Alteraciones en la reactividad autonómica cardiovascular y en el flujo sanguíneo cerebral en la fibromialgia y su asociación con variables de dolor y severidad clínica

Abstract

Fibromyalgia is a complex condition involving persistent widespread pain and other usual symptoms such as fatigue, sleep problems or emotional disturbances. While its origin is not completely established, the most widely accepted explanation is central pain sensitization. Recently, the stress response and the autonomic system have been studied to improve its understanding. This thesis aimed to explore the cardiovascular autonomic response to stress and the cerebral blood flow hemodynamics to a pain sensitization protocol, along with the association of both responses with the clinical severity of fibromyalgia. The results support the existence of an autonomic impairment manifested by cardiovascular and baroreflex hyporesponsiveness, which seems to be independent of diagnoses like depression. Furthermore, the clinical status in terms of pain, sleep or fatigue is related to these cardio- and cerebrovascular responses. The findings and methods employed may result useful in the research and management of this condition.