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Dysautonomia may be the pathogenesis behind fibromyalgia

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Results from a new questionnaire designed to assess dysautonomia suggest that condition, rather than polysymptomatic distress, may be the underlying pathogenesis in patients with fibromyalgia, according to researchers in Mexico City.

Researchers attempted to validate the questionnaire in patients with fibromyalgia diagnosed according to American College of Rheumatology (ACR) criteria.

“The ACR 2010 preliminary fibromyalgia diagnostic criteria is based on the Polysymptomatic Distress Scale,” Laura-Aline Martinez-Martinez, MD, and colleagues wrote, highlighting the developers of the scale noted it could assess illness severity while allowing for a dichotomous diagnosis. “We noted that Polysymptomatic Distress Scale items have clear dysautonomia connotations,” Martinez-Martinez and colleagues wrote.

Investigators compared the Composite Autonomic Symptom Score (COMPASS)-31 questionnaire, an abbreviated version of an older COMPASS evaluation, with the Polysymptomatic Distress Scale (PSD) and the Fibromyalgia Impact Questionnaire (FIQ). The study included 25 women with fibromyalgia based on both 1990 and 2010 ACR criteria, 19 women with active rheumatoid arthritis (RA) and 24 healthy control participants. The mean participant age was 41, and the groups had a similar age. All participants completed the COMPASS-31, PSD scale and FIQ.

Investigators found a correlation between the COMPASS-31 score and PSD and between COMPASS-31 and the FIQ. They discovered a strong correlation between COMPASS-31 scores and pain on the VAS in patients with fibromyalgia, but not in patients with RA. They also found higher COMPASS-31 scores in patients with fibromyalgia compared to patients with RA and healthy participants.

“A consistent line of investigation suggests that dysautonomia may explain the multisystem fibromyalgia features, and that fibromyalgia is a sympathetically maintained neuropathic pain syndrome,” the researchers wrote. “The sympathetic nervous network is the main component of the stress response system.” – by Shirley Pulawski

Reference:

Martinez-Martinez LA, et al. Paper #71. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosure: The researchers report no relevant financial disclosures.