Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome

In addition to the debilitating fatigue, the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. These pain complaints show the greatest overlap between CFS and fibromyalgia (FM). Although the literature provides evidence for central sensitization as cause for the musculoskeletal pain in FM, in CFS this evidence is currently lacking, despite the observed similarities in both diseases. The knowledge concerning the physiological mechanism of central sensitization, the pathophysiology and the pain processing in FM, and the knowledge on the pathophysiology of CFS lead to the hypothesis that central sensitization is also responsible for the sustaining pain complaints in CFS. This hypothesis is based on the hyperalgesia and allodynia reported in CFS, on the elevated concentrations of nitric oxide presented in the blood of CFS patients, on the typical personality styles seen in CFS and on the brain abnormalities shown on brain images. To examine the present hypothesis more research is required. Further investigations could use similar protocols to those already used in studies on pain in FM like, for example, studies on temporal summation, spatial summation, the role of psychosocial aspects in chronic pain, etc

Virtual Reality for Informal Caregivers of Heart Failure Patients: A Mixed Method Research Proposal

Informal Caregivers (CG) for heart failure patients are very important for preserving health status, preventing symptoms exacerbation and improving self-care. However, being a caregiver can be very burdensome, emotionally stressful and, often, associated with social interaction problems. Despite this, literature lacks in interventions aimed to reduce burden and improve wellbeing. The aim of this project is to reduce burden, improve mutuality and increase resilience with the use of immersive virtual reality. A concurrent mixed method design will be used to test the intervention with two experiments on volunteer CG. Open-ended questions will be used, meanwhile, to explore the impact of the experience. Caregiver Burden Inventory (CBI), Mutuality Scale (MS) and Connor Davidson Resilience Scale (CDRISC-25) will be administered both pre and post experiments. On psychophysiological indexes, an analysis of variance will be performed (ANOVA). Data about burden, mutuality and resilience will be presented through data integration with the content analysis of the open-ended questions in a joint display