Clinical and experimental rheumatology最新文献

{"title":"Vagal nerve stimulation and fibromyalgia: an additional therapeutic option.","authors":"Giulio Dolcini, Martina Favretti, Daniele Franculli, Giorgia Buoncuore, Greta Pellegrino, Marco Di Carlo, Piercarlo Sarzi-Puttini, Fabrizio Conti, Cristina Iannuccelli, Manuela Di Franco","doi":"10.55563/clinexprheumatol/johqvo","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/johqvo","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is a chronic syndrome characterised by widespread pain, sleep, mood and cognitive disturbances, asthenia and muscle stiffness. The aetiopathogenesis of FM is not fully understood, but autonomic nervous system dysfunction could play a fundamental role in the development of chronic pain and could alter serum levels of neuro-inflammatory mediators like Brain Derived Neurotrophic Factor (BDNF). Transcutaneous vagus nerve stimulation (tVNS) is a non-invasive bioelectronic technique that increases parasympathetic nervous system activity and there is growing evidence that it can modulate nociception and improve mood and sleep quality. The aim of this pilot study was to evaluate the efficacy of auricular vagal neuromodulation therapy (AVNT™) in reducing disease severity and improving sleep quality of FM patients; secondly, to evaluate fluctuations in serum BDNF levels after treatment.</p><p><strong>Methods: </strong>Eighteen patients with FM, underwent AVNT™ treatment consisting of 30-minute stimulation, 5 times a week, for 4 consecutive weeks.</p><p><strong>Results: </strong>After two weeks of treatment, an early reduction in the WPI score (p=0.03) was detected, then confirmed at week 4 (p=0.004). At week 4, significant reduction either in the revised Fibromyalgia Impact Questionnaire (rFIQ) total score (p=0.02), rFIQ general health (p=0.002) and symptoms (p<0.001) components and the Pittsburgh Sleep Quality Index (PSQI) level (p=0.02) was also detected. No significant changes in BDNF levels were found either after two or four weeks of treatment.</p><p><strong>Conclusions: </strong>In conclusion, our preliminary results show that the treatment with AVNT™ reduced disease severity and improved sleep quality in FM patients.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"43 6","pages":"1095-1104"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of different exercises in women with fibromyalgia syndrome: a randomised controlled trial.","authors":"Ömer Şevgin, Burak Buğday, Rabia Aydoğan Baykara, Gizem Günendi, Burcu Akkurt, Hilal Atasoy, Beyzanur Dikmen Hoşbaş, Mustafa Ferit Akkurt, Berna Karamancıoğlu","doi":"10.55563/clinexprheumatol/uol8so","DOIUrl":"10.55563/clinexprheumatol/uol8so","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate the impact of aerobic exercise, resistance exercise combined with aerobic exercise, and yoga exercises combined with aerobic exercise on pain and disease activity in patients with fibromyalgia syndrome (FM).</p><p><strong>Methods: </strong>The study population comprised 60 individuals with FM who met the inclusion criteria. The participants were randomly assigned to one of three groups. The first group underwent aerobic exercise (n=20), the second group combined aerobic exercise with yoga (n=20), and the third group engaged in aerobic and resistance exercise (n=20). All exercise interventions were conducted for a total of 12 weeks. Disease activity was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), while pain status was assessed with the Melzack-Melzack Pain Questionnaire (MMPQ). All assessments were conducted before and following the completion of the exercise program. The clinical trial number of this study is NCT06006494.</p><p><strong>Results: </strong>The measurements of the aerobic exercise and yoga group were significantly lower than those of the aerobic and resistance exercise group. A statistically significant difference was observed between the groups in terms of post-treatment MMPQ scores. The measurements of the aerobic exercise and yoga group were significantly lower than those of the aerobic exercise only and aerobic and resistance exercise groups. No statistically significant difference was observed between the post-treatment MMPQ scores of the aerobic and aerobic resistance exercise groups.