Abstract
Fibromyalgia is a multi-symptomatic disorder characterized by generalized pain. The pathophysiology of fibromyalgia is supposedly an interplay between central nervous system hyper-responsiveness, autonomic dysfunction, and peripheral pain. In this cross-sectional study, the objective was to assess central sensitization and autonomic activity in patients with fibromyalgia compared with control. Fifty adults diagnosed with fibromyalgia by the modified American College of Rheumatology 2010 criteria and an equal number of age- and sex-matched controls participated in the study in an urban tertiary care hospital. Central sensitization was assessed by history and by evidence of increased prefrontal cortical activity as measured by cortical oxygenation using functional near-infrared spectroscopy. Autonomic activity was assessed by heart rate variability, electrodermal activity, and deep breathing test in three physiological states: rest, sympathetic stress (cold pressor test), and deep breathing. Mann–Whitney U-test, paired t-test, Wilcoxon test, and Friedman test with Bonferroni a priori were used to analyze the data. Cortical activity was significantly higher in the fibromyalgia group than control. There was no significant difference in autonomic activity between the fibromyalgia and control groups. In the fibromyalgia group, variable degrees of sympathetic hyperactivity and normal parasympathetic activity were observed. Central sensitization may be playing a primary role in the pathophysiology of generalized pain in fibromyalgia.
Highlights
Fibromyalgia (FM) is a multi-symptomatic disorder with a varying degree of generalized pain
Central sensitization was assessed by history and by evidence of cortical activation as measured by non-invasive functional near-infrared spectroscopy (Woolf, 2011; Fillingim et al, 2016)
Fifty adults diagnosed with FM by modified American College of Rheumatology (ACR) 2010 criteria and an equal number of age- and sex-matched controls participated in the study
Summary
Fibromyalgia (FM) is a multi-symptomatic disorder with a varying degree of generalized pain. Meeus et al (2013) had summarized that only moderate evidences are present regarding the autonomic changes in FM These inconsistent changes in the ANS may be attributed to presence of different subgroups among FM patients (Giesecke et al, 2003; Plazier et al, 2015). There is a need to replicate studies with all the relevant parameters in the same patient population to avoid hidden subgroup confounders. In this cross-sectional study, the objective was to assess central sensitization and autonomic activity in patients with FM and to compare them with those of control
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