Parasympathetic reactivity in fibromyalgia and temporomandibular disorder

Associations with sleep problems, symptom severity, and functional impairment

Tory A. Eisenlohr-Moul, Leslie J. Crofford, Thomas W. Howard, Juan Yepes, Charles R. Carlson, Reny De Leeuw

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Despite evidence of autonomic disturbances in chronic multisymptom illnesses such as temporomandibular disorder (TMD) and fibromyalgia, additional work is needed to characterize the role of parasympathetic reactivity in these disorders. Given the high levels of comorbidity with psychiatric disorders characterized by stronger parasympathetic decline than controls in safe contexts (leading to higher arousal), it was hypothesized that individuals with TMD and fibromyalgia would respond similarly. In this preliminary investigation, 43 women with TMD (n = 17), TMD + fibromyalgia (n = 11), or neither (controls; n = 15) completed a baseline assessment of respiratory sinus arrhythmia (a measure of parasympathetic activity) followed by ongoing parasympathetic assessment during a questionnaire period. As predicted, patients showed greater parasympathetic decline during psychosocial assessment, suggesting an autonomic stance that supports defensive rather than engagement behaviors. Individual differences in parasympathetic reduction during the questionnaire period were related to a variety of physical and psychosocial variables. Although this study has a number of key limitations, including a convenience sampling approach and small group sizes, if replicated in larger samples, the findings would have important implications for the treatment of patients with these disorders. Perspective Compared to controls, individuals with TMD or TMD and fibromyalgia demonstrated greater parasympathetic decline during psychosocial assessment, and individual differences in parasympathetic decline predicted negative patient outcomes. Such parasympathetic decline may demonstrate a tendency to readily perceive danger in safe environments.

Original languageEnglish (US)
Pages (from-to)247-257
Number of pages11
JournalJournal of Pain
Volume16
Issue number3
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Temporomandibular Joint Disorders
Fibromyalgia
Sleep
Individuality
Arousal
Psychiatry
Comorbidity
Chronic Disease

Keywords

  • Autonomic reactivity
  • chronic pain
  • fibromyalgia
  • polyvagal theory
  • respiratory sinus arrhythmia
  • temporomandibular disorder

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Parasympathetic reactivity in fibromyalgia and temporomandibular disorder : Associations with sleep problems, symptom severity, and functional impairment. / Eisenlohr-Moul, Tory A.; Crofford, Leslie J.; Howard, Thomas W.; Yepes, Juan; Carlson, Charles R.; De Leeuw, Reny.

In: Journal of Pain, Vol. 16, No. 3, 01.01.2015, p. 247-257.

Research output: Contribution to journalArticle

Eisenlohr-Moul, Tory A. ; Crofford, Leslie J. ; Howard, Thomas W. ; Yepes, Juan ; Carlson, Charles R. ; De Leeuw, Reny. / Parasympathetic reactivity in fibromyalgia and temporomandibular disorder : Associations with sleep problems, symptom severity, and functional impairment. In: Journal of Pain. 2015 ; Vol. 16, No. 3. pp. 247-257.
@article{6adf346e0e2b4ae38f8b90e77dec501d,
title = "Parasympathetic reactivity in fibromyalgia and temporomandibular disorder: Associations with sleep problems, symptom severity, and functional impairment",
abstract = "Despite evidence of autonomic disturbances in chronic multisymptom illnesses such as temporomandibular disorder (TMD) and fibromyalgia, additional work is needed to characterize the role of parasympathetic reactivity in these disorders. Given the high levels of comorbidity with psychiatric disorders characterized by stronger parasympathetic decline than controls in safe contexts (leading to higher arousal), it was hypothesized that individuals with TMD and fibromyalgia would respond similarly. In this preliminary investigation, 43 women with TMD (n = 17), TMD + fibromyalgia (n = 11), or neither (controls; n = 15) completed a baseline assessment of respiratory sinus arrhythmia (a measure of parasympathetic activity) followed by ongoing parasympathetic assessment during a questionnaire period. As predicted, patients showed greater parasympathetic decline during psychosocial assessment, suggesting an autonomic stance that supports defensive rather than engagement behaviors. Individual differences in parasympathetic reduction during the questionnaire period were related to a variety of physical and psychosocial variables. Although this study has a number of key limitations, including a convenience sampling approach and small group sizes, if replicated in larger samples, the findings would have important implications for the treatment of patients with these disorders. Perspective Compared to controls, individuals with TMD or TMD and fibromyalgia demonstrated greater parasympathetic decline during psychosocial assessment, and individual differences in parasympathetic decline predicted negative patient outcomes. Such parasympathetic decline may demonstrate a tendency to readily perceive danger in safe environments.",
keywords = "Autonomic reactivity, chronic pain, fibromyalgia, polyvagal theory, respiratory sinus arrhythmia, temporomandibular disorder",
author = "Eisenlohr-Moul, {Tory A.} and Crofford, {Leslie J.} and Howard, {Thomas W.} and Juan Yepes and Carlson, {Charles R.} and {De Leeuw}, Reny",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.jpain.2014.12.005",
language = "English (US)",
volume = "16",
pages = "247--257",
journal = "Journal of Pain",
issn = "1526-5900",
publisher = "Churchill Livingstone",
number = "3",