</p><p><strong>Conclusions: </strong>The combination of aerobic exercise and yoga is more efficacious in the treatment of FM than aerobic exercise alone or a combination of resistance exercises and aerobic exercise.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1010-1018"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Baduanjin Qigong and transcranial direct current stimulation on quality of sleep and disease impact in elderly patients with fibromyalgia: a randomised, sham-controlled study.","authors":"Heiresh Saeed Ali, Razieh Khanmohammadi, Elahe Arabameri, Ina Shaw, Brandon S Shaw","doi":"10.55563/clinexprheumatol/4e5i45","DOIUrl":"10.55563/clinexprheumatol/4e5i45","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this randomised double-blinded controlled trial was to investigate the effect of Baduanjin Qigong (BQG) and transcranial direct current stimulation (tDCS) on quality of sleep and disease impact in elderly patients with fibromyalgia (FM).</p><p><strong>Methods: </strong>A randomised, double-blind, clinical trial conducted, involving 68 elderly female and male patients with FM were selected through convenience sampling, and randomly assigned into one of four intervention groups: (1) BQG combined with the tDCS group (BQGT) (n=17); (2) BQG combined with the sham tDCS group (BQGS) (n=17); (3) walking combined with tDCS (WAT) (n=17); and (4) walking combined with sham tDCS (WAS) (n=17). All participants were assessed at baseline and 12 weeks post-test for disease impact and sleep quality using the Revised FM Impact Questionnaire (FIQR) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Data were analysed using Multivariate Analysis of Variance (MANOVA).</p><p><strong>Results: </strong>Sleep quality was significantly associated with individual interventions (F(21, 167) =2.88, p<0.05, Wilk's Λ=0.411, partial η²=0.257). FIQ scores also showed significant associations (F(3, 64) =4.47, p< 0.05, Wilk's Λ=0.210, partial η²=0.173). Treatments significantly affected FIQR (F(3) =3.901, p<0.05, partial η²=0.155), FIQR symptoms (F(3) =4.458, p<0.05, partial η² =0.173), PSQI total (F(3) =6.044, p<0.05, partial η² =0.221), sleep disturbances (F(3) =10.314, p<0.05, partial η²=0.326), and sleep dysfunction (F(3) =11.487, p<0.05, partial η²=0.350). Significant differences were found between WAT and WAS for FIQR (p=0.016), and between BQGT and WAS (p=0.049), and WAT and WAS (p=0.009) for FIQR symptoms. PSQI total showed significant differences between BQGT and BQGS (p=0.030), BQGT and WAT (p=0.039), and BQGT and WAS (p=0.000). Significant differences in sleep disturbances were observed between BQGT and BQGS (p=0.000), BQGT and WAT (p=0.001), and BQGT and WAS (p=0.000). Further differences were found between BQGT and WAS (p=0.000), BQGS and WAS (p=0.004), and WAT and WAS (p=0.000).</p><p><strong>Conclusions: </strong>This study shows that physical activity interventions, and especially BQG, significantly improve sleep quality and disease symptoms, with notable effects on PSQI scores and FIQR, especially when combined with tDCS across different groups. These findings highlight the importance of combining interventions into holistic brain-body treatments for managing FM effectively.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1040-1048"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web search trends on fibromyalgia: development of a machine learning model.","authors":"Matteo Luigi G Leoni, Marco Mercieri, Antonella Paladini, Marco Cascella, Martina Rekatsina, Fabiola Atzeni, Alberto Pasqualucci, Laura Bazzichi, Fausto Salaffi, Piercarlo Sarzi-Puttini, Giustino Varrassi","doi":"10.55563/clinexprheumatol/05r0ib","DOIUrl":"10.55563/clinexprheumatol/05r0ib","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is a chronic pain condition characterised by widespread musculoskeletal pain, fatigue, and cognitive dysfunction. The growing reliance on the internet for health-related information has transformed how individuals seek medical knowledge, particularly for complex conditions like FM. This study aimed to analyse online search behaviours related to FM across multiple countries, identify temporal trends, and assess machine learning models for predicting search interest.