title: Hearing loss in fibromyalgia? Somatic sensory and non-sensory symptoms in patients with fibromyalgia and other rheumatic disorders.
abstract: OBJECTIVE
  It has been proposed that fibromyalgia can be understood as a disorder of central sensitisation and dysregulation (CD) and that characteristic somatic symptoms are the result of 'central augmentation'. We examined this hypothesis by analysing sensory and non-sensory variables in the context of the updated (2010) American College of Rheumatology definition of fibromyalgia and the fibromyalgianess (polysymptomatic distress) scale.
  
  
  METHODS
  We studied 11,288 patients, including those with fibromyalgia, rheumatoid arthritis (RA) and osteoarthritis (OA). We divided somatic symptoms into sensory (hearing difficulties) and evaluative (easy bruising and hair loss) non-sensory symptoms, and included a non-symptom that was neutral as to psychological content or meaning (influenza vaccination). Data were analysed by logistic regression and adjusted for age and sex.
  
  
  RESULTS
  Fibromyalgia patients reported more sensory and non-sensory symptoms than patients with RA and OA, but not more non-symptoms. At all levels of fibromyalgianess (or fibromyalgia intensity) the probability of sensory and non-sensory symptoms was similar across all rheumatic diseases, and this association occurred in FM criteria (+) and criteria (-) patients. No association was noted with the non-symptom control question.
  
  
  CONCLUSIONS
  While the CD hypothesis is consistent with hearing problems in fibromyalgia, there is no medical explanation for the evaluative symptoms of hair loss and bruising being increased. The associations between fibromyalgia/fibromyalgianess and evaluative (not sensory) symptoms must occur through mechanisms other than central sensitization and augmentation, and are consistent with over-reporting that has a psychological basis. However, augmentation of sensory symptoms does not preclude simultaneous over-reporting.
authors.affiliation: National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine, Wichita, KS, USA. fwolfe@arthritis-research.org
authors.forename: Frederick
authors.initials: F
authors.lastname: Wolfe
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Rasker
authors.forename: Winfried
authors.initials: W
authors.lastname: Häuser
mesh_terms: D000367:Age Factors; D000368:Aged; D000505:Alopecia / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001309:Auditory Threshold; D003288:Contusions / Q000209:etiology; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D006309:Hearing; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D012684:Sensory Thresholds; D012737:Sex Factors; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines