Fibromyalgia (FM) is a heterogeneous chronic condition with wide variability in symptom burden, psychosocial distress, and functional impact. This study aimed to identify latent FM subgroups reflecting multidimensional patient profiles using comprehensive biopsychosocial variables and model-based clustering methods within UK Biobank. Individuals meeting the 2016 American College of Rheumatology FM criteria (n = 4,172) were analysed using Gaussian mixture clustering. Twenty-eight variables across sociodemographic, clinical symptoms, and psychological/behavioural domains were included. Cluster stability was evaluated using bootstrap resampling and adjusted Rand indices (ARI). Variable importance was assessed using Random Forest analysis. Three distinct subgroups were identified: the Resilient Majority (62.3%) with low symptoms and psychological resilience; the Severe Phenotype (20.1%) with pronounced pain, fatigue, and psychological distress; and the Socially Vulnerable Minority (17.6%) characterized by ethnic diversity, rural residence, and social isolation. Sociodemographic and psychological/behavioural variables (e.g. frequency of feeling down, home area population density, ethnicity, frequency of home visits, and smoking status) demonstrated greater discriminative contribution than clinical symptom variables. All clusters demonstrated high stability (ARI > 0.93). These findings identify subgroups within FM defined not only by symptom severity but also by structural vulnerabilities and psychosocial factors. Recognizing such heterogeneity has implications for developing stratified, equitable management approaches that integrate psychosocial dimensions alongside clinical symptoms. PERSPECTIVE: Three fibromyalgia subgroups were identified: a resilient majority, a severe phenotype with socioeconomic disadvantage, and a socially vulnerable minority characterized by ethnic diversity and rural isolation patterns. Psychosocial factors outperformed clinical symptoms in discriminating subgroups, underscoring the need for stratified and patient-centred management addressing the biopsychosocial complexity of fibromyalgia.

Juvenile primary fibromyalgia syndrome (JPFS) is a pediatric rheumatologic condition characterized by (1) persistent, widespread musculoskeletal pain in multiple locations and (2) other symptoms such as fatigue, headaches, poor sleep or cognitive symptoms, among others. These alterations may be associated with the development of psychological distress, poorer mental health and lower quality of life, although no clear consensus has been reached. Thus, this study aimed to examine the psychological symptoms associated with JPFS, compared with a healthy comparison group of children and adolescents. A systematic review was registered in Prospero (registration number CRD42023389230) and an electronic search was performed across five databases, using fibromyalgia, chronic widespread pain, children, and adolescents as keywords. Out of 1262 articles identified, 15 cross-sectional case-control studies were included after applying inclusion criteria -compare psychological variables between JPFS and healthy children and adolescents-. Publication bias was assessed with SIGN checklist. The results revealed a variety of psychological symptoms associated with JPFS which were categorized in four main domains -psychophysiological, cognitive-emotional, socio-academic and familial- with specific subcategories. In each one, significant differences were observed between groups in most variables, showing worse outcomes for the JPFS group. However, considerable heterogeneity was noted between studies. Future research should clarify psychological symptoms associated with the JPFS in order to enhance diagnosis and treatment.

A multidisciplinary approach is viewed as the primary treatment strategy for fibromyalgia (FM). Therapeutic exercise is an important component of this approach. Hypnotic cognitive therapy (HYP-CT), a relatively new intervention strategy, has not traditionally been incorporated in FM treatment, although it has shown beneficial effects in other chronic pain conditions. This study aims to investigate the potential benefits of a combined approach that incorporates HYP-CT with therapeutic exercise in the rehabilitation of individuals with FM.

BackgroundThe relationship between reaction time on the left/right judgment task and clinical psycho-affective measures is unknown in women with fibromyalgia syndrome.ObjectiveThe aim of this study was to determine whether there is a relationship between reaction time on the left/right judgment task and clinical and psycho-affective measures in women with fibromyalgia syndrome.Materials and Methods113 women with fibromyalgia syndrome were recruited. All participants underwent assessment using the left/right judgment task, administered via the Recognise™ application. Kinesiophobia and pain catastrophizing were assessed using Tampa Scale Kinesiophobia, and Pain Catastrophizing Scale. Functional health status was assessed with the Fibromyalgia Impact Questionnaire, pain intensity with Visual Analog Scale, central sensitization with Central Sensitization Inventory. Pearson's correlation coefficients were calculated to assess associations between reaction time and clinical and psycho-affective measures. Finally, exploration stepwise multiple linear regression performed to identify predictors of FIQ.ResultsThe results showed a positive association of higher values of the Fibromyalgia Impact Questionnaire with left shoulder reaction time (β = 0.80; CI 95% 0.74 to 0.97; p = 0.009), left cervical reaction time (β = 8.41; CI 95% 3.85 to 12.96; p = 0.001), left hand reaction time (β = 0.11; CI 95% 0.10 to 0.21; p = 0.013), left low back reaction time (β = 7.7; CI 95% 7.1 to 12.5; p = 0.034) and right low back reaction time (β = 8.3; CI 95% 3.6 to 15.0; p = 0.016), with the regression model explaining 16% (R[2] = 0.16). For correlations showed an association with Pain Catastrophizing Scale and left cervical (r = 0.23, p = 0.011).ConclusionIn this exploratory cross-sectional study, there was a positive association between Fibromyalgia Impact Questionnaire and reaction time in specific body segments (left shoulder, left cervical, left hand, left low back, and right low back) and low to moderate correlation between longer reaction on the left/right judgment task and poorer clinical and psycho-affective measures in women with fibromyalgia syndrome.