</p><p><strong>Methods: </strong>Google Trends data (2020-2024) were analysed across sixteen countries. Time-series analysis, linear regression, and the Mann-Kendall trend test assessed monotonic trends, while seasonal decomposition identified periodic fluctuations. An Auto-Regressive Integrated Moving Average (ARIMA) model forecasted search volumes for 2025. Machine learning models, including Random Forest (RF) and Extreme Gradient Boosting (XGBoost), were used to predict search trends, with feature importance evaluated using SHAP (Shapley Additive Explanations) values.</p><p><strong>Results: </strong>Search interest in FM varied across countries, with China, the UK, the USA and Canada showing the highest engagement, while Peru, Spain and Turkey had the lowest. Brazil, Italy and the UK exhibited rising search trends, whereas Argentina, Canada, Greece and the USA showed declines. Seasonal analysis revealed mid-year peaks in Brazil and Italy, while Turkey saw late autumn increases. ARIMA forecasting predicted stable or increasing trends in Brazil, Canada and Mexico, while Germany and Venezuela showed slight declines. Machine learning analysis identified short-term search history (search volumes from the previous day, week, and month) as the most influential predictor.</p><p><strong>Conclusions: </strong>Understanding online search behaviour can enhance FM education. Targeted awareness campaigns and improved digital health literacy initiatives could sustain engagement and improve patient knowledge. Future efforts should focus on optimising online health resources and integrating evidence-based decision aids.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1082-1094"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hidden burden of fibromyalgia: exploring work impairment and quality of life in caregivers.","authors":"Demet Ferahman, Ömer Faruk Bucak, Soner Arik, Tuğba Şahbaz","doi":"10.55563/clinexprheumatol/obdrlt","DOIUrl":"10.55563/clinexprheumatol/obdrlt","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) syndrome is a chronic musculoskeletal disorder that profoundly impacts not only patients but also their informal caregivers, affecting their quality of life and work productivity. This study aims to investigate the impact of FM on the work productivity and quality of life of informal caregivers.</p><p><strong>Methods: </strong>This cross-sectional study included FM patients who applied to our Physical Medicine and Rehabilitation clinic and their informal caregivers. FM was diagnosed using the revised 2016 American College of Rheumatology (ACR) criteria. A healthy control group and their cohabiting relatives were also included. FM patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), while caregivers and control group relatives completed the Work Productivity and Activity Impairment Questionnaire-General Health (WPAI-GH) and the World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF).</p><p><strong>Results: </strong>The study included 68 FM caregivers and 68 control group relatives. WPAI scores revealed significant differences in presenteeism, overall work productivity loss, and activity impairment between FM caregivers and controls (p<0.05), though no difference in absenteeism was observed. WHOQoL-BREF scores showed significant reductions across all quality-of-life domains for FM caregivers compared to controls, with a notable correlation between the FIQR scores of FM patients and the social relationships domain of their caregivers (p=0.026, r=-0.269).</p><p><strong>Conclusions: </strong>FM poses substantial burdens on both patients and their informal caregivers, reducing caregivers' work productivity and quality of life. Given the chronic nature of FM and the resulting long-term caregiving responsibilities, interventions that support both patients and caregivers, such as integrated healthcare and psychotherapy, may be beneficial. Further longitudinal studies are needed to examine these effects over time and support the development of comprehensive caregiver support strategies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1027-1034"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between nocturnal heart rate variability parameters and circulating neuropeptides in patients suffering from fibromyalgia.","authors":"María Carmen Navarro-Gonzalez, Claudia