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Autonomic Small-Fiber Pathology in Patients With Fibromyalgia.
Falco, Pietro; Galosi, Eleonora; Di Stefano, Giulia; Leone, Caterina; Di Pietro, Giuseppe; Tramontana, Lorenzo; De Stefano, Gianfranco; Litewczuk, Daniel; Esposito, Nicoletta; Truini, Andrea.
Afiliación
  • Falco P; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Galosi E; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Di Stefano G; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Leone C; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Di Pietro G; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Tramontana L; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • De Stefano G; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Litewczuk D; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Esposito N; Department of Human Neuroscience, Sapienza University, Rome, Italy.
  • Truini A; Department of Human Neuroscience, Sapienza University, Rome, Italy.
J Pain ; 25(1): 64-72, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37524221
ABSTRACT
In this clinical and skin biopsy study, we aimed to investigate whether fibromyalgia-associated small-fiber pathology (SFP), consisting of an intraepidermal nerve fiber loss, implies damage of dermal autonomic nerve fibers and how this damage is associated with autonomic symptoms that patients with fibromyalgia syndrome experience. Using skin biopsy, we investigated intraepidermal nerve fiber density, piloerector muscle, and sweat gland nerve fiber density (SGNFD) in 138 participants, that is, 58 patients with fibromyalgia syndrome, 48 healthy subjects, and 32 patients with small-fiber neuropathy. In patients with fibromyalgia-associated SFP, we also investigated how the different skin biopsy variables correlated with autonomic symptoms, as assessed with the Composite Autonomic Symptom Score 31 questionnaire. We found that in patients with fibromyalgia-associated SFP, the piloerector muscle and SGNFD were lower than that in healthy subjects. However, the autonomic small-fiber damage had no correlation with autonomic symptoms severity. In patients with SFP, the intraepidermal, piloerector muscle, and SGNFD were higher than that in patients with small-fiber neuropathy. Our clinical and skin biopsy study shows that patients with fibromyalgia have a reduction of dermal autonomic small fibers paralleling the intraepidermal nerve fiber loss, thus indicating that SFP also implies autonomic small nerve fiber damage. However, the autonomic small-fiber damage we found had no correlation with the severity of autonomic symptoms, and thus its clinical impact is still undetermined. PERSPECTIVE In patients with fibromyalgia, SFP also affects autonomic fibers. These novel data provide additional insights into the pathophysiology of fibromyalgia syndrome, highlighting the complex role of small-fiber damage in the clinical picture of fibromyalgia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibromialgia / Neuropatía de Fibras Pequeñas Límite: Humans Idioma: En Revista: J Pain Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibromialgia / Neuropatía de Fibras Pequeñas Límite: Humans Idioma: En Revista: J Pain Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos