title: Update on laser-evoked potential findings in fibromyalgia patients in light of clinical and skin biopsy features.
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.
authors.affiliation: Basic Medical Sciences, Neuroscience and Sensory System Department, SMBNOS, Policlinico General Hospital, Bari Aldo Moro University, Via Amendola 207 A, 70124, Bari, Italy, m.detommaso@neurol.uniba.it.
authors.forename: Marina
authors.initials: M
authors.lastname: de Tommaso
authors.forename: Maria
authors.initials: M
authors.lastname: Nolano
authors.forename: Florenzo
authors.initials: F
authors.lastname: Iannone
authors.forename: Eleonora
authors.initials: E
authors.lastname: Vecchio
authors.forename: Katia
authors.initials: K
authors.lastname: Ricci
authors.forename: Marta
authors.initials: M
authors.lastname: Lorenzo
authors.forename: Marianna
authors.initials: M
authors.lastname: Delussi
authors.forename: Francesco
authors.initials: F
authors.lastname: Girolamo
authors.forename: Vito
authors.initials: V
authors.lastname: Lavolpe
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Provitera
authors.forename: Annamaria
authors.initials: A
authors.lastname: Stancanelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lapadula
authors.forename: Paolo
authors.initials: P
authors.lastname: Livrea
mesh_terms: D000328:Adult; D001706:Biopsy; D001921:Brain / Q000503:physiopathology*; D015897:Comorbidity; D004569:Electroencephalography; D004585:Electrooculography; D000078404:Epidermal Cells; D004817:Epidermis / Q000473:pathology*; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D006185:Habituation, Psychophysiologic / Q000502:physiology; D006801:Humans; D066331:Laser-Evoked Potentials / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D011788:Quality of Life; D011897:Random Allocation