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Reduced dermal nerve fiber diameter in skin biopsies of patients with fibromyalgia
Abstract
Recent studies have provided evidence of pathology and functional abnormalities of small nerve fibers as a potential correlate of pain in the fibromyalgia syndrome. Here, we aimed to quantify dermal unmyelinated nerve fiber diameter at the electron microscopic level to find a potential morphological correlate of the functional disturbance. Thirty-two patients with fibromyalgia syndrome, 12 patients with small fiber neuropathy, and 24 healthy controls were prospectively recruited. Skin biopsies of the distal and proximal legs and index finger were taken and processed for immunofluorescence and for electron microscopy. We determined the diameter of small unmyelinated nerve fibers by measuring ten transversely cut axons of each biopsy. The mean axon diameter was reduced in patients with fibromyalgia syndrome compared with patients with small fiber neuropathy and controls (P < 0.05). Furthermore, we confirmed previous findings of disturbed small fiber function in quantitative sensory testing and of reduced intraepidermal nerve fiber density in patients with fibromyalgia. Our study provides further evidence of small fiber pathology in fibromyalgia syndrome and discloses differences compared with small fiber neuropathy, indicating that different pathomechanisms may lead to small fiber loss in the 2 disorders.
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“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 [12]
In the citing paper
“In line with previous studies mainly performed in women with FMS,12,15,26,33,50 we found evidence for impaired small nerve fiber function in male patients with FMS. This was reflected by elevated thermal detection thresholds, increased mechanical pain thresholds, and alterations in the pleasant touch test.”
From Pain and small fiber pathology in men with fibromyalgia syndrome (2024) · cites this paper as [12]
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“Previous data on sensory profiles in FMS are quite divergent,12,15,26,27,33,50 which may be due to diversity in the normative reference values and subjectivity of this standardized, but psychophysical method.”
From Pain and small fiber pathology in men with fibromyalgia syndrome (2024) · cites this paper as [12]
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Research works printed but not linked: 27
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Metadata
- Authors
- Doppler, K., Rittner, H. L., Deckart, M., & Sommer, C.
- Affiliations
- Universitätsklinikum Würzburg (DE)
- Caritas-Krankenhaus Bad Mergentheim (DE)
- Corresponding author
- Doppler, Kathrin
- Venue
- Pain
- Published
- 2015-11
- Volume
- 156
- Issue
- 11
- Pages
- 2319-2325
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2395203281
- Cited by
- 130
- References
- 0
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 10 · 2023: 8 · 2022: 13 · 2021: 12 · 2020: 11 · 2019: 15 · 2018: 15 · 2017: 17 · 2016: 14 · 2015: 4
- FWCI
- 13.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Julius-Maximilians-Universität Würzburg
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- fibromyalgia, small fiber neuropathy, unmyelinated nerve fibers, axon diameter, skin biopsy, intraepidermal nerve fibers, quantitative sensory testing, small fiber dysfunction, neuropathic pain
- MeSH terms
- Adult, Aged, Biopsy, Electric Stimulation, Female, Fibromyalgia, Humans, Male, Middle Aged, Neural Conduction, Pain Measurement, Schwann Cells, Skin, Statistics, Nonparametric, Nerve Fibers, Unmyelinated, Ubiquitin Thiolesterase, Microscopy, Electron, Transmission
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