ORIGINAL ARTICLE
The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue
Gustavo A. Reyes del Paso,
Ana M. Contreras-Merino,
Pablo de la Coba,
Stefan Duschek,
Corresponding Author
Gustavo A. Reyes del Paso
Department of Psychology, University of Jaén, Jaén, Spain
Correspondence
Gustavo A. Reyes del Paso, Department of Psychology, University of Jaén, Jaén 23071, Spain.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAna M. Contreras-Merino
Department of Psychology, University of Jaén, Jaén, Spain
Contribution: Investigation, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorPablo de la Coba
Department of Psychology, University of Jaén, Jaén, Spain
Contribution: Data curation, Methodology, Resources, Writing - review & editing
Search for more papers by this authorStefan Duschek
Institute of Psychology, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
Contribution: Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorGustavo A. Reyes del Paso,
Ana M. Contreras-Merino,
Pablo de la Coba,
Stefan Duschek,
Corresponding Author
Gustavo A. Reyes del Paso
Department of Psychology, University of Jaén, Jaén, Spain
Correspondence
Gustavo A. Reyes del Paso, Department of Psychology, University of Jaén, Jaén 23071, Spain.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAna M. Contreras-Merino
Department of Psychology, University of Jaén, Jaén, Spain
Contribution: Investigation, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorPablo de la Coba
Department of Psychology, University of Jaén, Jaén, Spain
Contribution: Data curation, Methodology, Resources, Writing - review & editing
Search for more papers by this authorStefan Duschek
Institute of Psychology, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
Contribution: Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorFunding information
This research was supported by a grant from the Spanish Ministry of Science, Innovation and Universities co-financed by FEDER funds (RTI2018-095830-B-I00/AEI/10.13039/501100011033) and a FPU pre-doctoral contract (ref: FPU2018-02611) from the Spanish Ministry of Education, Culture and Sport
Abstract
This study investigated the cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia using the spontaneous sequence method. Systolic blood pressure (SBP), interbeat interval (IBI), stroke volume (SV), pre-ejection period (PEP), and total peripheral resistance (TPR) were continuously recorded in 40 fibromyalgia patients and 30 healthy individuals during a cold pressor test and a mental arithmetic task. Sequences of covariation between SBP and IBI (cardiac branch), SV and PEP (myocardial branch), and TPR (vasomotor branch) were identified. Baroreflex sensitivity (BRS) was represented by the slope of the regression line between values in the sequences; baroreflex effectiveness (BEI) was indexed by the proportion of progressive SBP changes that elicited reflex responses. Patients exhibited lower BRS in the three branches, lower BEI in the cardiac and vasomotor branches, and reduced reactivity in cardiac BRS and BEI, SBP, IBI, SV, and PEP. Moreover, BRS and BEI were inversely related to clinical pain, cold pressor pain, depression, trait anxiety, sleep problems, and fatigue. Reduced function of the three baroreflex branches implies diminished resources for autonomic inotropic, chronotropic, and vascular regulation in fibromyalgia. Blunted stress reactivity indicates a limited capacity for autonomic cardiovascular adjustment to situational requirements. The associations of BRS and BEI with pain perception may reflect the antinociceptive effects arising from baroreceptor afferents, where reduced baroreflex function may contribute to the hyperalgesia characterizing fibromyalgia. The associations with affective impairments, sleep problems, and fatigue suggest that baroreflex dysfunctions are also involved in the secondary symptoms of the disorder.
CONFLICT OF INTEREST
The authors have declared no conflicts of interest for this article.
Supporting Information
| Filename | Description |
|---|---|
| psyp13800-sup-0001-FigS1.docxWord document, 218.1 KB | FIGURE S1 Scatterplot and regression lines in the fibromyalgia (left) and healthy (right) groups displaying the relationship between myocardial (m) baroreceptor reflex sensitivity (BRS) and mean SV and SV variability |
| psyp13800-sup-0002-Supinfo.docxWord document, 31.7 KB |
TABLE S1 Cardiovascular variables during the cold pressor test and the mental arithmetic task in FMS patients and healthy controls (mean ± SD) Supplementary Material |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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