• Umut Varol, Edurne Úbeda-D'Ocasar, Margarita Cigarán-Méndez, José Luis Arias-Buría, César Fernández-de-Las-Peñas, Gallego-SendarrubiasGracia MaríaGMVALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Camilo Jose Cela University, Villanueva de la Cañada, Madrid, Spain.Department of Physiotherapy, Faculty of Health, Camilo José Cela University, V, and Juan Antonio Valera-Calero.
• VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Camilo Jose Cela University, Villanueva de la Cañada, Madrid, Spain.
• Pain Med. 2023 Mar 1; 24 (3): 275284275-284.

ObjectiveCurrent evidence suggests that fibromyalgia syndrome (FMS) involves complex underlying mechanisms. This study aimed to quantify the multivariate relationships between clinical, psychophysical, and psychological outcomes in women with FMS by using network analysis to understand the psychobiological mechanisms driving FMS and generating new research questions for improving treatment strategies.MethodsDemographic (age, height, weight), clinical (pain history, pain intensity at rest and during daily living activities), psychophysical (widespread pressure pain thresholds [PPT]), sensory-related (PainDETECT, S-LANSS, Central Sensitization Inventory [CSI]) and psychological (depressive and anxiety levels) variables were collected in 126 women with FMS. Network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network).ResultsThe network showed several local associations between psychophysical and clinical sensory-related variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs on the knee and tibialis anterior muscle (ρ: 0.33). PainDETECT was associated with LANSS (ρ: 0.45) and CSI (ρ: 0.24), whereas CSI was associated with HADS-A (ρ: 0.28). The most central variables were PPTs over the tibialis anterior (the highest Strength centrality) and CSI (the highest Closeness and Betweenness centrality).ConclusionOur findings support a model where clinical sensory-related, psychological, and psycho-physical variables are connected, albeit in separate clusters, reflecting a nociplastic condition with a relevant role of sensitization. Clinical implications of the findings, such as developing treatments targeting these mechanisms, are discussed.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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