RESEARCH ARTICLE
Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization a11111
Raffaele Costantini1*, Giannapia Affaitati2, Francesca Massimini3, Claudio Tana4, Paolo Innocenti1, Maria Adele Giamberardino2 1 Institute of Surgical Pathology, “G. D’Annunzio” University of Chieti, Chieti, Italy, 2 Fibromyalgia and Musculoskeletal Pain Center, Department of Medicine and Science of Aging and Ce.S.I., “G. D’Annunzio” University of Chieti, Chieti, Italy, 3 Institute of Clinical Pathology, “G. D’Annunzio” University of Chieti, Chieti, Italy, 4 Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Reggio Emilia, Italy * [email protected]
OPEN ACCESS Citation: Costantini R, Affaitati G, Massimini F, Tana C, Innocenti P, Giamberardino MA (2016) Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization. PLoS ONE 11(4): e0153408. doi:10.1371/journal.pone.0153408 Editor: Theodore John Price, University of Texas at Dallas, UNITED STATES Received: December 18, 2015 Accepted: March 29, 2016 Published: April 15, 2016 Copyright: © 2016 Costantini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data are provided in the manuscript; raw data are provided as supplementary files. Funding: The authors received no specific funding for this work. Competing Interests: The authors have declared that no competing interests exist. Abbreviations: aGb, asymptomatic gallbladder calculosis; AUs, abdominal ultrasounds; Cholec, cholecystectomy; EPTs, electrical pain thresholds;
Abstract Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1week, 1,3,6 and 12months after laparoscopic cholecystectomy in fibromyalgia patients with symptomatic calculosis (n = 31) vs calculosis patients without fibromyalgia (n. 26) and at comparable time points in fibromyalgia patients not undergoing cholecystectomy, with symptomatic (n = 27) and asymptomatic (n = 28) calculosis, and no calculosis (n = 30). At basis, fibromyalgia+symptomatic calculosis patients presented a significant linear correlation between the number of previously experienced biliary colics and fibromyalgia pain (direct) and muscle thresholds (inverse) (p
Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization a11111
Raffaele Costantini1*, Giannapia Affaitati2, Francesca Massimini3, Claudio Tana4, Paolo Innocenti1, Maria Adele Giamberardino2 1 Institute of Surgical Pathology, “G. D’Annunzio” University of Chieti, Chieti, Italy, 2 Fibromyalgia and Musculoskeletal Pain Center, Department of Medicine and Science of Aging and Ce.S.I., “G. D’Annunzio” University of Chieti, Chieti, Italy, 3 Institute of Clinical Pathology, “G. D’Annunzio” University of Chieti, Chieti, Italy, 4 Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Reggio Emilia, Italy * [email protected]
OPEN ACCESS Citation: Costantini R, Affaitati G, Massimini F, Tana C, Innocenti P, Giamberardino MA (2016) Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization. PLoS ONE 11(4): e0153408. doi:10.1371/journal.pone.0153408 Editor: Theodore John Price, University of Texas at Dallas, UNITED STATES Received: December 18, 2015 Accepted: March 29, 2016 Published: April 15, 2016 Copyright: © 2016 Costantini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data are provided in the manuscript; raw data are provided as supplementary files. Funding: The authors received no specific funding for this work. Competing Interests: The authors have declared that no competing interests exist. Abbreviations: aGb, asymptomatic gallbladder calculosis; AUs, abdominal ultrasounds; Cholec, cholecystectomy; EPTs, electrical pain thresholds;
Abstract Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1week, 1,3,6 and 12months after laparoscopic cholecystectomy in fibromyalgia patients with symptomatic calculosis (n = 31) vs calculosis patients without fibromyalgia (n. 26) and at comparable time points in fibromyalgia patients not undergoing cholecystectomy, with symptomatic (n = 27) and asymptomatic (n = 28) calculosis, and no calculosis (n = 30). At basis, fibromyalgia+symptomatic calculosis patients presented a significant linear correlation between the number of previously experienced biliary colics and fibromyalgia pain (direct) and muscle thresholds (inverse) (p
