Inflammatory Markers, Impulsivity and Aggression in Fibromyalgia Patients

Öz

Background: Psychosomatic mechanisms are recognized to play a role in fibromyalgia (FMS), particularly in its manifestation of chronic pain. This study aimed to explore the association between hematological and biochemical test results and levels of impulsivity and aggression in patients with FMS. Materials and Methods: The study comprised 146 women, including 73 healthy controls and 73 patients diagnosed with FMS. Hematological and biochemical test results were analyzed, and participants were assessed using Fibromyalgia Impact Questionnaire (FIQ), the Buss-Perry Aggression Questionnaire (BPAQ), and the Barratt Impulsiveness Scale-Short Form (BIS-11-SF). Results: The BIS-11-SF scale score for the FMS group was 58.67 ± 16.83, compared to 48.07 ± 15.43 for the control group (p < 0.001). Similarly, the BAQ score was significantly higher in the FMS group (71.95 ± 18.45) than in the control group (55.91 ± 16.86, p < 0.001). Moreover, a significant negative correlation was found between BMI and SII, SIRI, and NLR (p = 0.003, p = 0.038, and p = 0.001, respectively). Conclusion: Women with fibromyalgia are more impulsive and aggressive than the normal population. According to the results of our study, the parameters obtained from complete blood count cannot predict the levels of impulsivity and aggression.

Anahtar Kelimeler

• Fibromyalgia
• inflammatory markers
• impulsivity
• aggression

Fibromiyalji Hastalarında İnflamatuvar Belirteçler, Dürtüsellik ve Saldırganlık

Öz

Amaç: Psikosomatik kökenli mekanizmaların kronik ağrı ile seyreden fibromiyalji (FMS) hastalığında görev aldığı bilinmektedir. Biz bu hasta grubunda hemogram ve biyokimya tetkikleri ile dürtüsellik ve saldırganlık arasındaki ilişkiyi incelemeyi amaçladık. Materyal ve Metod: Çalışmaya 73 sağlıklı kontrol grubu ve 73 FMS tanılı hasta olmak üzere 146 kadın dahil edildi. Hemogram ve biyokimya tetkik sonuçları değerlendirilen bu kişilere ayrıca Fibromiyalji Etki Anketi (FEA), Buss-Perry Saldırganlık Ölçeği (BAQ), Barratt Dürtüsellik Ölçeği Kısa Form (BIS-11-SF) ölçekleri uygulandı. Bulgular: Vaka grubunun BIS-11-SF ölçek puanı 58,67±16,83 iken kontrol grubunun ölçek puanı 48,07±15,43 olarak saptandı (p<0,001). Benzer şekilde vaka grubunun BAQ puanı 71,95±18,45 iken kontrol grubunun ölçek puanı 55,91±16,86 olarak saptandı (p<0,001). BKI ile SII, SIRI ve NLR arasında negatif yönde anlamlı ilişki olduğu saptandı (0,003, 0,038, 0,001) Sonuç:Fibromiyalji tanılı kadınlar normal popülasyona göre daha dürtüsel ve daha saldırgandır. Çalışmamızın sonuçlarına göre tam kan sayımından elde edilen parametreler dürtüsellik ve saldırganlık düzeylerini yordayamamaktadır.

Anahtar Kelimeler

• Fibromiyalji
• inflamatuvar belirteçler
• dürtüsellik
• saldırganlık

Kaynakça

1. 1. Kleykamp BA, Ferguson MC, McNicol E, Bixho I, Arnold LM, Edwards RR, et al. The Prevalence of Psychiatric and Chronic Pain Comorbidities in Fibromyalgia: an ACTTION systematic review. Semin Arthritis Rheum. 2021;51:166–174.
2. 2. Kocyigit B.F., Akyol A. Fibromyalgia syndrome: Epidemiology, diagnosis and treatment. Reumatologia. 2022;60:413–421.
3. 3. De Tommaso M., Vecchio E., Nolano M. The puzzle of fibrom-yalgia between central sensitization syndrome and small fiber neuropathy: a narrative review on neurophysiological and morphological evidence. Neurol. Sci. 2022;43:1667–1684.
4. 4. Ramanathan S, Panksepp J, Johnson B. Is fibromyalgia an endocrine/ endorphin deficit disorder? Is low dose naltrex-one a new treatment option?. Psychosomatics. 2012;53:591-594
5. 5. Bains A, Kohrman S, Punko D, Fricchione G. A Link Between Inflammatory Mechanisms and Fibromyalgia. Adv Exp Med Bi-ol. 2023;1411:357-378.
6. 6. Alciati A, Cirillo M, Masala IF, Sarzi-Puttini P, Atzeni F. Differ-ences in depression, anxiety and stress disorders between fi-bromyalgia associated with rheumatoid arthritis and primary fibromyalgia. Stress Health. 2021;37:255–262.
7. 7. Sariyildiz A, Benlidayi IC, Ornek C, Basaran S. Value of Diverse Hematological Markers in Fibromyalgia: A Real-World Study. J Clin Pract Res. 2024;46(4):370–376.
8. 8. Ertekin B, Yortanlı M, Özelbaykal O, Doğru A, Girişgin AS, Acar T. The Relationship between Routine Blood Parameters and the Prognosis of COVID-19 Patients in the Emergency De-partment. Emerg Med Int. 2021;2021:7489675.

