Full Papers
Outcome of small fibre pathology in fibromyalgia: a real life longitudinal observational study
S.G. Quitadamo1, E. Vecchio2, M. Delussi3, G. Libro4, L. Clemente5, R. Lombardi6, D. Modena7, M. Giannotta8, F. Iannone9, M. De Tommaso10
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy.
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy.
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy.
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy.
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy.
- Neuroalgology Unit, Carlo Besta Institute, Milano, Italy.
- Neuroalgology Unit, Carlo Besta Institute, Milano, Italy.
- Rheumatology Clinic, DETO Department, Aldo Moro University, Bari, Italy.
- Rheumatology Clinic, DETO Department, Aldo Moro University, Bari, Italy.
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy. marina.detommaso@uniba.it
CER15685
2023 Vol.41, N°6
PI 1216, PF 1224
Full Papers
Free to view
(click on article PDF icon to read the article)
PMID: 35916296 [PubMed]
Received: 17/03/2022
Accepted : 19/05/2022
In Press: 27/07/2022
Published: 28/06/2023
Abstract
OBJECTIVES:
Small fibre pathology is frequently described in fibromyalgia (FM), but its evolution and its role in clinical outcome of the disease are unclear. This longitudinal observational real-life study aimed to monitor the evolution of skin nerve fibre density in FM, in view of the clinical data.
METHODS:
Sixty-two FM patients were controlled by means of skin biopsy and clinical assessment after 18 months of follow-up.
RESULTS:
At T0 intraepidermal nerve fibre density (IENFD) was normal in 10 patients, reduced at thigh-proximal-site in 46 cases and decreased at proximal and foot-distal-site in 6 patients. At follow up-T1-the IENFD was unchanged, while Brief Pain Inventory-BPI-pain sub score, DN4 and fatigue were improved. Reduced IENFD at proximal and distal sites, together with fatigue and BPI-motor and work sub scores were predictors of more severe disability measured with Fibromyalgia Impact Questionnaire (FIQ) at T1. Reduced IENFD influenced a minor effect of drugs-antiepileptics and/or antidepressants, and physical exercise on fatigue.
CONCLUSIONS:
Small fibre impairment seems stable in medium term in FM. A possible influence of small fibre dysfunction on motor performance could have a role in FM evolution. The beneficial effect of physical exercise could be limited in patients with reduced IENFD.