ArticlePain reports2018
Specific symptoms may discriminate between fibromyalgia patients with vs without objective test evidence of small-fiber polyneuropathy.
Article in Pain reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Epidermal Neurite Density in Skin Biopsies From Patients With Juvenile Fibromyalgia.The Journal of rheumatology · 2021Pooled it
- Structured Symptom Assessment to Identify Patients With Small Fiber or Autonomic Neuropathy in Fibromyalgia.European journal of neurology · 2025Article
- Small Fiber Neuropathy in Veterans With Gulf War Illness.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- The diagnostic assessment of fibromyalgia and the role of small fiber pathology.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Small fibre pathology, small fibre symptoms and pain in fibromyalgia syndrome.Scientific reports · 2024Article
- Distinguishing fibromyalgia syndrome from small fiber neuropathy: a clinical guide.Pain reports · 2024Article
- Clinical criteria and diagnostic assessment of fibromyalgia: position statement of the Italian Society of Neurology-Neuropathic Pain Study Group.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- The puzzle of fibromyalgia between central sensitization syndrome and small fiber neuropathy: a narrative review on neurophysiological and morphological evidence.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Review
- Implications of Nerve Fiber Density on the Diagnosis and Treatment of Juvenile Fibromyalgia.Journal of pain research · 2022Review
- Article
- Intraepidermal Nerve Fiber Density as Measured by Skin Punch Biopsy as a Marker for Small Fiber Neuropathy: Application in Patients with Fibromyalgia.Diagnostics (Basel, Switzerland) · 2021Review
- Small Fiber Polyneuropathy May Be a Nexus Between Autonomic Nervous System Dysregulation and Pain in Interstitial Cystitis/Bladder Pain Syndrome.Frontiers in pain research (Lausanne, Switzerland) · 2021Review
- Scientific Advances in and Clinical Approaches to Small-Fiber Polyneuropathy: A Review.JAMA neurology · 2019Article
- Sustained Enlargement in Vagus and Sural Nerve Cross-Sectional Areas in Fibromyalgia: A Longitudinal Study.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionMultiple studies now confirm that ∼40% of patients with fibromyalgia syndrome meet diagnostic criteria for small-fiber polyneuropathy (SFPN) and have objective pathologic or physiologic evidence of SFPN, whereas 60% do not. Given possibilities that tens or hundreds of millions globally could have SFPN, developing screening tools becomes important.
objectivesThis analysis explored whether specific symptoms might help distinguish these fibromyalgia endophenotypes.
methodsWith institutional review board approval, all adults tested for SFPN by distal-leg skin biopsy or autonomic function testing at Massachusetts General Hospital in 2014 to 2015 were queried about symptoms. Inclusion required a physician's fibromyalgia syndrome diagnosis plus meeting the American College of Rheumatology 2010 Fibromyalgia Criteria. The primary outcome was the validated Small-fiber Symptom Survey, which captures severity of all known SFPN-associated symptoms. The Composite Autonomic Symptom Score-31, Short-Form Health Survey-36, and Short-Form McGill Pain Questionnaires provided secondary outcomes.
resultsAmong the 39 participants, 14 had test-confirmed SFPN (SFPN+) and 25 did not (SFPN-). Their pain severity did not differ. Paresthesias ("tingling") were different (worse) in the SFPN+ group (3.14 ± 0.9 vs 2.28 ± 1.1;
conclusionAmong patients with fibromyalgia, most symptoms overlap between those with or without confirmed SFPN. Symptoms of dysautonomia and paresthesias may help predict underlying SFPN. The reason to screen for SFPN is because-unlike fibromyalgia-its medical causes can sometimes be identified and definitively treated or cured.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.