9. 9. Smith TL, Weyrich AS. Platelets as central mediators of sys-temic inflammatory responses. Thromb Res. 2011;127:391–4.
10. 10. Cakcak İE, Türkyılmaz Z, Demirel T. Relationship between SIRI, SII values, and Alvarado score with complications of acute ap-pendicitis during the COVID-19 pandemic. Ulus Travma Acil Cerrahi Dergisi. 2022;28(6):751-755.
11. 11. Zinellu A, Collu C, Nasser M, Paliogiannis P, Mellino S, Zinellu E, et al. The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibro-sis. J Clin Med. 2021;10(18):4134.
12. 12. Samanci R, Ataoglu S, Ozsahin M, Ankarali H, Admis O. An investigation of serum irisin levels and inflammatory markers in fibromyalgia syndrome. North Clin Istanb. 2019;6(4):341-347.
13. 13. Akturk S, Buyukavci R. Evaluation of blood neutrophil-lymphocyte ratio and platelet distribution width as inflamma-tory markers in patients with fibromyalgia. Clin Rheumatol. 2017;36(8):1885–1889.
14. 14. Al-Nimer MSM, Mohammad TAM. Correlation of hematologi-cal indices and ratios derived from them with FIQR scores in fibromyalgia. Pak J Med Sci. 2018;34(5):1219–1224.
15. 15. Pomares FB, Funck T, Feier NA, Roy S, Daigle-Martel A, Ceko M. et al. Histological Underpinnings of Grey Matter Changes in Fibromyalgia Investigated Using Multimodal Brain Imaging. J. Neurosci. 2017;37:1090–1101.
16. 16. González B, Novo R, Peres R. Personality and psychopathology heterogeneity in MMPI-2 and health-related features in fi-bromyalgia patients. Scand. J. Psychol. 2021;62:203–210.
17. 17. Borchers AT, Gershwin ME. Fibromyalgia: A Critical and Com-prehensive Review. Clin. Rev. Allergy Immunol. 2015;49:100–151.
18. 18. Gálvez-Sánchez CM, Duschek S, Reyes del Paso GA. Psycholog-ical impact of fibromyalgia: current perspectives. Psychol. Res. Behav. Manag. 2019;12:117–127.
19. 19. Galvez-Sánchez CM, Reyes Del Paso GA, Duschek S, Montoro CI. The Link between Fibromyalgia Syndrome and Anger: A Systematic Review Revealing Research Gaps. Journal of clini-cal medicine. 2022;11(3):844.
20. 20. Ho MY, Mobini S, Chiang TJ, Bradshaw CM, Szabadi E. Theory and method in the quantitative analysis of “impulsive choice” behaviour: implications for psychopharmacology. Psycho-pharmacology (Berl). 1999;146(4):362- 72.
21. 21. Sarısoy G, Atmaca A, Ecemiş G, Gümüş K, Pazvantoğlu O. [Impulsivity in patients with obesity and correlations with body perception and self-esteem]. Anadolu Psikiyatri Dergisi. 2013;14(1):53-61.
22. 22. Seo D, Patrick CJ, Kennealy PJ. Role of serotonin and dopa-mine system interactions in the neurobiology of impulsive aggression and its comorbidity with other clinical disorders. Aggression and Violent Behavior. 2008;13:383-395.
23. 23. Montoro CI, Reyes del Paso GA. Personality and fibromyalgia: relationships with clinical, emotional, and functional varia-bles. Pers Individ Dif. 2015;85:236–244.
24. 24. Shelley-Tremblay J, Ernst A, Kline JP. The effects of sucrose consumption on left-frontal asymmetry and anger in persons with Fibromyalgia Syndrome. J. Musculoskelet. Pain 2009;17:334–349.
25. 25. Baykara S, Berk E. Relationship Between Severity of Fibrom-yalgia and Impulsivity. Turkiye Klinikleri J Health Sci. 2018;3(3):208-13.
