Sifting the wheat from the chaff? Evidence for the existence of an asymmetric fibromyalgia phenotype

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art_KAZIYAMA_Sifting_the_wheat_from_the_chaff_Evidence_for_2020.PDF (230.02 KB)
Citações na Scopus
5
Tipo de produção
article
Data de publicação
2020
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
SIQUEIRA, Silvia R. D. Tesseroli de
Citação
EUROPEAN JOURNAL OF PAIN, v.24, n.8, p.1635-1647, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background The different phenotypic presentations of fibromyalgia (FM) have been infrequently studied and may have diagnostic and therapeutic implications. The aim of this study was to explore differences between FM patients with classical symmetric (s-FM) presentation and FM patients with marked asymmetric (a-FM) pain. Methods We performed two consecutive cross-sectional studies on FM patients and matched healthy volunteers (HV). FM patients were divided into a-FM (and s-FM groups according to their score of pain intensity on each body side; patients with a difference of >= 40 mm in VAS between left and right sides were classified as a-FM, otherwise classified as s-FM. Participants (FM = 32; HV = 31) were assessed for clinical, cortical excitability (CE), quantitative sensory testing (QST; study 1), and intraepidermal nerve fibre density (IENFD) determinations (study 2). Results While pain intensity did not significantly differ between s-FM and a-FM patients, pain interference in daily activities was significantly higher in the a-FM as compared to the s-FM group (54.7 +/- 8.9 and 37.6 +/- 13.5;p < .0001). PPT was significantly lower in the more painful side of a-FM as compared to the HV (27.7 +/- 7.9 and 49.9 +/- 13.0;p < .0001), while PPT in the less painful side of a-FM was significantly higher than PPT values in the s-FM (35.8 +/- 8.3 and 27.7 +/- 5.5;p = .031). S-FM and a-FM had significantly abnormal intracortical inhibition values on CE measurements compared to HV. There were no significant differences in IENFD between groups. Conclusions Within the current FM criteria, there exist different phenotypes with clinical, psychophysics, and neurophysiological findings that are not related to peripheral IENFD abnormalities. Significance Current fibromyalgia criteria may contain different phenotypes of fibromyalgia based on the lateralization of pain.
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URI
https://observatorio.fm.usp.br/handle/OPI/37786
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IOT
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/41
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