Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;24(8):1537-1547.
doi: 10.1002/ejp.1607. Epub 2020 Jun 16.

Peripheral and central nervous system correlates in fibromyalgia

Eleonora Vecchio  1 , Raffaella Lombardi  2 , Matilde Paolini  2 , Giuseppe Libro  1 , Marianna Delussi  1 , Katia Ricci  1 , Silvia G Quitadamo  1 , Eleonora Gentile  1 , Francesco Girolamo  3 , Florenzo Iannone  4 , Giuseppe Lauria  2   5 , Marina de Tommaso  1
Affiliations
Free article

Peripheral and central nervous system correlates in fibromyalgia

Eleonora Vecchio et al. Eur J Pain. 2020 Sep.
Free article

Abstract

Background: Fibromyalgia (FM) is a syndrome characterized by altered pain processing at central and peripheral level, whose pathophysiologic mechanisms remain obscure. We aimed at exploring the structural changes of peripheral nociceptor measured by skin biopsy, the functional changes of central nociceptive pathway assessed by laser-evoked potentials (LEP), and their correlation with clinical features and comorbidities.

Methods: In all, 81 patients diagnosed with FM underwent skin biopsies with quantification of intraepidermal nerve fibre density (IENFD) at the thigh and distal leg, and LEP recording by stimulating hand, thigh and foot. Nerve conduction study (NCS), clinical features, comorbidity with migraine and mood disorders, and previous, non-active immune-mediated disorders were recorded.

Results: Intraepidermal nerve fibre density was reduced in 85% of patients at the thigh and in 12.3% of patients at the distal leg, whereas it was normal in 14.8% of patients. N2P2 habituation index from laser stimulation at the thigh was altered in 97.5% of patients and correlated with reduced IENFD at the thigh. LEP latencies and amplitudes did not differ among groups. No association was found between IENFD, LEP, clinical features and comorbidities.

Conclusions: Fibromyalgia patients most commonly showed a mild loss of peripheral nociceptors at the thigh rather than distal small fibre neuropathy. This finding was associated with an altered habituation index and strengthened the hypothesis that central sensitization plays a key role in the pathogenesis of the disease.

Significance: Central impairment of pain processing likely underlies FM, which in most patients is associated with mild proximal small fibre pathology.

PubMed Disclaimer

References

REFERENCES

    1. Bank, P. J. M., Peper, C. E., Marinus, J., Van Hilten, J. J., & Beek, P. J. (2015). Intended and unintended (sensory-) motor coupling between the affected and unaffected upper limb in complex regional pain syndrome. European Journal of Pain, 19(7), 1021-1034.
    1. Belza, B., Miyawaki, C. E., Liu, M., Aree-Ue, S., Fessel, M., Minott, K. R., & Zhang, X. (2018). A systematic review of studies using the multidimensional assessment of fatigue scale. Journal of Nursing Measurement, 26(1), 36-75.
    1. Bidari, A., Hassanzadeh, M., Mohabat, M., Talachian, E., & Khoei, E. M. (2014). Validation of a Persian version of the Fibromyalgia Impact Questionnaire (FIQ-P). Rheumatology International, 34(2), 181-189.
    1. Bouhassira, D., Attal, N., Alchaar, H., Boureau, F., Brochet, B., Bruxelle, J., … Vicaut, E. (2005). Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain, 114(1-2), 29-36.
    1. Caraceni, A., Mendoza, T. R., Mencaglia, E., Baratella, C., Edwards, K., Forjaz, M. J., … Cleeland, C. S. (1996). A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain, 65(1), 87-92.

Publication types