26. 26. Paroli M, Gioia C, Accapezzato D, Caccavale R. Inflammation, Autoimmunity, and Infection in Fibromyalgia: A Narrative Review. International Journal of Molecular Sciences. 2024; 25(11):5922.
27. 27. Schweiger V, Martini A, Nizzero M, Bonora E, Del Balzo G, Gottin L, et al. Prevalence of FMS Diagnosis According to ACR 2016 Revised Criteria in a Pain Therapy Centre in Italy: Ob-servational Study. Medicina (Kaunas). 2024;60(4):599.
28. 28. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991;18(5):728-3.
29. 29. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995;51:768-74.
30. 30. Buss, A. and Perry, M. The agression questionnaire. Journal of Personality and Social Psychology. 1992; 63(3):452-4.
31. 31. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000;20(1):9-12
32. 32. Güleç H, Tamam L, Güleç MY, Turhan M, Karakuş G, Zengin M, et al. [Psychometricproperties of the Turkish version of the Barratt Impulsiveness Scale-11]. Bulletin of Clin Psychophar-macol. 2008;18(4):251-8.
33. 33. Madran, H. A. D. Buss-Perry saldırganlık ölçeği’nin Türkçe formunun geçerlik ve güvenirlik çalışması. Türk Psikoloji Dergisi. 2012;24(2):1-6.
34. 34. Zinellu A, Collu C, Nasser M, Paliogiannis P, Mellino S, Zinellu E, et al. The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibro-sis. J Clin Med. 2021;10(18):4134.
35. 35. González-Álvarez ME, Riquelme-Aguado V, González-Pérez Á, Murillo-Llergo R, Manjón-Olmedillas M, Turroni S, et al. Asso-ciation Between Systemic Neuroinflammation, Pain Percep-tion and Clinical Status in Fibromyalgia Patients: Cross-Sectional Study. Cells. 2024; 13(20):1719.
36. 36. Pickard L, Noël J, Henley JM, Collingridge GL, Molnar E. De-velopmental Changes in Synaptic AMPA and NMDA Receptor Distribution and AMPA Receptor Subunit Composition in Liv-ing Hippocampal Neurons. J. Neurosci. Off. J. Soc. Neuro-sci. 2000;20: 7922–7931.
37. 37. Behm FG, Gavin IM, Karpenko O, Lindgren V, Gaitonde S, Gashkoff, PA, et al. Unique Immunologic Patterns in Fibrom-yalgia. BMC Clin. Pathol. 2012;12:25.
38. 38. Salemi S, Rethage J, Wollina U, Michel BA, Gay RE, Gay S, et al. Detection of interleukin 1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha in skin of patients with fibromyalgia. J Rheumatol. 2003;30(1):146-50.
39. 39. Xiao Y, Haynes WL, Michalek JE, Russell IJ. Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syn-drome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate. Rheumatol Int. 2013;33:1259–64.
40. 40. Seto A, Han X, Price LL, Harvey WF, Bannuru RR, Wang C. The role of personality in patients with fibromyalgia. Clin Rheu-matol. 2019;38(1):149-157.
41. 41. Bucourt E, Martaillé V, Mulleman D, Goupille P, Joncker-Vannier I, Huttenberger B, et al. Comparison of the big five personality traits in fibromyalgia and other rheumatic diseas-es. Joint Bone Spine. 2017;84(2):203-7.
42. 42. Margari F, Lorusso M, Matera E, Pastore A, Zagaria G, Bruno F, et al. Aggression, impulsivity, and suicide risk in benign chronic pain patients-a cross-sectional study. Neuropsychiatr Dis Treat. 2014;10:1613-20.
43. 43. Yıldız S, Kazğan A, Tabara M, Atmaca M. The Relationship Between Impulsivity Level and Neutrophil / Lymphocyte Ra-tio, Platelet/ Lymphocyte Ratio and Mean Platelet Volume in Individuals Diagnosed with Gambling Disorder. Med Records. 2021;3(3):177-183.