Cognitive–behavioral therapy attenuates nociceptive responding in patients with fibromyalgia: A pilot study
Abstract
Objective To explore the possibility that cognitive-behavioral therapy (CBT) influences fibromyalgia symptoms via descending inhibition of nociception, we evaluated the effects of CBT on the nociceptive flexion reflex (NFR) threshold, an objective measure of spinal nociceptive transmission. Methods Female fibromyalgia patients (n = 32) were randomized to 6 weekly sessions of telephone-delivered CBT or usual care (UC). Assessments of the NFR threshold and clinical outcomes were conducted at baseline, week 6 (post-CBT), and week 12. Results From baseline to week 6, the NFR threshold increased in the CBT group and decreased in the UC group (mean +/- SD 4.4 +/- 13.7 mA versus -10.2 +/- 9.9 mA; P = 0.005). This difference was also apparent at week 12 (mean +/- SD 7.3 +/- 9.2 mA for CBT versus -5.4 +/- 13.5 mA for UC; P = 0.01). The groups reported similar reductions in NFR pain ratings at week 6 (mean +/- SD -20.2 +/- 23.9 for CBT versus -14.9 +/- 16.4 for UC; P = 0.8) and week 12 (mean +/- SD -8.9 +/- 25.3 for CBT versus -10.8 +/- 24.1 for UC; P = 0.4). Conclusion Compared with UC, CBT reduced nociceptive responding in fibromyalgia patients. Moreover, while the UC group exhibited longitudinal decreases in both the stimulation level and pain associated with the NFR threshold, those receiving CBT required more intense stimulation to elicit the NFR as well as rated that stimulation as less painful than at baseline. These data indicate the need for a larger study to confirm that chan…
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All studies used live face-to-face contact except one delivered by telephone.
“All studies were conducted by live face-toface contact except one study which was delivered by telephone (voice-to-voice) (Ang et al., 2010).”
From Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials (2018) · cites this paper as Ang et al., 2010
Only one study had total treatment time below 5 h and seven had more than 25 h.
“Only one study had a total treatment time <5 h (Ang et al., 2010) and seven studies had a treatment time of >25 h (Wigers et al., 1996;Soares and Grossi, 2002;Thieme et al., 2003;Thieme et al., 2006;Falcao et al., 2008;Castel et al., 2012;Karlsson et al., 2015).”
From Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials (2018) · cites this paper as Ang et al., 2010
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References 35 · Cited by 66
- Authors
- Ang, D. C., Chakr, R., Mazzuca, S., France, C. R., Steiner, J., & Stump, T.
- Affiliations
- Indiana University Indianapolis (US)
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2010-04-29
- Volume
- 62
- Issue
- 5
- Pages
- 618-623
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- OpenAlex
- W1976787256
- Cited by
- 66
- References
- 35
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 5 · 2016: 1 · 2015: 3 · 2014: 6 · 2013: 5 · 2012: 8
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- cognitive behavioral therapy, fibromyalgia, nociception, descending inhibition, nociceptive flexion reflex, spinal nociceptive transmission, telephone-delivered therapy, pain intensity
- MeSH terms
- Adult, Female, Fibromyalgia, Humans, Middle Aged, Pain, Pain Measurement, Pilot Projects, Cognitive Behavioral Therapy, Treatment Outcome, Pain Threshold, Statistics, Nonparametric, Pain Management
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