Dysautonomia in fibromyalgia syndrome: sympathetic skin responses and RR Interval analysis

Abstract

This study was planned to investigate the dysfunction of the autonomic nervous system in fibromyalgia syndrome (FM) using sympathetic skin responses (SSR) and RR interval analysis. Thirty-four FM and 22 healthy subjects were recruited for the study. They were questioned for symptoms that are characteristic for FM and medical outcome study short form-36 (SF-36) was used to determine the quality of life of the subjects. Tender points were counted and the disease duration was noted. SSR was recorded from palm and sole with stimulation of contralateral median and tibial nerves respectively. R-R interval variation was evaluated at rest (R%) and during deep breathing (DR%). The mean ages of the patients were 37+/- 10.2 and 37+/-10.6, respectively. The mean tender point count was 14.9+/-2.3 and the disease duration was 16.6+/-12.1 months. The symptoms were discrepant in FM (P<0.001). The scores of the eight items of SF-36 in FMS patients were significantly lower than the control group (P<0.001). We could not elicit SSR in five FM patients (15%) from the sole and in two patients (6%) from the palm. The latencies of SSR recorded from both palms and soles of FM patients were significantly longer than healthy subjects (P<0.001). The mean amplitude of SSR recorded from both palm and sole was not statistically different from control subjects (P>0.05). RRIV obtained from FM and the control subjects at rest and during deep breathing showed that the decrease in DR% was significant compared to normal subjects (P<0.001). As a result, we can state that sympathetic as well as parasympathetic nervous system dysfunction occurs in FM patients and this abnormality could be determined by SSR and RRIV analysis.

EEG Biofeedback Treatment Improves Certain Attention and Somatic Symptoms in Fibromyalgia: A Pilot Study

“…Nevertheless, our findings should not be taken as evidence for an isolated CNS pathogenesis in FMS since unequivocal peripheral abnormalities have been identified in this syndrome. These abnormalities include those of muscle tissue (Olsen and Park 1998;Park et al 2000;Sprott et al 2004), the PNS, and the autonomic nervous system (Raj et al 2000;Cohen et al 2001;Ulas et al 2006;Caro et al 2008), and the immune system (Caro 1989;Salemi et al 2003;Caro and Winter 2005;Caro and Winter 2008;Caro et al 2008). Nevertheless, it is known that CNS pain perception may interact somewhat with attention related cognition (Pickering et al 2002).…”

A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia

“…We speculate that these improvements may be related to an augmentation of parasympathetic tone as a consequence of the daily use of PYD (28) and regular exercise (29). There is now persuasive evidence that FM patients have dysautonomia, as evidenced by results of heart rate variability studies, tilt-table testing (30), and sympathetic skin responses (31)(32)(33)(34). Two common clinical manifestations of dysautonomia are neurally mediated hypotension and postural orthostatic tachycardia syndrome (35,36).…”

Evaluation of Sympathetic Skin Response and F Wave in Fibromyalgia Syndrome Patients

“…Some studies have reported the intra-individual variations for amplitudes (2-48%) and latencies (2-22%). [25,[27][28][29][30] Although Özgöçmen et al [25] found a close correlation between SSR latencies [26] investigated the autonomic nervous system dysfunction in FMS patients. They found significantly longer SSR distal latencies which are in contrast with our results.…”