Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Fibromyalgia: First Proof Found

14.03.2013
Fibromyalgia has a reputation as a mysterious illness: The symptoms are diverse, the causes are unknown and the diagnosis is difficult. For the first time, researchers at the University Hospital of Würzburg now have found clear proof of damage to patients' small fibers.

The responsibility for pain and temperature sensation lies with so-called small fibers, i.e. small-caliber pain-transmitting nerve fibers terminating in the skin. In the search for the causes of fibromyalgia-related pain, University of Würzburg researchers have focused their research on these fibers.

With success: "We have detected clear signs of damage to the small fibers in patients with fibromyalgia syndrome," says Nurcan Üçeyler, a private lecturer at the Department of Neurology of the University Hospital of Würzburg. The results of their study are reported in the current issue of the journal Brain.

Paradigm shift: organic basis identified

According to Üçeyler, this discovery heralds a "paradigm shift": The results of the study are highly relevant in that they challenge the conventional pathophysiological concept of fibromyalgia. "Since we have established that the small fibers are impaired in patients with fibromyalgia, the pain related to this disease now fulfils the criteria for being considered as neuropathic pain, i.e. pain arising from an impairment or illness of the nervous system," Üçeyler explains. Furthermore, for the first time, medical professionals have an objectively measurable criterion at their disposal to help them with their diagnosis.

The study

Nurcan Üçeyler and Prof. Claudia Sommer examined 35 patients in their study. 25 of them were affected by fibromyalgia, and ten of them suffered from depression – a condition often ascribed to fibromyalgia patients due to the lack of clear-cut criteria for a reliable diagnosis. The latter ten patients did not experience any pain. In addition, suitable control groups were recruited for each test.

The medical researchers examined the study participants with three specific testing methods: Quantitative sensory testing (QST) is used, among other things, to determine the thermal detection and pain thresholds of the small fibers. The elicitation of pain-related evoked potentials (PREP) provides information on the electrical excitability of the nerve fibers. A punch biopsy provides skin samples for morphological analysis under the microscope. "These three methods are objective procedures, which supplement each other in the assessment of small fiber function, enabling us to make a multidimensional analysis," says Üçeyler.

The results

The study result was clear: "All three test methods revealed definite signs of damage to the small fibers in patients with fibromyalgia syndrome," the medical researcher explains. Fibromyalgia patients were less sensitive to temperature stimuli in the QST test. During the PREP elicitations, those affected by the disease exhibited weaker responses to the pain stimuli. The researchers found significant abnormalities in the microscopic examination as well: "Punch biopsy samples showed a significantly reduced number of small fibers – a finding typical of diseases with small fiber involvement," Nurcan Üçeyler notes.

The researchers found it particularly interesting that fibromyalgia patients not only differed in their test results from healthy study participants, but that they could also be differentiated from patients suffering from depression without any pain symptoms – the latter showed similar results to healthy people. Although fibromyalgia patients had about as many depressive symptoms as the depressive study participants, they were the only ones affected by an impairment of their small fibers.

The team of Nurcan Üçeyler and Claudia Sommer derives a clear result from the study: "Even though it is not yet known why the small fibers are impaired in fibromyalgia patients, our results could provide the basis for a redefinition of the fibromyalgia syndrome as a disease."

The fibromyalgia syndrome

Fibromyalgia affects an estimated two to four percent of the general adult population in western countries. The fibromyalgia syndrome is characterized by chronic pain in several body regions; further symptoms include sleep disturbances, daytime fatigue and depressive symptoms. The disease is more prevalent in women than in men and leads to a greatly reduced quality of life.

The diagnosis is made by excluding alternative diseases on the basis of the patient's description of typical symptoms. Usually, the examination of patients with fibromyalgia reveals no pathological findings, no matter whether clinical tests, laboratory tests or additional apparatus-based diagnostic methods are used. This is why the fibromyalgia syndrome is still not generally recognized as a "real disease" even today: No pathogenic agent or understandable pathological mechanism has been identified for the condition.

Prolonged quest for a diagnosis

Thus, fibromyalgia patients visiting a physician's office are often not taken seriously, having to listen to remarks like: "Fibromyalgia? There is no such thing." They also find themselves frequently confronted with the statement that their complaints are a manifestation of depression. It is true that fibromyalgia patients often also have symptoms of depression. But it's just as possible that these are caused by chronic pain. Due to these "misdiagnoses", it often takes years until fibromyalgia is diagnosed and the symptoms are treated. The long quest for adequate treatment is often frustrating for patients and physicians alike. It also puts a high cost burden on our health system.

The study was financially supported with research funds of the University of Würzburg.

"Small fibers in fibromyalgia syndrome", Nurcan Üçeyler, Daniel Zeller, Ann-Kathrin Kahn, Susanne Kewenig, Sarah Kittel-Schneider, Annina Schmid, Jordi Casanova-Molla, Karlheinz Reiners, Claudia Sommer; doi:10.1093/brain/awt053

Gunnar Bartsch | Uni Würzburg
Further information:
http://www.uni-wuerzburg.de

More articles from Health and Medicine:

nachricht Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can the immune system be boosted against Staphylococcus aureus by delivery of messenger RNA?

Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.

Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....

Im Focus: A quantum walk of photons

Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.

The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Marine Conservation: IASS Contributes to UN Ocean Conference in New York on 5-9 June

24.05.2017 | Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

 
Latest News

How herpesviruses win the footrace against the immune system

26.05.2017 | Life Sciences

Water forms 'spine of hydration' around DNA, group finds

26.05.2017 | Life Sciences

First Juno science results supported by University of Leicester's Jupiter 'forecast'

26.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>