Modulation of catastrophic thinking, pain and inflammation in fibromyalgia: From behavior to molecular biology.

Abstract

Fibromyalgia (FM) is a disease characterized by chronic pain (CP), stress, and cognitive alterations. Catastrophic thinking (CT) is mediated by cortisol, IL-6, and the serotonin receptor 5HT1A (5HT1A). The study’s objective was to identify whether the modification of CT affects these biological variables, comparing a cognitive behavioral intervention (CBI) and a psycho-physiological intervention (PPI) in women with FM. The duration of both inter-ventions was 11 weeks. It was a non-probabilistic, comparative, experimental, and clinical study. Forty-eight women of the Rheumatology Service of the General Hospital of Mexico participated. Health Assessment Questionnaire (HAQ-DI), Catastrophizing Scale for Fibromyalgia (PCS), and Perceived Stress Scale (PSS) were administered. The relative expression of IL-6 and serotonin receptor (5HT1A) genes were quantified by real-time PCR; likewise, IL-6 and cortisol levels were measured in serum. The ICC showed significant changes in perception of stress (p = 0.05), in PC in the rumination scales (p = 0.05), magnification (p = 0.01), hopelessness (p = 0.01), cortisol (p = 0.01) and IL-6 (p = 0.01). Pain scores (p = 0.01) improved in both groups. The IPF showed an increase in the relative expression of the gene that codes for the serotonin receptor 5HT1A (p = 0.05). IL-6 was found to be a predictor of rumination thinking in the ICC group. The results allow us to conclude that ICC had a greater impact on CP, stress, IL-6 and cortisol, compared to the PPI.