Pain matters for central sensitization: sensory and psychological parameters in patients with fibromyalgia syndrome

Abstract

Introduction: Patients suffering from fibromyalgia syndrome (FMS) are heterogenous. They often present with sensory abnormalities and comorbidities. Objectives:We aimed to answer the following questions: (1) Is there a specific somatosensory profile in our patient cohort? (2) Can we detect subgroups characterized by a specific combination of sensory and psychological features? and (3) Do psychological parameters influence sensory signs? Methods: In 87 patients with FMS quantitative sensory testing was performed on the hand and evaluated in combination with questionnaire results regarding pain, psychological comorbidities, sleep, and functionality. Results: Patients presented different somatosensory patterns, but no specific subgroups regarding sensory signs and psychological features were detected. Hypersensitivity for noxious mechanical and thermal stimuli and hyposensitivity for nonnoxious mechanical stimuli were the most prominent features. Thirty-one percent of patients showed signs of central sensitization as indicated by abnormally increased pinprick hyperalgesia or dynamic mechanical allodynia. Central sensitization was associated with higher pain intensities (P , 0.001). Only a small influence of psychiatric comorbidities on mechanical pain sensitivity (P 5 0.044) and vibration detection (P 5 0.028) was found, which was partly associated with high pain intensities. A small subgroup of patients (11.4%) demonstrated thermal hyposensitivity (loss of small-fiber function). Conclusion: Patients with FMS showed various somatosensory abnormalities. These were not significantly influenced by psychological comorbidities. Signs for central sensitization were detected in about one-third of patients and associated with higher pain intensities. This supports the notion of central sensitization being a major pathophysiological mechanism in FMS, whereas small-fiber loss may be less important.

Thermal Pain Thresholds Are Significantly Associated with Plasma Proteins of the Immune System in Chronic Widespread Pain—An Exploratory Pilot Study Using Multivariate and Network Analyses

“…CWP had lowered pain thresholds for cold and heat (Table 1), a finding that agrees with other studies [54][55][56][57][58]. For both the CWP and CON, CPT and HPT were generally not associated with clinical variables, which agrees with a study of FM [58].…”

“…CWP had lowered pain thresholds for cold and heat (Table 1), a finding that agrees with other studies [54][55][56][57][58]. For both the CWP and CON, CPT and HPT were generally not associated with clinical variables, which agrees with a study of FM [58]. The exception was in CWP: HADS and QOL showed significant associations with HPT, and HADS was a strong regressor of HPT although it was not markedly stronger than the most important proteins.…”

Therapeutic Approaches to Nociplastic Pain Based on Findings in the Reserpine-Induced Fibromyalgia-Like Animal Model

“…Hypersensitivity (HS) to cold stimuli is also demonstrated by the acetone application test (da Silva Brum et al, 2021). Although the above-mentioned evoked pain phenotypes in RIM animal model may correspond to HS in the exposure of patients to external stimuli (e.g., pinprick HA) (Rehm et al, 2021), they do not fully reflect the primary symptom characterized by spontaneous ongoing pain in patients with FM.…”

Sensory Perception Quotient Reveals Visual, Scent and Touch Sensory Hypersensitivity in People With Fibromyalgia Syndrome

“…People living with FMS often report allodynia and pain hypersensitivity ( 9 , 10 ). Environmental sensitivity is commonly reported by people with FMS ( 11 , 12 ).…”