, Crofford LJ, Spaeth M, Russell IJ, Clauw DJ Biology and therapy of fibromyalgia. Evidence-based biomarkers for fibromyalgia syndrome. Arthritis Res Ther 2008; 10:211.

    PubMed  Google Scholar 

  7. De Cosmo G, Aceto P, Clemente A, Congedo E Auditory evoked potentials. Minerva Anestesiol 2004; 70:293–297.

    PubMed  Google Scholar 

  8. Carrillo RR, Ros E, Barbour B, Boucheny C, Coenen O Event-driven simulation of neural population synchronization facilitated by electrical coupling. Biosystems 2007; 87:275–280.

    Article  Google Scholar 

  9. Polich, J Cognitive brain potentials Curr Dir Psychol Sci 1993; 2:175–262.

    Google Scholar 

  10. Vecchio F, Määttä S The use of auditory event-related potentials in Alzheimer’s disease diagnosis. Int J Alzheimer Dis 2011; 653173.

    Google Scholar 

  11. Hong JS, Lee JH, Yoon YH, Choi JH, Shin JE, Kim SM, Park YG The assessment of reliability of cognitive evoked potential in normal person. Ann Rehabil Med 2013; 37:263–268.

    Article  Google Scholar 

  12. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33:160–172.

    CAS  PubMed  Google Scholar 

  13. Lavin A, Grace AA 1998; Dopamine modulates the responsivity of mediodorsal thalamic cells recorded in vitro. J Neurosci 18:10566–10578.

  14. Jensen M, Karoly P In: Turk DC, Melzack R, editors. Self-report scales and procedures for assessing pain in adults. Handbook of pain assessment 1992; New York: The Guildford Press; 135–151.

  15. Zigmond AS, Snaith RP The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67:361–370.

    Article  CAS  Google Scholar 

  16. Busch A, Schachter CL, Peloso PM, Bombardier C Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2002; (3):CD003786.

  17. Jones KD, Burckhardt CS, Clark SR, Bennett RM, Potempa KM. A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia. J Rheumatol 2002; 29:1041–1048.

    PubMed  Google Scholar 

  18. Clauw DJ, Arnold LM, McCarberg BH The science of fibromyalgia. Mayo Clin Proc 2011; 86:907–911.

    Article  Google Scholar 

  19. Wentz KA, Lindberg C, Hallberg LR Psychological functioning in women with fibromyalgia: A grounded theory study. Health Care Women Int 2004; 25:702–729.

    Article  Google Scholar 

  20. Lerma C, Martinez A, Ruiz N, Vargas A, Infante O, Martinez-Lavin M Nocturnal heart rate variability parameters as potential fibromyalgia biomarker: Correlation with symptoms severity. Arthritis Res Ther 2011; 13:R185.

    Article  Google Scholar 

  21. Giaquinto S Evoked potentials in rehabilitation. A review. Funct Neurol 2004; 19:219–225.

    PubMed  Google Scholar 

  22. Carrillo-de-la-Peña MT, Vallet M, Pérez Ml, Gómez-Perretta C Intensity dependence of auditory-evoked cortical potentials in fibromyalgia patients: A test of the generalized hypervigilance hypothesis. J Pain 2006; 7:480–487.

    Article  Google Scholar 

  23. Hollins M, Harper D, Gallagher S, Owings EW, Lim PF, Miller V, et al. Perceived intensity and unpleasantness of cutaneous and auditory stimuli: An evaluation of the generalized hypervigilance hypothesis. Pain 2009; 141:215–221.

    Article  Google Scholar 

  24. Staud R New evidence for central sensitization in patients with fibromyalgia Curr Rheumatol Rep 2004; 6:259.

  25. Polich J, Herbst KL P300 as a clinical assay: Rationale, evaluation, and findings. Int J Psychophysiol 2000; 38:3–19.

    Article  CAS  Google Scholar 

  26. Ozgocmen S, Yoldas T, Kamanli A, Yildizhan H, Yigiter R, Ardicoglu O Auditory P300 event related potentials and serotonin reuptake inhibitor treatment in patients with fibromyalgia. Ann Rheum Dis 2003; 62:551–555.

    Article  CAS  Google Scholar 

  27. Park DC, Glass JM, Minear M, Crofford LJ Cognitive function in fibromyalgia patients. Arthritis Rheum 2001; 44:2125–2133.

    Article  CAS  Google Scholar 

  28. Hauser WX, Frank Petzke Y, C Sommer Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. J Pain 2010; 11:505–521.

    Article  Google Scholar 

  29. Siler AC, Gardner H, Yanit K, Cushman T, McDonagh M Systematic review of the comparative effectiveness of antiepileptic drugs for fibromyalgia. J Pain 2011; 12:407–415.

    Article  CAS  Google Scholar 

  30. Kim SH, Lee Y, Lee S, Mun CW Evaluation of the effectiveness of pregabalin in alleviating pain associated with fibromyalgia: Using functional magnetic resonance imaging study. PLoS One 2013; 8:e74099.

    Article  CAS  Google Scholar 

  31. Crofford LJ The relationship of fibromyalgia to neuropathic pain syndromes. J Rheumatol Suppl 2005; 75:41–45.

    PubMed  Google Scholar 

  32. Mease PJ, Dundon K, Sarzi-Puttini P Pharmacotherapy of fibromyalgia. Best Pract Res Clin Rheumatol 2011; 25:285–297.

    Article  CAS  Google Scholar 

  33. Uçeyler N, Offenbächer M, Petzke F, Häuser W, Sommer C New treatment options for fibromyalgia: Critical appraisal of duloxetine. Neuropsychiatr Dis Treat 2008; 4:525–529.

    PubMed  PubMed Central  Google Scholar 

  34. Wilcke ST, Clauw DJ Pharmacotherapy in fibromyalgia (FM) — implications for the underlying pathophysiology. Pharmacol Ther 2010; 127:283–294.

    Article  Google Scholar 

  35. Staud R Treatment of fibromyalgia and its symptoms. Expert Opin Pharmacother 2007; 8:1629–1642.

    Article  CAS  Google Scholar 

  36. Hauser W, Thieme K, Turk DC Guidelines on the management of fibromyalgia syndrome — a systematic review. Eur J Pain 2010; 14:5–10.

    Article  Google Scholar 

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Correspondence to Dina S. Al-Zifzaf.

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Abdel-Kader, A.A., Kamel, N.S., EI-Ganzouri, A.M. et al. Auditory-evoked potentials as a tool for follow-up of fibromyalgia. Egypt Rheumatol Rehabil 40, 224–233 (2013). https://doi.org/10.4103/1110-161X.123810

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