}

TY - JOUR

T1 - Parasympathetic reactivity in fibromyalgia and temporomandibular disorder

T2 - Associations with sleep problems, symptom severity, and functional impairment

AU - Eisenlohr-Moul, Tory A.

AU - Crofford, Leslie J.

AU - Howard, Thomas W.

AU - Yepes, Juan

AU - Carlson, Charles R.

AU - De Leeuw, Reny

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Despite evidence of autonomic disturbances in chronic multisymptom illnesses such as temporomandibular disorder (TMD) and fibromyalgia, additional work is needed to characterize the role of parasympathetic reactivity in these disorders. Given the high levels of comorbidity with psychiatric disorders characterized by stronger parasympathetic decline than controls in safe contexts (leading to higher arousal), it was hypothesized that individuals with TMD and fibromyalgia would respond similarly. In this preliminary investigation, 43 women with TMD (n = 17), TMD + fibromyalgia (n = 11), or neither (controls; n = 15) completed a baseline assessment of respiratory sinus arrhythmia (a measure of parasympathetic activity) followed by ongoing parasympathetic assessment during a questionnaire period. As predicted, patients showed greater parasympathetic decline during psychosocial assessment, suggesting an autonomic stance that supports defensive rather than engagement behaviors. Individual differences in parasympathetic reduction during the questionnaire period were related to a variety of physical and psychosocial variables. Although this study has a number of key limitations, including a convenience sampling approach and small group sizes, if replicated in larger samples, the findings would have important implications for the treatment of patients with these disorders. Perspective Compared to controls, individuals with TMD or TMD and fibromyalgia demonstrated greater parasympathetic decline during psychosocial assessment, and individual differences in parasympathetic decline predicted negative patient outcomes. Such parasympathetic decline may demonstrate a tendency to readily perceive danger in safe environments.

AB - Despite evidence of autonomic disturbances in chronic multisymptom illnesses such as temporomandibular disorder (TMD) and fibromyalgia, additional work is needed to characterize the role of parasympathetic reactivity in these disorders. Given the high levels of comorbidity with psychiatric disorders characterized by stronger parasympathetic decline than controls in safe contexts (leading to higher arousal), it was hypothesized that individuals with TMD and fibromyalgia would respond similarly. In this preliminary investigation, 43 women with TMD (n = 17), TMD + fibromyalgia (n = 11), or neither (controls; n = 15) completed a baseline assessment of respiratory sinus arrhythmia (a measure of parasympathetic activity) followed by ongoing parasympathetic assessment during a questionnaire period. As predicted, patients showed greater parasympathetic decline during psychosocial assessment, suggesting an autonomic stance that supports defensive rather than engagement behaviors. Individual differences in parasympathetic reduction during the questionnaire period were related to a variety of physical and psychosocial variables. Although this study has a number of key limitations, including a convenience sampling approach and small group sizes, if replicated in larger samples, the findings would have important implications for the treatment of patients with these disorders. Perspective Compared to controls, individuals with TMD or TMD and fibromyalgia demonstrated greater parasympathetic decline during psychosocial assessment, and individual differences in parasympathetic decline predicted negative patient outcomes. Such parasympathetic decline may demonstrate a tendency to readily perceive danger in safe environments.

KW - Autonomic reactivity

KW - chronic pain

KW - fibromyalgia

KW - polyvagal theory

KW - respiratory sinus arrhythmia

KW - temporomandibular disorder

UR - http://www.scopus.com/inward/record.url?scp=84924668064&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924668064&partnerID=8YFLogxK

U2 - 10.1016/j.jpain.2014.12.005

DO - 10.1016/j.jpain.2014.12.005

M3 - Article

VL - 16

SP - 247

EP - 257

JO - Journal of Pain

JF - Journal of Pain

SN - 1526-5900

IS - 3

ER -