Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study

Abstract Introduction Painful idiopathic distal sensory polyneuropathy (IDSP) and fibromyalgia syndrome (FMS) are cryptogenic chronic pain syndromes. The contribution of small fibre pathology (SFP) in FMS remains controversial. This study aims to quantify small nerve pathology in participants with I...

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Main Authors: Jamie Burgess, Anne Marshall, Leandros Rapteas, David Riley, Kohei Matsumoto, Cheng Boon, Alia Alchawaf, Maryam Ferdousi, Rayaz A. Malik, Andrew Marshall, Stephen Kaye, David Gosal, Bernhard Frank, Uazman Alam
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Language:English
Published: Adis, Springer Healthcare 2024-09-01
Series:Pain and Therapy
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Online Access:https://doi.org/10.1007/s40122-024-00646-x
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author Jamie Burgess
Anne Marshall
Leandros Rapteas
David Riley
Kohei Matsumoto
Cheng Boon
Alia Alchawaf
Maryam Ferdousi
Rayaz A. Malik
Andrew Marshall
Stephen Kaye
David Gosal
Bernhard Frank
Uazman Alam
author_facet Jamie Burgess
Anne Marshall
Leandros Rapteas
David Riley
Kohei Matsumoto
Cheng Boon
Alia Alchawaf
Maryam Ferdousi
Rayaz A. Malik
Andrew Marshall
Stephen Kaye
David Gosal
Bernhard Frank
Uazman Alam
author_sort Jamie Burgess
collection DOAJ
description Abstract Introduction Painful idiopathic distal sensory polyneuropathy (IDSP) and fibromyalgia syndrome (FMS) are cryptogenic chronic pain syndromes. The contribution of small fibre pathology (SFP) in FMS remains controversial. This study aims to quantify small nerve pathology in participants with IDSP and FMS and identify relationships of SFP with sensory phenotypes. Methods In this study, 73 individuals (FMS: 25, IDSP: 23, healthy volunteers: 25) underwent comprehensive assessment, including neurological exams, questionnaires, sensory tests, and corneal confocal microscopy. Results IDSP participants displayed lower wind-up ratio (WUR) relative to FMS (p < 0.001), loss of function to thermal and mechanical stimuli and elevated neuropathy disability scores compared to FMS and healthy volunteers (all p < 0.001). FMS participants demonstrated gain of function to heat and blunt pressure pain responses relative to IDSP, and healthy volunteers (heat: p = 0.002 and p = 0.003; pressure: both p < 0.001) and WUR (both p < 0.001). FMS participants exhibited reduced corneal nerve fibre density (p = 0.02), while IDSP participants had lower global corneal nerve measures (density, branch density, and length) relative to healthy volunteers (all p < 0.001). Utilising corneal nerve fibre length, SFP was demonstrated in 66.6% of participants (FMS: 13/25; IDSP: 22/23). Conclusion Participants with SFP, in both FMS and IDSP, reported symptoms indicative of small nerve fibre disease. Although distinctions in pain distributions are evident between individuals with FMS and IDSP, over 50% of participants between the two conditions displayed both a loss and gain of thermal and mechanical function suggestive of shared mechanisms. However, sensory phenotypes were associated with the presence of SFP in IDSP but not in FMS.
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spelling doaj-art-ee9fe44cd7704dc5adc0a5c4ccfbe1f52024-11-10T12:05:47ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2024-09-011361541155810.1007/s40122-024-00646-xIdiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping StudyJamie Burgess0Anne Marshall1Leandros Rapteas2David Riley3Kohei Matsumoto4Cheng Boon5Alia Alchawaf6Maryam Ferdousi7Rayaz A. Malik8Andrew Marshall9Stephen Kaye10David Gosal11Bernhard Frank12Uazman Alam13Institute of Life Course and Medical Sciences, University of LiverpoolInstitute of Life Course and Medical Sciences, University of LiverpoolInstitute of Life Course and Medical Sciences, University of LiverpoolInstitute of Life Course and Medical Sciences, University of LiverpoolLiverpool University Hospitals NHS Foundation Trust, Aintree HospitalDepartment of Clinical Oncology, The Royal Wolverhampton NHS TrustClatterbridge Cancer CentreFaculty of Biology, Medicine and Health, University of ManchesterDivision of Medicine, Qatar Foundation, Weill Cornell Medicine-QatarInstitute of Life Course and Medical Sciences, University of LiverpoolDepartment of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of LiverpoolDepartment of Neurology, Salford Royal NHS Foundation TrustInstitute of Life Course and Medical Sciences, University of LiverpoolInstitute of Life Course and Medical Sciences, University of LiverpoolAbstract Introduction Painful idiopathic distal sensory polyneuropathy (IDSP) and fibromyalgia syndrome (FMS) are cryptogenic chronic pain syndromes. The contribution of small fibre pathology (SFP) in FMS remains controversial. This study aims to quantify small nerve pathology in participants with IDSP and FMS and identify relationships of SFP with sensory phenotypes. Methods In this study, 73 individuals (FMS: 25, IDSP: 23, healthy volunteers: 25) underwent comprehensive assessment, including neurological exams, questionnaires, sensory tests, and corneal confocal microscopy. Results IDSP participants displayed lower wind-up ratio (WUR) relative to FMS (p < 0.001), loss of function to thermal and mechanical stimuli and elevated neuropathy disability scores compared to FMS and healthy volunteers (all p < 0.001). FMS participants demonstrated gain of function to heat and blunt pressure pain responses relative to IDSP, and healthy volunteers (heat: p = 0.002 and p = 0.003; pressure: both p < 0.001) and WUR (both p < 0.001). FMS participants exhibited reduced corneal nerve fibre density (p = 0.02), while IDSP participants had lower global corneal nerve measures (density, branch density, and length) relative to healthy volunteers (all p < 0.001). Utilising corneal nerve fibre length, SFP was demonstrated in 66.6% of participants (FMS: 13/25; IDSP: 22/23). Conclusion Participants with SFP, in both FMS and IDSP, reported symptoms indicative of small nerve fibre disease. Although distinctions in pain distributions are evident between individuals with FMS and IDSP, over 50% of participants between the two conditions displayed both a loss and gain of thermal and mechanical function suggestive of shared mechanisms. However, sensory phenotypes were associated with the presence of SFP in IDSP but not in FMS.https://doi.org/10.1007/s40122-024-00646-xIdiopathic distal sensory polyneuropathyFibromyalgia syndromeSmall fibreCorneal confocal microscopyQuantitative sensory testingNeuropathic pain
spellingShingle Jamie Burgess
Anne Marshall
Leandros Rapteas
David Riley
Kohei Matsumoto
Cheng Boon
Alia Alchawaf
Maryam Ferdousi
Rayaz A. Malik
Andrew Marshall
Stephen Kaye
David Gosal
Bernhard Frank
Uazman Alam
Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study
Pain and Therapy
Idiopathic distal sensory polyneuropathy
Fibromyalgia syndrome
Small fibre
Corneal confocal microscopy
Quantitative sensory testing
Neuropathic pain
title Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study
title_full Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study
title_fullStr Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study
title_full_unstemmed Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study
title_short Idiopathic Distal Sensory Polyneuropathy and Fibromyalgia Syndrome: A Comparative Phenotyping Study
title_sort idiopathic distal sensory polyneuropathy and fibromyalgia syndrome a comparative phenotyping study
topic Idiopathic distal sensory polyneuropathy
Fibromyalgia syndrome
Small fibre
Corneal confocal microscopy
Quantitative sensory testing
Neuropathic pain
url https://doi.org/10.1007/s40122-024-00646-x
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