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Update on laser-evoked potential findings in fibromyalgia patients in light of clinical and skin biopsy features

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Abstract

In fibromyalgia (FM), reduced habituation of laser-evoked potentials (LEPs) suggests a dysfunction of pain processing at a central level. In this study, we aimed to further examine the nociceptive pathways at the peripheral to the central level in a large group of FM patients by means of LEPs and skin biopsy, in light of healthy controls findings and main clinical features. One hundred and ninety-nine FM patients and 109 age- and sex-matched controls were submitted to LEPs by the dorsum of the right hand and the skin over the right chest and knee tender point stimulation. Skin biopsy was performed in 21 randomly selected FM patients and 60 age- and sex-matched controls. The mean N2–P2 amplitude was reduced in the whole FM group, with normal or even increased values in patients with migraine as comorbidity and reduced values in other patients including those presenting with distal sensory deficits. All patients had reduced N2–P2 habituation in respect to controls. In the FM group, LEPs habituation was correlated with pain at tender points and bad quality of life. Epidermal fiber density was significantly reduced in FM patients versus controls, and correlated with N2–P2 amplitude by the hand and chest tender-point stimulation. Dysfunction in the nociceptive system at both the central and peripheral levels may concur to explain phenotypical eterogeneity and clinical symptom complexity in fibromyalgia.

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Authors and Affiliations

  1. Basic Medical Sciences, Neuroscience and Sensory System Department, SMBNOS, Policlinico General Hospital, Bari Aldo Moro University, Via Amendola 207 A, 70124, Bari, Italy

    Marina de Tommaso, Eleonora Vecchio, Katia Ricci, Marta Lorenzo, Marianna Delussi, Francesco Girolamo, Vito Lavolpe & Paolo Livrea

  2. Neurology Department, “Salvatore Maugeri” Foundation IRCCS-Medical Center of Telese, Benevento, Italy

    Maria Nolano, Vincenzo Provitera & Annamaria Stancanelli

  3. Rheumatology Unit, Medical School, University of Bari Aldo Moro, Bari, Italy

    Florenzo Iannone & Giovanni Lapadula

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  1. Marina de Tommaso
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Correspondence to Marina de Tommaso.

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de Tommaso, M., Nolano, M., Iannone, F. et al. Update on laser-evoked potential findings in fibromyalgia patients in light of clinical and skin biopsy features. J Neurol 261, 461–472 (2014). https://doi.org/10.1007/s00415-013-7211-9

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