Small fibre pathology in patients with fibromyalgia syndrome
Nurcan Üçeyler,Daniel Zeller,Ann-Kathrin Kahn,Susanne Kewenig,Sarah Kittel-Schneider,Annina B. Schmid,J Casanova-Molla,Karlheinz Reiners,Claudia Sommer +8 more
TLDR
A reduction in dermal unmyelinated nerve fibre bundles was found in skin samples of patients with fibromyalgia syndrome compared with patients with depression and with healthy control subjects, whereas myelination nerve fibres were spared.Abstract:
Fibromyalgia syndrome is a clinically well-characterized chronic pain condition of high socio-economic impact Although the pathophysiology is still unclear, there is increasing evidence for nervous system dysfunction in patients with fibromyalgia syndrome In this case-control study we investigated function and morphology of small nerve fibres in 25 patients with fibromyalgia syndrome Patients underwent comprehensive neurological and neurophysiological assessment We examined small fibre function by quantitative sensory testing and pain-related evoked potentials, and quantified intraepidermal nerve fibre density and regenerating intraepidermal nerve fibres in skin punch biopsies of the lower leg and upper thigh The results were compared with data from 10 patients with monopolar depression without pain and with healthy control subjects matched for age and gender Neurological and standard neurophysiological examination was normal in all patients, excluding large fibre polyneuropathy Patients with fibromyalgia syndrome had increased scores in neuropathic pain questionnaires compared with patients with depression and with control subjects (P < 0001 each) Compared with control subjects, patients with fibromyalgia syndrome but not patients with depression had impaired small fibre function with increased cold and warm detection thresholds in quantitative sensory testing (P < 0001) Investigation of pain-related evoked potentials revealed increased N1 latencies upon stimulation at the feet (P < 0001) and reduced amplitudes of pain-related evoked potentials upon stimulation of face, hands and feet (P < 0001) in patients with fibromyalgia syndrome compared to patients with depression and to control subjects, indicating abnormalities of small fibres or their central afferents In skin biopsies total (P < 0001) and regenerating intraepidermal nerve fibres (P < 001) at the lower leg and upper thigh were reduced in patients with fibromyalgia syndrome compared with control subjects Accordingly, a reduction in dermal unmyelinated nerve fibre bundles was found in skin samples of patients with fibromyalgia syndrome compared with patients with depression and with healthy control subjects, whereas myelinated nerve fibres were spared All three methods used support the concept of impaired small fibre function in patients with fibromyalgia syndrome, pointing towards a neuropathic nature of pain in fibromyalgia syndromeread more
Citations
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An Inflammation-Centric View of Neurological Disease: Beyond the Neuron.
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References
More filters
Journal ArticleDOI
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
TL;DR: The CES-D scale as discussed by the authors is a short self-report scale designed to measure depressive symptomatology in the general population, which has been used in household interview surveys and in psychiatric settings.
Journal ArticleDOI
The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee.
Frederick Wolfe,Hugh A. Smythe,Muhammad B. Yunus,Robert M. Bennett,Claire Bombardier,Don L. Goldenberg,Peter Tugwell,Stephen M. Campbell,Micha Abeles,Patricia Clark,Adel G. Fam,Stephen J. Farber,Justus J. Fiechtner,C. Michael Franklin,Robert A. Gatter,Daniel Hamaty,James A. Lessard,Alan S. Lichtbroun,Alfonse T. Masi,Glenn A. McCain,W. John Reynolds,Thomas J. Romano,I. Jon Russell,Robert P. Sheon +23 more
TL;DR: Criteria for the classification of fibromyalgia are widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites, and no exclusions are made for the presence of concomitant radiographic or laboratory abnormalities.
Journal ArticleDOI
Neuropathic pain Redefinition and a grading system for clinical and research purposes
Rolf-Detlef Treede,Troels S. Jensen,James N. Campbell,Giorgio Cruccu,Jonathan O. Dostrovsky,J. W. Griffin,Per Hansson,Richard A. C. Hughes,Turo Nurmikko,Jordi Serra +9 more
TL;DR: A grading system of definite, probable, and possible neuropathic pain is proposed, which includes the grade possible, which can only be regarded as a working hypothesis, and the grades probable and definite, which require confirmatory evidence from a neurologic examination.
Journal ArticleDOI
Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol and reference values
Roman Rolke,Ralf Baron,Christoph Maier,Thomas R. Tölle,Rolf-Detlef Treede,Antje Beyer,Andreas Binder,Niels Birbaumer,Frank Birklein,I. C. Bötefür,S. Braune,Herta Flor,Volker Huge,R. Klug,G. B. Landwehrmeyer,Walter Magerl,Christian Maihöfner,C. Rolko,C. Schaub,Andrea Scherens,Till Sprenger,Michael Valet,B. Wasserka +22 more
TL;DR: Application of this standardized QST protocol in patients and human surrogate models will allow to infer underlying mechanisms from somatosensory phenotypes as well as judge plus or minus signs in patients.
Book
Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice
TL;DR: This book provides a comprehensive review of most peripheral nerve and muscle diseases, including specific techniques and locations for performing each test, and is of value to neurologists and physiatrists who are interested in neuromuscular disorders and noninvasive electrodiagnostic methods.
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Frederick Wolfe,Hugh A. Smythe,Muhammad B. Yunus,Robert M. Bennett,Claire Bombardier,Don L. Goldenberg,Peter Tugwell,Stephen M. Campbell,Micha Abeles,Patricia Clark,Adel G. Fam,Stephen J. Farber,Justus J. Fiechtner,C. Michael Franklin,Robert A. Gatter,Daniel Hamaty,James A. Lessard,Alan S. Lichtbroun,Alfonse T. Masi,Glenn A. McCain,W. John Reynolds,Thomas J. Romano,I. Jon Russell,Robert P. Sheon +23 more
Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol and reference values
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