Generalized Hypersensitivity in Patients With Fibromyalgia Syndrome

Not Applicable

Recruiting

Brief Summary: Fibromyalgia (FM) is a chronic musculoskeletal pain disorder with unknown causes. Our previous studies showed abnormal sensations of second pain (wind-up), indicating central hypersensitivity as an important mechanism of FM. Triggering events have been implicated as the cause of central hypersensitivity.

Detailed Description: Increasing evidence has shown that the hypersensitivity of FM is not limited to painful stimuli but seems to extend to non-painful stimuli as well. These stimuli include smell, taste, touch, light, and sound. This study will provide detailed QST examinations of FM subjects and controls' responses to light using visually evoked potentials (VEP). In addition, careful characterization of experimental pain responding across multiple sensory modalities will be examined.

Recruitment & Eligibility

Inclusion Criteria

Individuals diagnosed with FM will have pain of > 3 months and meet the 1990 and 2011 Diagnostic Criteria for FM (ACR)
Healthy, pain-free age and sex matched controls without chronic pain

Exclusion Criteria

Presence of chronic disease (e.g. cancer, cardiovascular disease, liver disease, kidney disease, diabetes, etc.).
FM patients must be willing to discontinue or hold their FM related medications for a minimum of one day prior to the visit.
Significant vision loss not corrected by eye wear
Family history of photosensitive epilepsy

Arm && Interventions

Group	Intervention	Description
Effects of PASAT on Sensory Testing	Paced Auditory Serial Addition task (PASAT)	After baseline evaluation of light and pain sensitivity FM subjects and controls will undergo the PASAT task. This task consists of responding to a rapid presentation of numbers by ear phones. Subjects are asked to add each 2 consecutive numbers and provide a response each time the sum is equal to 13. This test will last several minutes and delivered at increasing speed.

Primary Outcome Measures

Name	Time	Method
Visual Evoked Potentials (VEP) During Flicker	1 hour	FM and control subject will focus on a light source while VEPs are obtained. EEG tracings will be evaluated by special software to detect VEP. For intensity ratings of the flicker stimulus a numerical ratings scale (0-100) will be used ranging from "no sensation" to the "most intense sensation possible". All measures will be obtained in triplicates and the averages will be used for statistical comparisons.
Verbal Pain Ratings of Painful Heat and Pressure Stimuli using a Numerical Pain Scale from 0 - 100	1 hour	FM and control subjects will provide verbal ratings of experimental pain stimuli. For this purpose a numerical ratings scale (0-100) will be used ranging from "no sensation" to the "most intense sensation possible". All measures will be obtained in triplicates and the averages will be used for statistical comparisons.

Secondary Outcome Measures

Name	Time	Method
Response to 2011 Fibromyalgia Criteria Questionnaire	0.5 hours	FM and control subjects will complete the 2011 FM Questionnaire. The answers of this questionnaire will be added to obtain the wide-spread pain index and the somatic symptom score. The scores will be combined to obtain the final score. Scores of \>12 fulfill the Criteria for Fibromyalgia
Response to the Center for Epidemiological Studies (CES-D) Depression Questionnaire	0.5 hours	FM and control subjects will complete the CES-D. The answers of this questionnaire will be combined to obtain a final score. Total scores of \>15 are consistent with the diagnosis of major depression.

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