The impact of emotion-related autonomic nervous system responsiveness on pain sensitivity in female patients with fibromyalgia.
OBJECTIVE
Patients with fibromyalgia have shown hyporeactive autonomic nervous system (ANS) responses to physical stressors, augmented pain to ANS changes, and heightened negative emotions, which can increase pain. This study examined ANS reactivity to negative emotions and its association with pain in fibromyalgia and control participants.


METHODS
Sixty-two women with fibromyalgia and 59 women in a control group recalled neutral, and anger- and sadness-eliciting experiences while ANS activity was monitored. Clinical and experimental pain were assessed in response to each emotion.


RESULTS
Compared with neutral recall, heart rate (p = .050), mean arterial pressure (p < .001), and high-frequency heart rate variability (p = .012) increased in response to sadness, whereas heart rate decreased (p = .002) and mean arterial pressure increased (p < .001) in response to anger; however, ANS responses did not differ between patients and control participants (all p > .29). Among patients only, decreased preejection period (anger-pain threshold: r = 0.31, p = .018) and total peripheral resistance in response to negative emotions (anger-pain tolerance: r = 0.35, p = .025; sadness-pain threshold: r = 0.51, p < .001; sadness-pain tolerance: r = 0.61, p < .001) correlated with more pain.


CONCLUSIONS
These data suggest that the ANS is not hyporesponsive to elicited emotions in fibromyalgia; however, patients with a larger pain response showed an ANS response pattern reflecting heightened β-adrenergic and reduced α-adrenergic reactivity. Future research should test whether a specific ANS response pattern to emotions is a consequence of increased pain or whether it amplifies pain.
Department of Medical Psychology, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. H.vanMiddendorp@mps.umcn.nl.
Henriët
H
van Middendorp
Mark A
MA
Lumley
Jan H
JH
Houtveen
Johannes W G
JW
Jacobs
Johannes W J
JW
Bijlsma
Rinie
R
Geenen
D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D004644:Emotions / Q000502:physiology*; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology* / Q000523:psychology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology* / Q000523:psychology; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology; D014655:Vascular Resistance / Q000502:physiology; D055815:Young Adult
autonomic nervous system; cardiovascular responsiveness; emotions; fibromyalgia; pain; stress