Cornea nerve fiber quantification and construction of phenotypes in patients with fibromyalgia

被引:45
作者
Oudejans, Linda [1 ]
He, Xuan [1 ]
Niesters, Marieke [1 ]
Dahan, Albert [1 ]
Brines, Michael [2 ]
van Velzen, Monique [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Anesthesiol, Leiden, Netherlands
[2] Araim Pharmaceut Inc, Tarrytown, NY USA
来源
SCIENTIFIC REPORTS | 2016年 / 6卷
关键词
CONFOCAL MICROSCOPY; CENTRAL SENSITIZATION; POLYNEUROPATHY UNDERLIES; FUNCTIONAL CONNECTIVITY; OBJECTIVE EVIDENCE; SKIN BIOPSIES; NEUROPATHY; DIAGNOSIS; DENSITY; SEVERITY;
D O I
10.1038/srep23573
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Cornea confocal microscopy (CCM) is a novel non-invasive method to detect small nerve fiber pathology. CCM generally correlates with outcomes of skin biopsies in patients with small fiber pathology. The aim of this study was to quantify the morphology of small nerve fibers of the cornea of patients with fibromyalgia in terms of density, length and branching and further phenotype these patients using standardized quantitative sensory testing (QST). Small fiber pathology was detected in the cornea of 51% of patients: nerve fiber length was significantly decreased in 44% of patients compared to age- and sex-matched reference values; nerve fiber density and branching were significantly decreased in 10% and 28% of patients. The combination of the CCM parameters and sensory tests for central sensitization, (cold pain threshold, mechanical pain threshold, mechanical pain sensitivity, allodynia and/or windup), yielded four phenotypes of fibromyalgia patients in a subgroup analysis: one group with normal cornea morphology without and with signs of central sensitization, and a group with abnormal cornea morphology parameters without and with signs of central sensitization. In conclusion, half of the tested fibromyalgia population demonstrates signs of small fiber pathology as measured by CCM. The four distinct phenotypes suggest possible differences in disease mechanisms and may require different treatment approaches.
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页数:9
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