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Researchers Find Evidence Of SFPN In Fibromyalgia Patients

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Fibromyalgia is estimated to affect up to 5% of people in Western countries. It is a condition characterised by chronic soft tissue pain, fatigue and sleep disturbances. The problem is that the causes of fibromyalgia remain unknown and there are few effective treatments. However, a study conducted at Massachusetts General Hospital (MGH) has found a connection between fibromyalgia and small-fibre polyneuropathy (SFPN).

About half of the fibromyalgia patients recruited for the study had damaged nerve fibres in their skin. The researchers also found other evidence of the presence of SFPN. What makes this discovery important is the fact that the two conditions share many symptoms but, in contrast to fibromyalgia, SFPN has an established pathology and its causes are known. Some of the specific medical conditions triggering SFPN are curable, for example Hepatitis C virus infection. Anne Louise Oaklander, corresponding author of the study, pointed out that the results were among the first objective evidence of an underlying mechanism in some fibromyalgia cases. Having an idea of the cause is the stepping stone to discovering better treatments, she added.

The MGH research team selected 27 adults suffering from fibromyalgia and 30 healthy subjects for a control group. The SFPN diagnostic process involved physical examination and questionnaires to assess neuropathy, as well as skin biopsies and tests of autonomic functions. The analysis of the data showed that 13 fibromyalgia patients had significantly reduced nerve fibre density, autonomic function tests deviating from the norm or both, which pointed to the presence of SFPN.

But given the complexity of fibromyalgia, one explanation will not do for all patients, Oaklander pointed out. Further research needs to focus on the subjects who did not exhibit signs of SFPN so that other causes can be found.