• Caterina Leone, Eleonora Galosi, Nicoletta Esposito, Pietro Falco, Alessandra Fasolino, Giuseppe Di Pietro, Giulia Di Stefano, Filippo Camerota, Jan Vollert, and Andrea Truini.
• Department of Human Neuroscience, Sapienza University, Rome, Italy.
• Eur J Pain. 2023 Jan 1; 27 (1): 163173163-173.

BackgroundIn this clinical and psychophysical study, we aimed to verify whether patients with fibromyalgia with and without small-fibre pathology and patients with pure small-fibre neuropathy share common sensory phenotypes.MethodsUsing an algorithm based on quantitative sensory testing variables, we grouped 64 consecutive patients with fibromyalgia (20 with small-fibre pathology, 44 without) and 30 patients with pure small-fibre neuropathy into different sensory phenotypes: sensory loss, thermal hyperalgesia, mechanical hyperalgesia and healthy phenotypes.ResultsWe found that the frequency of the different sensory phenotypes differed markedly between patients with fibromyalgia and patients with small-fibre neuropathy. In patients with fibromyalgia, with and without small-fibre pathology, healthy and hyperalgesia phenotypes (both thermal and mechanical) were similarly represented, whilst sensory loss and mechanical hyperalgesia phenotypes were the most frequent phenotypes in patients with small-fibre neuropathy.ConclusionsOur findings indicate that small-fibre damage is associated with distinct sensory phenotypes in patients with fibromyalgia and in patients with small-fibre neuropathy. The lack of phenotype differences between patients with fibromyalgia with and without small-fibre pathology and the relatively high frequency of the healthy phenotype in these patients highlight a complex relationship between small-fibre pathology and pain in patients with fibromyalgia.© 2022 European Pain Federation - EFIC ®.

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