Small fiber pathology in fibromyalgia syndrome

Abstract. About 50% of women with fibromyalgia syndrome have reduced skin innervation. This finding is consistent in patient cohorts from different regions of the world. Small fiber function may also be affected, as shown by various studies using different methods, such as quantitative sensory testi...

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Main Authors: Claudia Sommer, Nurcan Üçeyler
Format: Article
Language:English
Published: Wolters Kluwer 2025-02-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001220
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author Claudia Sommer
Nurcan Üçeyler
author_facet Claudia Sommer
Nurcan Üçeyler
author_sort Claudia Sommer
collection DOAJ
description Abstract. About 50% of women with fibromyalgia syndrome have reduced skin innervation. This finding is consistent in patient cohorts from different regions of the world. Small fiber function may also be affected, as shown by various studies using different methods, such as quantitative sensory testing or special small fiber neurophysiology such as C-fiber microneurography. Microneurography in particular has shown increased spontaneous activity, mechanosensitivity, and enhanced activity-induced slowing in C fibers of patients with fibromyalgia. Generalized reduction of skin innervation, ie, proximally and distally, was associated with higher symptom severity and more pronounced central nervous system changes as seen in magnetic resonance tomography. The question whether peripheral or central nervous system changes come first, or whether both are signs of an underlying pathology, has not been resolved yet. For clinical practice, it is important to note that reduced skin innervation in fibromyalgia must not be confused with small fiber neuropathy, which is a separate entity with different characteristics and pathophysiology. Further prospective research is warranted to transfer these findings in the peripheral nervous system into clinical fibromyalgia patient management.
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spelling doaj-art-5686d95636344bce89a322d35d7c18292025-01-24T09:20:44ZengWolters KluwerPAIN Reports2471-25312025-02-01101e122010.1097/PR9.0000000000001220PR90000000000001220Small fiber pathology in fibromyalgia syndromeClaudia Sommer0Nurcan Üçeyler1Department of Neurology, University Hospital Würzburg, Würzburg, GermanyDepartment of Neurology, University Hospital Würzburg, Würzburg, GermanyAbstract. About 50% of women with fibromyalgia syndrome have reduced skin innervation. This finding is consistent in patient cohorts from different regions of the world. Small fiber function may also be affected, as shown by various studies using different methods, such as quantitative sensory testing or special small fiber neurophysiology such as C-fiber microneurography. Microneurography in particular has shown increased spontaneous activity, mechanosensitivity, and enhanced activity-induced slowing in C fibers of patients with fibromyalgia. Generalized reduction of skin innervation, ie, proximally and distally, was associated with higher symptom severity and more pronounced central nervous system changes as seen in magnetic resonance tomography. The question whether peripheral or central nervous system changes come first, or whether both are signs of an underlying pathology, has not been resolved yet. For clinical practice, it is important to note that reduced skin innervation in fibromyalgia must not be confused with small fiber neuropathy, which is a separate entity with different characteristics and pathophysiology. Further prospective research is warranted to transfer these findings in the peripheral nervous system into clinical fibromyalgia patient management.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001220
spellingShingle Claudia Sommer
Nurcan Üçeyler
Small fiber pathology in fibromyalgia syndrome
PAIN Reports
title Small fiber pathology in fibromyalgia syndrome
title_full Small fiber pathology in fibromyalgia syndrome
title_fullStr Small fiber pathology in fibromyalgia syndrome
title_full_unstemmed Small fiber pathology in fibromyalgia syndrome
title_short Small fiber pathology in fibromyalgia syndrome
title_sort small fiber pathology in fibromyalgia syndrome
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001220
work_keys_str_mv AT claudiasommer smallfiberpathologyinfibromyalgiasyndrome
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