• Stefanie Rehm, Juliane Sachau, Jana Hellriegel, Julia Forstenpointner, Børsting JacobsenHenrikHDepartment of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.Mind-Body Lab, Department of Psychology, University of Oslo, Oslo, Norway., Pontus Harten, Janne Gierthmühlen, and Ralf Baron.
• Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
• Pain Rep. 2021 Jan 1; 6 (1): e901.

IntroductionPatients suffering from fibromyalgia syndrome (FMS) are heterogenous. They often present with sensory abnormalities and comorbidities.ObjectivesWe aimed to answer the following questions: (1) Is there a specific somatosensory profile in our patient cohort? (2) Can we detect subgroups characterized by a specific combination of sensory and psychological features? and (3) Do psychological parameters influence sensory signs?MethodsIn 87 patients with FMS quantitative sensory testing was performed on the hand and evaluated in combination with questionnaire results regarding pain, psychological comorbidities, sleep, and functionality.ResultsPatients presented different somatosensory patterns, but no specific subgroups regarding sensory signs and psychological features were detected. Hypersensitivity for noxious mechanical and thermal stimuli and hyposensitivity for nonnoxious mechanical stimuli were the most prominent features. Thirty-one percent of patients showed signs of central sensitization as indicated by abnormally increased pinprick hyperalgesia or dynamic mechanical allodynia. Central sensitization was associated with higher pain intensities (P < 0.001). Only a small influence of psychiatric comorbidities on mechanical pain sensitivity (P = 0.044) and vibration detection (P = 0.028) was found, which was partly associated with high pain intensities. A small subgroup of patients (11.4%) demonstrated thermal hyposensitivity (loss of small-fiber function).ConclusionPatients with FMS showed various somatosensory abnormalities. These were not significantly influenced by psychological comorbidities. Signs for central sensitization were detected in about one-third of patients and associated with higher pain intensities. This supports the notion of central sensitization being a major pathophysiological mechanism in FMS, whereas small-fiber loss may be less important.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

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