How nerve damage plays a role in fibromyalgia. Recent study

From: Lisa Martin

In a recent study of patients with fibromyalgia, moderate to severe nerve damage was observed in skin cells in almost half of the patients.

Damage to the nerves of the nerve fibers was considered a small fiber polyneuropathy or SFPN. Small fiber polyneuropathy is caused by some specific diseases.

There is currently no known cause for fibromyalgia, so this discovery of nerve damage could make some progress toward finding exactly what causes the disorder.

Fibromyalgia disorders distinguish patients from one patient to another, but typical symptoms include chronic widespread pain, extreme fatigue, and hypersensitivity to pain and pressure. The disorder affects women disproportionately compared to men.

Consider nerve damage

Some progress has been made in the correct diagnosis of the disorder, but its pathology remains a mystery. Fibromyalgia has some of the same symptoms as small-fiber polyneurotherapy, in which small-fiber polyneurotherapy has caused widespread chronic pain in people diagnosed.

The study was conducted in 27 adults with fibromyalgia disorder and in a group of 30 healthy volunteers who volunteered for the study. The same tests used in small fiber polyneurotherapy diagnoses were used to evaluate the participants in the study. The tests included a physical examination and the management of a questionnaire.

In addition, the researchers administered skin biopsies to help assess nerve fibers in patients’ legs and monitor the patient’s blood pressure, sweating and heart rate.

Neuropathy was found in very high numbers in patients with fibromyalgia, while the group of healthy individuals seemed normal. Thirteen of the 27 patients with fibromyalgia were registered as individuals with reduced density of nerve fibers in their skin.

The approximately thirteen individuals also had odd results of autonomous functional tests. Based on these results, it was assumed that these thirteen subjects had a small fiber polyneurotherapy.

Although the conclusions drawn from this test suggest that there is no cause for the development of all the conditions of fibromyalgia, they give some clues to the researchers, which in some patients cause fibromyalgia.

Fibromyalgia disorder is a very complex, unique and complex disorder. Its symptoms and severity are different for each affected patient. Due to this unique differentiation, there is no explanation for the development of fibromyalgia.

This process can take months or years to find answers, which are the main causes of fibromyalgia. Before working on a cure for fibromyalgia, researchers must first find out exactly what causes the development of the disorder in patients.

This study is currently unique. The results were published recently, so other laboratories should soon begin to perform their own tests and experiments after the design of this study.

It is possible that some have already started with some adjustments. Finding a better diagnosis of fibromyalgia is a continuous process.

And finding better treatments for those people caused by the fibromyalgia disorder is one of the top priorities when it comes to this unique disorder.

Evidence of nerve damage in approximately half of patients with fibromyalgia

Summary: About half of a small group of patients with fibromyalgia, a common syndrome that causes chronic pain and other symptoms, have been diagnosed with nerve fiber damage to the skin and other signs of a condition known as small-fiber polyneuropathy (SFPN), Unlike fibromyalgia, SFPN has a different pathology and is known to be caused by specific medical conditions, some of which can be treated and sometimes cured.

About half of a small group of patients with fibromyalgia, a common syndrome that causes chronic pain and other symptoms, have been diagnosed with nerve fiber damage to their skin and other signs of a condition called small fiber polyneuropathy (SFPN). . Unlike fibromyalgia, which had no known causes and few effective treatments, SFPN has a clear pathology and is known to be caused by certain medical conditions, some of which can be treated and sometimes cured. The study conducted by researchers at the Massachusetts General Hospital (MGH) will appear in the journal PAIN and was published online.

“This provides some of the first objective evidence of a mechanism behind some cases of fibromyalgia, and the identification of an underlying cause is the first step to finding better treatments,” says Anne Louise Oaklander, MD, PhD, director of the Unit nerve injuries in the MGH Department of Neurology and corresponding pain painter.

The term fibromyalgia describes a range of symptoms, including chronic and generalized pain, increased hypersensitivity and fatigue, which is believed to affect 1 to 5 percent of Westerners, most commonly women. While a diagnosis of fibromyalgia has been recognized by the National Institutes of Health and the American College of Rheumatology, its biological basis remains unknown. Fibromyalgia shares many symptoms with SFPN, a recognized cause of chronic and widespread pain for which objective evidence exists.

To investigate the possible relationship between the two diseases, 27 adult patients diagnosed with fibromyalgia and 30 healthy volunteers were included in the current study. Participants underwent a series of tests to diagnose SFPN, which included neuropathy from a physical examination and answers to questionnaires, skin biopsies to determine the number of nerve fibers in the lower legs and tests of autonomous functions such as frequency heart disease, blood pressure and sweating.

The questionnaires, the evaluation of the exams and the skin biopsies showed significant values ​​of neuropathy in the patients with fibromyalgia, but not in the control group. Of the 27 patients with fibromyalgia, 13 had a marked decrease in nerve fiber density, abnormal autonomic function tests, or both, indicating the presence of SFPN. Participants who met the criteria for SFPN were also screened for known causes of the disease, and although none of them had evidence of diabetes, a common cause of SFPN, two found an infection with the hepatitis C virus that can be successfully treated, and more than half had signs of some type of immune system dysfunction.

“Until now, we have not had a good idea of ​​what causes fibromyalgia, but now we have evidence of some, but not all of the patients. Fibromyalgia is too complex for a “one size fits all” explanation, says Oaklander, an associate professor of neurology at Harvard Medical School. “The next step of independently validating our findings from other laboratories is already underway, and we must also monitor patients who do not meet the SFPN criteria to see if we can find other causes. Helping one of these people to obtain a definitive diagnosis and a better treatment would be a great achievement. “

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