Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome
Abstract
Although individuals with fibromyalgia syndrome (FMS) consistently report wide-spread pain, clear evidence of structural abnormalities or other sources of chronic stimulation of pain afferents in the involved body areas is lacking. Without convincing evidence for peripheral tissue abnormalities in FMS patients, it seems likely that a central pathophysiological process is at least partly responsible for FMS, as is the case for many chronic pain conditions. Therefore, the present study sought to obtain psychophysical evidence for the possibility that input to central nociceptive pathways is abnormally processed in individuals with long standing FMS. In particular, temporal summation of pain (wind-up) was assessed, using series of repetitive thermal stimulation of the glabrous skin of the hands. Although wind-up was evoked both in control and FMS subjects, clear differences were observed. The perceived magnitude of the sensory response to the first stimulus within a series was greater for FMS subjects compared to controls, as was the amount of temporal summation within a series. Within series of stimuli, FMS subjects reported increases in sensory magnitude to painful levels for interstimulus intervals of 2-5 s, but pain was evoked infrequently at intervals greater than 2 s for control subjects. Following the last stimulus in a series, after-sensations were greater in magnitude, lasted longer and were more frequently painful in FMS subjects. These results have multiple implications for the general characterization of pain in FMS and for an understanding of the underlying pathophysiological basis.
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The pathophysiology of fibromyalgia syndrome seems to be related to sensitization of central nervous system processes, which underlie alterations in pain perception, deficient pain inhibition, temporal summation of pain, and other indicators of pain sensitization.
“Regarding the etiopathophysiology of FMS, while its etiology remains unknown, the pathophysiology of this chronic condition seems to be related to the sensitization of CNS processes, e.g., [5,22,23], which underlie the alterations in pain perception displayed by these patients, (e.g., allodynia and hyperalgesia) [24], deficient pain inhibition [25], temporal summation of pain [26] and other”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [26]
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- Authors
- Staud, R., Vierck, C. J., Cannon, R. L., Mauderli, A. P., & Price, D. D.
- Affiliations
- University of Florida Health (US)
- University of Florida (US)
- Corresponding author
- Staud, Roland
- Venue
- Pain
- Published
- 2001-03
- Volume
- 91
- Issue
- 1
- Pages
- 165-175
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2074122852
- Cited by
- 774
- References
- 54
- Citations by year
- 2026: 9 · 2025: 18 · 2024: 19 · 2023: 17 · 2022: 24 · 2021: 35 · 2020: 24 · 2019: 32 · 2018: 22 · 2017: 19 · 2016: 26 · 2015: 35 · 2014: 29 · 2013: 46 · 2012: 42
- FWCI
- 21.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (NS-07261, R01NS007261, NS38767, R01NS038767)
- National Center for Research Resources (RR-00082, M01RR000082)
- 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 › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- fibromyalgia, temporal summation of pain, wind-up, central sensitization, thermal pain, central pain processing, psychophysical pain assessment
- MeSH terms
- Female, Fibromyalgia, Hand, Hot Temperature, Humans, Male, Pain, Psychophysics, Reference Values, Time Factors, Pain Threshold
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