Evaluation of pain and flexor reflex responses and their association with clinical parameters in patients with fibromyalgia

Abstract

Objectives: In the present study, we aimed to evaluate electrophysiological outcomes of flexor reflexes (FR) emerging in response to painful stimuli in fibromyalgia (FM) patients. Patients and methods: This study included a total of 21 female FM patients (mean age 36.8±8.0 years; range, 20 to 50 years) and 28 healthy female controls (mean age 37.3±8.8 years; range, 22 to 53 years). Clinical features of the patients, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores were recorded. Electrophysiological stimulation threshold, visual analog scale (VAS) scores of generated pain after each stimulation, current intensity, flexor responses obtained from muscles, and electrophysiological measurement of these responses were noted. Results: The threshold for perception of electrical current was higher and resistance level to maximum electrical current was lower in FM patients (p<0.05). The VAS scores of FM patients under maximum electrical current were higher than the control group (p<0.05), while the lowest current value in which FR response obtained in FM patients was lower (p<0.05). The latency was lower, amplitude was higher, and response area was wider in FM patients (p<0.05). No significant relationship between the FIQ, BDI, BAI scores and stimulant perception threshold levels was found in FM patients (p>0.05). Conclusion: Based on these findings, FR responses may be useful as an electrophysiological parameter in FM diagnosis.

Neural indices of multimodal sensory and autonomic hyperexcitability in fibromyalgia

“…FM participants perceived the ECS as more uncomfortable than the CNT group ( Fig. 1 c), which replicates previous reports ( Desmeules et al, 2014 , Erturk Celik and Beyazova, 2020 , Rhudy et al, 2013 ). Importantly, in comparison to CNT participants, the FM group showed greater P50 to ECS, which correlated with the FM profile ( Fig.…”

“…Indeed, lower pain thresholds for mechanical (pressure) and thermal (heat and cold) stimuli in participants with FM have been well-established ( de la Coba et al, 2022 , Desmeules et al, 2003 , Plesner and Vaegter, 2018 ). Similarly, people with FM show increased sensitivity to electrical stimulation ( Erturk Celik and Beyazova, 2020 , Rhudy et al, 2013 ). Taken together, the evidence is indicative of deficient inhibitory top-down pain modulation pathways ( Staud, 2006 , Woolf, 2011 ).…”