Small nerve fiber involvement in patients referred for fibromyalgia
Abstract
INTRODUCTION: Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain often accompanied by other symptoms suggestive of neuropathic pain. We evaluated patients for small fiber neuropathy (SFN) who were referred for fibromyalgia (FM). METHODS: We studied 20 consecutive subjects with primary FM. Patients underwent neurological examination, nerve conduction studies, and skin biopsies from distal leg and thigh. RESULTS: Electrodiagnostic studies were normal in all patients. SFN was diagnosed in 6 patients by reduced epidermal nerve fiber density. These patients also showed abnormalities of both adrenergic and cholinergic fibers. CONCLUSIONS: A subset of FM subjects have SFN, which may contribute to their sensory and autonomic symptoms. Skin biopsy should be considered in the diagnostic work-up of FM.
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The exact impact of the peripheral nervous system on pain in fibromyalgia syndrome is still a matter of debate.
“however, the exact impact of the peripheral nervous system on pain in FMS is still a matter of debate.”
From Pain and small fiber pathology in men with fibromyalgia syndrome (2024) · cites this paper as [18]
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Fibromyalgia and overlapping disorders: The unifying concept of central sensitivity syndromes
Yunus, M. B. (2007) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2006.12.009 · Cited by 780 · see citing works
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Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s)
Clauw, D. J. (2015) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2015.04.024 · Cited by 169 · see citing works
Reduction of skin innervation is associated with a severe fibromyalgia phenotype
Evdokimov, D., Frank, J., Klitsch, A., Unterecker, S., Warrings, B., Serra, J., Papagianni, A., Saffer, N., Meyer zu Altenschildesche, C., Kampik, D., et al. (2019) · Annals of Neurology · doi:10.1002/ana.25565 · Cited by 152 · see citing works
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Pain and small fiber pathology in men with fibromyalgia syndrome
Feulner, B., Gross, F., Evdokimov, D., Malik, R. A., Kampik, D., & Üçeyler, N. (2024) · PAIN Reports · doi:10.1097/pr9.0000000000001212 · Cited by 8 · see citing works
Central Sensitization and Small-fiber Neuropathy Are Associated in Patients With Fibromyalgia
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- Authors
- Giannoccaro, M. P., Donadio, V., Incensi, A., Avoni, P., & Liguori, R.
- Affiliations
- University of Bologna (IT)
- Istituto delle Scienze Neurologiche di Bologna (IT)
- Corresponding author
- Giannoccaro, Maria Pia
- Venue
- Muscle & Nerve
- Publisher
- Wiley
- Published
- 2014-01-28
- Volume
- 49
- Issue
- 5
- Pages
- 757-759
- ISSN
- 0148-639X (ISSN-L)
- 1097-4598
- OpenAlex
- W1898582655
- Cited by
- 113
- References
- 2
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 7 · 2023: 6 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 11 · 2018: 10 · 2017: 7 · 2016: 12 · 2015: 13 · 2014: 11
- FWCI
- 8.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Muscle & Nerve (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Keywords
- fibromyalgia, small fiber neuropathy, epidermal nerve fiber density, skin biopsy, adrenergic fibers, cholinergic fibers, neuropathic pain, autonomic symptoms, sensory symptoms
- MeSH terms
- Adult, Biopsy, Electrodiagnosis, Erythromelalgia, Female, Fibromyalgia, Humans, Leg, Male, Middle Aged, Nerve Fibers, Neural Conduction, Neurologic Examination, Skin, Cohort Studies, Cholinergic Neurons, Adrenergic Neurons
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