Abstract

BackgroundThis study aimed to test the changes in the conduction properties of peripheral nerves in patients with primary fibromyalgia (FM). Thirty patients with FM and sixteen healthy controls participated in this study. Visual analogue scale (VAS) for pain severity, pain duration, Widespread Pain Index (WPI), Symptom Severity (SS) scale, Hamilton depression rating scale, Taylor’s manifest anxiety scale, and Fibromyalgia Impact Questionnaire (FIQR) were used for measurement of psychiatric comorbidities and quality of life for each patient. Routine motor and sensory nerve conduction studies of both median, ulnar, common peroneal, posterior tibial, and sural nerves were measured for all study participants.ResultsWe found statistically significant increase in Sensory Conduction Velocity (SCV), Sensory Nerve Action Potential (SNAP) amplitude, and decrease in Sensory Latency (SL) in patients with FM compared to controls. There were no significant changes in motor nerve conduction between patients and controls. Regression analysis showed a significant relation between WPI and both SCV and SL especially in nerves of upper limbs. However, no significant relation between SCV and SL and other presumed predictors including VAS for pain severity, pain duration, SS scale, FIQR, and psychiatric comorbidities. Patients with FM suffered more depression and anxiety than controls.ConclusionsWe found enhanced conductivity of the sensory rather than the motor nerves in patients with FM. To our knowledge, this is the first study to describe these sensory changes which may add further evidence of peripheral sensitization in patients with FM.

Highlights

  • This study aimed to test the changes in the conduction properties of peripheral nerves in patients with primary fibromyalgia (FM)

  • Patients with FM suffers more depression and anxiety compared to healthy controls in Hamilton Depression Rating Scale (HAM-D) and Taylor’s Manifest Anxiety Scale (TMAS) scales (t = 8.4, P < 0.0001; and t = 10. 2, P < 0.0001, respectively)

  • We found that the Sensory Conduction Velocity (SCV) and Sensory Nerve Action Potential (SNAP) amplitude were significantly higher, and Sensory Latency (SL) was significantly lower in patients with FM compared to healthy controls

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Summary

Introduction

This study aimed to test the changes in the conduction properties of peripheral nerves in patients with primary fibromyalgia (FM). Many studies support the hypothesis of CS as it was found that patients with FM have abnormal concentrations of CNS neuropeptides, biogenic amines, and functional alterations of the hypothalamus–pituitary–adrenal axis [3, 4]. Those changes are associated with a widespread lowering of the pain threshold leading to hypersensitivity to mechanical pain (allodynia) which is diffuse one, not limited to specific tender points [5, 6]. The two components increase each other’s and both are CNS processed phenomena [7]

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