Lerma, Felipe-Israel López-Trejo, Evelyn Aranda-Cano, Alfonso Salgado-Aguayo, Daniel Paz-Gómez, María Isabel Barrera-Villalpando, Luis H Silveira, Violeta Higuera-Ortiz, Angélica Vargas-Guerrero, Manuel Martínez-Lavín, Laura Aline Martinez-Martinez","doi":"10.55563/clinexprheumatol/rfy9hb","DOIUrl":"10.55563/clinexprheumatol/rfy9hb","url":null,"abstract":"<p><strong>Objectives: </strong>A consistent line of investigation proposes fibromyalgia (FM) as a stress-evoked, sympathetically maintained neuropathic pain syndrome. The purpose of this study was to measure dysautonomia-associated neuropeptide serum levels in women suffering from FM and to correlate these levels with heart rate variability parameters and disease severity.</p><p><strong>Methods: </strong>We studied 23 women suffering from FM without comorbid conditions and 15 age and body mass index-matched healthy women. At the time of the study, all participants were free from medications that could affect the autonomic nervous system. Time-domain parameters were extracted from nocturnal (00.00 to 06.00 hours) heart rate variability Holter recordings. The following 7 neuropeptide levels were measured via the 7-Plex Human Neuropeptide Magnetic Kit Milliplex MAP: alpha-melanocyte-stimulating hormone, beta-endorphin, cortisol, neurotensin, orexin, oxytocin and substance P.</p><p><strong>Results: </strong>The serum levels of beta-endorphin (669.24±186.28 vs. 541.71±146.26 pg/ml, p=0.028) and neurotensin (156.23±58.15 vs. 116.64±47.93 pg/ml, p=0.016) were significantly greater in patients with FM. Both neuropeptides were negatively correlated with the nocturnal heart rate R-R interval standard deviation (Rho=-0.52 p=0.025 and Rho=-0.6, p=0.003) and with the FIQR \"tenderness to touch\" (Rho -0.49 and Rho -0.41, p<0.05).</p><p><strong>Conclusions: </strong>The serum levels of beta-endorphin and neurotensin in women suffering from FM correlate with nocturnal heart rate variability parameters, revealing sympathetic hyperactivity. The unexpectedly increased circulating levels of these two analgesic neuropeptides in the FM group can be interpreted as a homeostatic attempt by the central nervous system to ease peripherally generated pain.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1035-1039"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower circulating IGF-1 levels in fibromyalgia: meta-analysis highlighting potential pathogenic role.","authors":"Young Ho Lee, Gwan Gyu Song","doi":"10.55563/clinexprheumatol/g17lb8","DOIUrl":"10.55563/clinexprheumatol/g17lb8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between circulating insulin-like growth factor (IGF-1) levels and fibromyalgia (FM).</p><p><strong>Methods: </strong>Meta-analyses were performed to compare serum/plasma IGF-1 levels in patients with FM and healthy controls and in patients with FM according to subgroups based on region, sample size, data type, publication year, and matched variables (age, sex, and/or BMI).</p><p><strong>Results: </strong>Twelve studies from eleven reports including 512 patients with FM and 308 controls were selected. IGF-1 levels were not found to be decreased in the FM group (standardised mean differences (SMD) =-0.347, 95% confidence interval [CI]: -0.747 to 0.053, p=0.089. However, sensitivity analysis showed that results of one study significantly affected the pooled SMD (SMD =-0.458, 95% CI: -0.822 to -0.093, p=0.014), indicating that the results of this meta-analysis were unstable. Additionally, the SMD changed to be significant after adjusting for publication bias (SMD =-0.513, 95% CI: -0.924 to -0.102). Stratification according to data type showed a significantly lower IGF-1 level in the FM group with original data (SMD =-0.458, 95% CI: -0.857 to -0.060, p=0.024). Stratification by publication year revealed a significantly lower IGF-1 level in the FM group by recent year (year >2012) (SMD =-0.679, 95% CI: -1.066 to -0.293, p=0.001).</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrated that IGF-1 levels were significantly lower in patients with FM, suggesting that IGF-1 might play an important role in the pathogenesis of FM.