J Rheum Dis.  2021 Jan;28(1):31-37. 10.4078/jrd.2021.28.1.31.

The Impact of Tinnitus on Fibromyalgia

• Chung CH
• Jang G
• Lee CH

• KMID: 2510340
• DOI: http://doi.org/10.4078/jrd.2021.28.1.31

Abstract

Objective
. Fibromyalgia (FM) is a disorder characterized by chronic diffuse pain and enhanced pain response to stimuli and is caused by central sensitization. Tinnitus also is related to central sensitization. So we investigated the impact of tinnitus on FM.
Methods
. We included 22 FM patients with tinnitus and 25 FM patients without tinnitus. We assessed a range of symptoms using the Widespread Pain Index; Symptom Severity Score scale; Visual Analogue Scale of pain; and the Korean versions of the Fibromyalgia Impact Questionnaire (FIQ), the Insomnia Severity Index, and the Short-form Health Survey (SF-36). Information about the severity of tinnitus in FM patients was evaluated using the Korean version of the Tinnitus Handicap Questionnaire (THQ-K).
Results
. There were significant differences between the group that had mild tinnitus (THQ＜38) and the group that had moderate-to-severe tinnitus (THQ≥38) for FIQ score (p=0.025) and for the physical functioning (p=0.003), social functioning (p=0.035), and mental health (p=0.017) components of the SF-36. Also, after dividing patients into 2 groups according to insomnia severity, significant differences were observed in FIQ score (p=0.002) and in body pain (p=0.001), general health (p=0.008), vitality (p=0.003), social functioning (p=0.003), role limitation due to emotional condition (p=0.001), and mental health (p＜0.001) components of the SF-36.
Conclusion
. The FM patients with severe tinnitus had more functional impairments and lower quality of life than those with mild tinnitus. Severe insomnia also was accompanied by worse health status and lower quality of life.

Keyword

Fibromyalgia; Tinnitus; Insomnia; Quality of life

Reference

1. Cagnie B, Coppieters I, Denecker S, Six J, Danneels L, Meeus M. 2014; Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. Semin Arthritis Rheum. 44:68–75. DOI: 10.1016/j.semarthrit.2014.01.001. PMID: 24508406.

2. Clauw DJ. 2014; Fibromyalgia: a clinical review. JAMA. 311:1547–55. DOI: 10.1001/jama.2014.3266. PMID: 24737367.

3. Cohen H. 2017; Controversies and challenges in fibromyalgia: a review and a proposal. Ther Adv Musculoskelet Dis. 9:115–27. DOI: 10.1177/1759720X17699199. PMID: 28458723. PMCID: PMC5394529.

4. Lee HJ, Choi E, Nahm FS, Choi SS, Kim YH, Moon JY, et al. 2018; Prevalence of fibromyalgia in fourteen Korean tertiary care university hospital pain clinics. J Pain Res. 11:2417–23. DOI: 10.2147/JPR.S172221. PMID: 30425555. PMCID: PMC6200436.

5. Phillips K, Clauw DJ. 2013; Central pain mechanisms in the rheumatic diseases: future directions. Arthritis Rheum. 65:291–302. DOI: 10.1002/art.37739. PMID: 23045168. PMCID: PMC3610409.

6. Watson NF, Buchwald D, Goldberg J, Noonan C, Ellenbogen RG. 2009; Neurologic signs and symptoms in fibromyalgia. Arthritis Rheum. 60:2839–44. DOI: 10.1002/art.24772. PMID: 19714636. PMCID: PMC2769083.

7. Cil ÖÇ, Zateri C, Güçlü O, Oymak S, Tezcan E. 2020; The effect of fibromyalgia treatment on tinnitus. Am J Otolaryngol. 41:102390. DOI: 10.1016/j.amjoto.2020.102390. PMID: 31926598.

8. Cima RFF, Mazurek B, Haider H, Kikidis D, Lapira A, Noreña A, et al. 2019; A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment. HNO. 67(Suppl 1):10–42. DOI: 10.1007/s00106-019-0633-7. PMID: 30847513.

9. Noreña AJ, Farley BJ. 2013; Tinnitus-related neural activity: theories of generation, propagation, and centralization. Hear Res. 295:161–71. DOI: 10.1016/j.heares.2012.09.010. PMID: 23088832.

10. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, et al. 2016; 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 46:319–29. DOI: 10.1016/j.semarthrit.2016.08.012. PMID: 27916278.

11. Kang JH, An M, Choi SE, Xu H, Park DJ, Lee JK, et al. 2019; Performance of the revised 2016 fibromyalgia diagnostic criteria in Korean patients with fibromyalgia. Int J Rheum Dis. 22:1734–40. DOI: 10.1111/1756-185X.13661. PMID: 31342642.

12. Cho YW, Song ML, Morin CM. 2014; Validation of a Korean version of the insomnia severity index. J Clin Neurol. 10:210–5. DOI: 10.3988/jcn.2014.10.3.210. PMID: 25045373. PMCID: PMC4101097.

13. Jun HJ, Yoo IW, Hwang SJ, Hwang SY. 2015; Validation of a Korean version of the tinnitus handicap questionnaire. Clin Exp Otorhinolaryngol. 8:198–201. DOI: 10.3342/ceo.2015.8.3.198. PMID: 26330911. PMCID: PMC4553347.

14. Han CW, Lee EJ, Iwaya T, Kataoka H, Kohzuki M. 2004; Development of the Korean version of Short-Form 36-Item Health Survey: health related QOL of healthy elderly people and elderly patients in Korea. Tohoku J Exp Med. 203:189–94. DOI: 10.1620/tjem.203.189. PMID: 15240928.

15. Ware JE Jr, Gandek B. 1998; Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 51:903–12. DOI: 10.1016/S0895-4356(98)00081-X. PMID: 9817107.

16. Koca TT, Seyithanoglu M, Sagiroglu S, Berk E, Dagli H. 2018; Frequency of audiological complaints in patients with fibromyalgia syndrome and its relationship with oxidative stress. Niger J Clin Pract. 21:1271–7. DOI: 10.4103/njcp.njcp_95_18. PMID: 30297558.

17. Russell IJ, Vaeroy H, Javors M, Nyberg F. 1992; Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum. 35:550–6. DOI: 10.1002/art.1780350509. PMID: 1374252.

18. Russell IJ, Orr MD, Littman B, Vipraio GA, Alboukrek D, Michalek JE, et al. 1994; Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum. 37:1593–601. DOI: 10.1002/art.1780371106. PMID: 7526868.

19. Russell IJ. 2018; Management of pain in the fibromyalgia syndrome. J Arthritis. 7:273. DOI: 10.4172/2167-7921.1000273.

20. Liedberg GM, Björk M, Börsbo B. 2015; Self-reported nonrestorative sleep in fibromyalgia - relationship to impairments of body functions, personal function factors, and quality of life. J Pain Res. 8:499–505. DOI: 10.2147/JPR.S86611. PMID: 26300656. PMCID: PMC4536834.