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Automated Nociceptive Withdrawal Reflex Measurements Reveal Normal Reflex Thresholds and Augmented Pain Ratings in Patients with Fibromyalgia
Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
University of Gothenburg, Gothenburg, Sweden.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.ORCID iD: 0000-0002-6396-5104
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2020 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, no 6, article id 1992Article in journal (Refereed) Published
Abstract [en]

The nociceptive withdrawal reflex (NWR) is used to probe spinal cord excitability in chronic pain states. Here, we used an automated and unbiased procedure for determining the NWR threshold and compared the reflex thresholds and corresponding pain ratings in a well-characterized cohort of fibromyalgia (n = 29) and matched healthy controls (n = 21). Surface electrical stimuli were delivered to the foot in a stepwise incremental and decremental manner. The surface electromyographic activity was recorded from the ipsilateral tibialis anterior muscle. Fibromyalgia patients reported significantly higher scores for psychological distress and pain-related disability and a significantly lower score for perceived state of health compared to the matched controls. The subjective pain ratings were significantly higher in patients. The NWR thresholds were similar to the controls. In the patients, but not in controls, the NWR thresholds and subjective pain ratings were significantly correlated. Our results showed an increased subjective pain sensitivity in fibromyalgia, but we found no evidence for spinal sensitization based on the reflex measures.

Place, publisher, year, edition, pages
Switzerland: MDPI, 2020. Vol. 9, no 6, article id 1992
Keywords [en]
chronic pain; electromyography; fibromyalgia; nociceptive withdrawal reflex; sensitization
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-167142DOI: 10.3390/jcm9061992ISI: 000549467200001OAI: oai:DiVA.org:liu-167142DiVA, id: diva2:1448023
Note

Funding agencies:  Swedish Research CouncilSwedish Research Council [2018-02470]; County Council of Ostergotland [ALF: LIO-700931, LIO-900631]

Available from: 2020-06-26 Created: 2020-06-26 Last updated: 2024-10-22Bibliographically approved

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Ydrefors, JohannesWentzel Olausson, UlrikaGhafouri, BijarJohansson, Ann-CharlotteOlausson, HåkanGerdle, BjörnNagi, Saad

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Ydrefors, JohannesWentzel Olausson, UlrikaGhafouri, BijarJohansson, Ann-CharlotteOlausson, HåkanGerdle, BjörnNagi, Saad
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Center for Social and Affective NeuroscienceFaculty of Medicine and Health SciencesDepartment of Clinical NeurophysiologyDivision of Prevention, Rehabilitation and Community MedicinePain and Rehabilitation CenterCenter for Medical Image Science and Visualization (CMIV)
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