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1122-1127"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best practice recommendations for clinical psychological interventions in patients with fibromyalgia.","authors":"Federica Galli, Filippo Maria Nimbi, Alessia Renzi, Marco Cavicchioli, Carlo Lai, Annalisa Tanzilli, Cristina Iannuccelli, Manuela Di Franco, Martina Mesce, Alessandro Torelli, Alessandra Alciati, Lorys Castelli, Piercarlo Sarzi-Puttini","doi":"10.55563/clinexprheumatol/4arpi4","DOIUrl":"10.55563/clinexprheumatol/4arpi4","url":null,"abstract":"<p><strong>Objectives: </strong>The role of psychological aspects in the overall care of fibromyalgia (FM) is extremely relevant. Nevertheless, there is a lack of practical guidelines for rheumatologists for supporting effective referral to clinical psychology specialists together with the implementation of psychological practices in the treatment of FM.</p><p><strong>Methods: </strong>The current work reviews the core psychological and psychopathological features highlighted by FM patients together with the best psychological interventions for treating FM.</p><p><strong>Results: </strong>General recommendations are provided concerning key aspects of psychological assessment and related treatment choices taking into account individual characteristics of each patient.</p><p><strong>Conclusions: </strong>The current work suggests a practical checklist for clinicians reporting the main key points for supporting an adequate referral to clinical psychologists.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1112-1121"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediterranean diet and its low-antigenic and anti-inflammatory properties on fibromyalgia: a systematic review.","authors":"Emily E Miller, Swathy Jayakrishnan, Francesca Froio, Douaa Ahmed, Hamza Haq, Sofia Schnurer, Maria Vittoria Messina, Bruno Barillà, Asia Saturnino, Marta Vomero, Annalisa Marino, Luca Navarini, Roberto Giacomelli, Evika Karamagioli, Paolo Pozzilli, Daniel E Zoughbie","doi":"10.55563/clinexprheumatol/2usk4p","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/2usk4p","url":null,"abstract":"<p><strong>Objectives: </strong>The Mediterranean diet is known for its antioxidant, anti-inflammatory, and low-antigen properties. The rationale is that this diet can modulate fibromyalgia (FM) symptoms for patients, but it has not been reviewed focusing on its low-antigen and anti-inflammatory properties. The objective of this review is to understand whether these properties of the Mediterranean diet can potentially alleviate symptoms of FM.</p><p><strong>Methods: </strong>This study was conducted using the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Two electronic databases- PubMed and Google Scholar, were searched for interventional, observational, therapeutic, and clinical trial articles published between 2019 and 2024. Key search words included: 'Fibromyalgia' 'Mediterranean Diet' 'Low-Antigen Diet' 'Anti-inflammatory Diet' 'Omega3' and 'Vitamin D'.</p><p><strong>Results: </strong>Of 88 records screened in the title/abstract stage, 5 interventional, 5 observational, 0 therapeutic, and 0 clinical trial articles were included in the systematic review. The sample sizes in interventional studies varied between 13 and 84 and for observational studies varied between 84 and 442. Evidence suggests that adherence to a Mediterranean diet is associated with significant improvements in FM-related symptoms, including chronic widespread pain, autonomic dysfunction, persistent fatigue, sleep disturbances, and cognitive impairments such as 'fibro fog'.</p><p><strong>Conclusions: </strong>The articles studied within this review show that there is a relationship between the gut and how FM symptoms can be affected. They suggest that placing patients with early symptoms of FM on a Mediterranean diet may have a low to moderate effect on manifestation, especially before medications are introduced.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"43 6","pages":"970-977"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Thumb Rule - an approach to optimise musculoskeletal ultrasound scanning in Rheumatology.","authors":"Emilio Filippucci, Lene Terslev, Søren T Torp-Pedersen, Edoardo Cipolletta","doi":"10.55563/clinexprheumatol/dpq2qm","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/dpq2qm","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}