Small-fibre pathology has no impact on somatosensory system function in patients with fibromyalgia.

Abstract:

:We aimed to investigate whether small-fibre pathology, a common skin biopsy finding in patients with fibromyalgia, implies clinically important abnormalities of somatosensory system function and verify whether it is associated with voltage-gated sodium channel variants. In 57 consecutively enrolled patients with fibromyalgia, we used skin biopsy to distinguish patients with and without small-fibre pathology. In all patients, we assessed somatosensory system function using quantitative sensory testing (QST) and laser-evoked potentials and investigated voltage-gated sodium channel genotyping. We then compared these variables in patients with and without small-fibre pathology. We found that clinical measures, QST, and laser-evoked potential variables did not differ between patients with and without small-fibre pathology. In most patients with small-fibre pathology, QST and laser-evoked potential variables fell within normative ranges commonly used in clinical practice. Of the 57 patients, one patient without small-fibre pathology and 2 patients with small-fibre pathology had rare variants of voltage-gated sodium channels, namely SCN11A, SCN9A, and SCN1A variants. The SCN9A variant, found in a patient with small-fibre pathology, was an already profiled gain-of-function mutation, previously reported in small-fibre neuropathy. Our findings suggest that small-fibre pathology has a negligible impact on somatosensory system function in fibromyalgia. The genetic analysis suggests that patients with rare small-fibre neuropathy due to voltage-gated sodium channel variants may be misdiagnosed as patients with fibromyalgia.

journal_name

Pain

journal_title

Pain

authors

Fasolino A,Di Stefano G,Leone C,Galosi E,Gioia C,Lucchino B,Terracciano A,Di Franco M,Cruccu G,Truini A

doi

10.1097/j.pain.0000000000001920

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

2385-2393

issue

10

eissn

0304-3959

issn

1872-6623

pii

00006396-202010000-00019

journal_volume

161

pub_type

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