Pain Processing and Vegetative Dysfunction in Fibromyalgia: A Study by Sympathetic Skin Response and Laser Evoked Potentials

Marina de Tommaso, Katia Ricci, Giuseppe Libro, Eleonora Vecchio, Marianna Delussi, Anna Montemurno, Giuseppe Lopalco, Florenzo Iannone, Marina de Tommaso, Katia Ricci, Giuseppe Libro, Eleonora Vecchio, Marianna Delussi, Anna Montemurno, Giuseppe Lopalco, Florenzo Iannone

Abstract

Background: A dysfunction of pain processing at central and peripheral levels was reported in fibromyalgia (FM). We aimed to correlate laser evoked potentials (LEPs), Sympathetic Skin Response (SSR), and clinical features in FM patients.

Methods: Fifty FM patients and 30 age-matched controls underwent LEPs and SSR by the right hand and foot. The clinical evaluation included FM disability (FIQ) and severity scores (WPI), anxiety (SAS) and depression (SDS) scales, and questionnaires for neuropathic pain (DN4).

Results: The LEP P2 latency and amplitude and the SSR latency were increased in FM group. This latter feature was more evident in anxious patients. The LEPs habituation was reduced in FM patients and correlated to pain severity scores. In a significant number of patients (32%) with higher DN4 and FIQ scores, SSR or LEP responses were absent.

Conclusions: LEPs and SSR might contribute to clarifying the peripheral and central nervous system involvement in FM patients.

Figures

Figure 1
Figure 1
Grand average of laser evoked potentials computed in the fibromyalgia group (50) and control subjects (30). For each case the average across two consecutive series of 30 stimuli was used to compute the group LEPs.
Figure 2
Figure 2
Sympathetic skin response by right median nerve stimulation in one representative fibromyalgia patient, female, 24 years old, and one healthy subject of the same sex and age.
Figure 3
Figure 3
Groups' grand average of SSR from hand and foot in Fibromyalgia patients (50) and controls (30). For each case the average of the 5 responses was included to compute the groups' SSRs.
Figure 4
Figure 4
Linear dispersion plots between laser evoked potentials P2 and sympathetic skin response (SSR) latencies in fibromyalgia (FM) patients and controls.

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