Approximately 1 in 4 women with chronic pelvic pain (CPP) report persistent pelvic pain after hysterectomy. Centralized symptoms-fatigue, multisite pain, and sleep disturbance, quantified using the Fibromyalgia Survey Score (FSS)-often co-occur with this risk, but the trajectory of centralized symptom burden after surgery, independent of pelvic pain outcome, is not well understood. Whether presurgical differences in central nervous system pain processing distinguish women whose centralized symptoms improve (improvers) from those whose do not (non-improvers) has not been tested. In this observational study, we assessed whether individuals who do and do not report improvement in FSS scores six months post-operatively differ in their baseline/pre-operative phenotypes and brain function. Sensory sensitivity scores were significantly higher in non-improvers than in improvers at baseline. We identified no significant, presurgical differences in age, average pelvic pain intensity, widespread pain, or pain interference between improvers and non-improvers. Functional connectivity was examined at rest and during the application of a distal, sustained pressure pain. We identified no significant group differences at rest. During sustained pressure pain, non-improvers showed greater connectivity than improvers between primary somatosensory cortex and posterior thalamic seeds with frontal, motor, cerebellar and limbic regions, but lower connectivity between the periaqueductal gray and subgenual cingulate cortex. Non-improvers also showed a greater pain-evoked increase in connectivity between the pelvic and leg representations of the primary sensory cortex and other sensorimotor regions in the pain-versus-rest contrast. Overall, non-improvers showed increased functional connectivity between regions associated with the multisensory integration of ascending pain, and decreased connectivity between regions associated with descending pain modulation. In exploratory analyses, some of these connections were additionally associated with symptom burden: sensory sensitivity, number of painful regions, and pain interference. This work may inform mechanisms of persistent symptom burden and guide surgical decision-making in patients with high central sensitization.

BackgroundFibromyalgia is a chronic pain disorder associated with sleep disturbance and substantial functional burden.ObjectiveThis study evaluated a self-organized explainable feature engineering (SOXFE) model for EEG-based fibromyalgia classification.MethodsA previously reported sleep EEG dataset from a 32-participant source cohort was analyzed separately for NREM Stage 2 and Stage 3. The analysis-ready version contained 136 labeled stage-record files: 74 for Stage 2 and 62 for Stage 3. The SOXFE model comprised LTPat feature extraction, training-only CWNCA feature selection, tkNN classification, IMV information fusion, and DLob-based explanation. Record-wise LORO was primary; segment-level 10-fold cross-validation was complementary.ResultsRecord-wise LORO used 74 outer folds for Stage 2 and 62 for Stage 3. Descriptive pooled held-out-epoch accuracy was 92.77% (95% CI: 91.76-93.67) for Stage 2 and 97.00% (95% CI: 96.22-97.63) for Stage 3. Every epoch from the held-out recording was excluded from training and selection. Complementary segment-level 10-fold cross-validation yielded 100.00% accuracy for both stages but was not used as evidence of record-wise generalization.ConclusionsThe model provided record-disjoint classification and traceable model-derived explanations in this single-source dataset. LORO prevented within-record epoch leakage. However, participant linkage was unavailable, so records from the same person may have occurred across outer partitions and the reported values may overestimate person-independent performance. Verified subject-wise validation is required before clinical use.

Chronic musculoskeletal pain (CMP), including osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia, and chronic low back pain (cLBP), contributes substantially to disability and reduced quality of life. Contemporary pain science supports biopsychosocial, multimodal management addressing nociceptive, neuropathic, and nociplastic mechanisms. Tai Chi is a multicomponent mind-body exercise integrating gentle movement, breathing, relaxation, balance, and attentional focus. This narrative review summarizes approximately 20 years of research on Tai Chi for CMP and considers its evolving evidence in contemporary rheumatology and pain management.