Abstract
The pathogenesis of fibromyalgia (FM) has not been clearly elucidated, but central sensitization, which plays an important role in the development of neuropathic pain, is considered to be the main mechanism. The cutaneous silent period (CSP), which is a spinal reflex mediated by A-delta cutaneous afferents, is useful for the evaluation of sensorimotor integration at the spinal and supraspinal levels. To understand the pathophysiology of FM, we compared CSP patterns between patients with FM and normal healthy subjects. Twenty-four patients with FM diagnosed in accordance with the 1990 American College of Rheumatology classification system and 24 age- and sex-matched healthy volunteers were recruited. The CSP was measured from the abductor pollicis brevis muscle. Demographic data, number of tender points, and visual analog scale and FM impact questionnaire scores were collected. The measured CSP and clinical parameters of the patient and control groups were compared. In addition, possible correlations between the CSP parameters and the other clinical characteristics were analyzed. Mean CSP latencies did not differ between patients (55.50 ± 10.97 ms) and healthy controls (60.23 ± 11.87 ms; p = 0.158), although the mean CSP duration was significantly longer in patients (73.75 ± 15.67 ms) than in controls (63.50 ± 14.05 ms; p = 0.021). CSP variables did not correlate with any clinical variables. The significantly longer CSP duration in FM patients suggests central dysregulation at the spinal and supraspinal levels, rather than peripheral small fiber dysfunction.
Highlights
Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and variable symptoms such as sleep disturbances, fatigue, depression, and cognitive dysfunction[1]
Patients were excluded if they had a history of any specific muscle disease, neuromuscular junction disorder, spinal surgery, or medical condition associated with peripheral neuropathy such as diabetes mellitus, alcohol abuse, metabolic disorders, malignancy, or long-term drug use
There were no significant differences in age, sex, or height between the two groups (Table 1)
Summary
Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and variable symptoms such as sleep disturbances, fatigue, depression, and cognitive dysfunction[1]. The mechanism underlying chronic pain in FM remains unclear, but cumulative evidence has suggested that central pain amplification plays a key role in the fundamental pathogenesis of FM. Pain amplification refers to augmented pain and sensory processing within the spinal cord and brain, and is sometimes termed “central sensitization”[2]. Lengthened CSP in FM Suggesting Central Sensitization data collection and analysis, decision to publish, or preparation of the manuscript
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