Hierarchical Cluster Analysis Based on Clinical and Neuropsychological Symptoms Reveals Distinct Subgroups in Fibromyalgia : A Population-Based Cohort Study
Maurel, Sara (Universitat Autònoma de Barcelona. Departament de Medicina)
Gimenez-Llort, Lydia (Universitat Autònoma de Barcelona. Institut de Neurociències)
Alegre Martín, José (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Castro-Marrero, Jesús (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2023
Resum:	Fibromyalgia (FM) is a condition characterized by musculoskeletal pain and multiple comorbidities. Our study aimed to identify four clusters of FM patients according to their core clinical symptoms and neuropsychological comorbidities to identify possible therapeutic targets in the condition. We performed a population-based cohort study on 251 adult FM patients referred to primary care according to the 2010 ACR case criteria. Patients were aggregated in clusters by a K-medians hierarchical cluster analysis based on physical and emotional symptoms and neuropsychological variables. Four different clusters were identified in the FM population. Global cluster analysis reported a four-cluster profile (cluster 1: pain, fatigue, poorer sleep quality, stiffness, anxiety/depression and disability at work; cluster 2: injustice, catastrophizing, positive affect and negative affect; cluster 3: mindfulness and acceptance; and cluster 4: surrender). The second analysis on clinical symptoms revealed three distinct subgroups (cluster 1: fatigue, poorer sleep quality, stiffness and difficulties at work; cluster 2: pain; and cluster 3: anxiety and depression). The third analysis of neuropsychological variables provided two opposed subgroups (cluster 1: those with high scores in surrender, injustice, catastrophizing and negative affect, and cluster 2: those with high scores in acceptance, positive affect and mindfulness). These empirical results support models that assume an interaction between neurobiological, psychological and social factors beyond the classical biomedical model. A detailed assessment of such risk and protective factors is critical to differentiate FM subtypes, allowing for further identification of their specific needs and designing tailored personalized therapeutic interventions.
Ajuts:	Instituto de Salud Carlos III PI09/90301
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Chronic pain ; Fibromyalgia ; Cluster analysis ; Neuropsychological symptoms ; Fatigue ; Mindfulness
Publicat a:	Biomedicines, Vol. 11 N. 10 (october 2023) , art. 2867, ISSN 2227-9059

DOI: 10.3390/biomedicines11102867
PMID: 37893239

15 p, 1.1 MB

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