Trial Report Idiopathic intracranial hypertension with ultrasound in fibromyalgia: Relation with function, central sensitization, & neuropathic pain, 2024, Ketenci

https://onlinelibrary.wiley.com/doi/abs/10.1111/1756-185X.15066

Full title:

Frequency of idiopathic intracranial hypertension with ultrasound in patients with fibromyalgia: Relation with function, central sensitization, and neuropathic pain

Sertaç Ketenci, Bora Uzuner, Dilek Durmuş, Murat Polat
First published: 09 February 2024

https://doi.org/10.1111/1756-185X.15066


Abstract

Objective
The purpose of this study was to evaluate the prevalence of idiopathic intracranial hypertension (IIH) in fibromyalgia (FMS) patients by utilizing ultrasound to measure the optic nerve sheath diameter (ONSD), a marker of elevated intracranial pressure and also to investigate the relationship with function, fatigue, quality of life (QOL), central sensitization (CS) and neuropathic pain.

Methods
The study encompassed 80 female FMS patients and 75 healthy controls. Ultrasound was employed to measure the average ONSD in both groups. Conditions potentially elevating intracranial pressure were ruled out following neurological assessments. Pain (via visual analog scale, VAS), function (revised Fibromyalgia Impact Questionnaire, r-FIQ), QOL (Short Form-36, SF-36), fatigue (fatigue severity scale, FACIT), CS (Central Sensitization Scale), and neuropathic pain (Douleur Neuropathique-4) were evaluated.

Results
The average ONSD was significantly higher in the patient group than the control group. Patients with ONSD >5.5 mm consistent with IIH were categorized as Group 1 (n = 54, 67.5%), while those with a diameter of 5.5 mm and below-formed Group 2. VAS pain (p = .033) and FIQ-R scores (p = .033) were significantly higher in Group 1 than Group 2. Headache was found more common in Group 1.

Conclusion
This study unveils a substantial occurrence (67.5%) of IIH in FMS patients, suggesting shared pathophysiological mechanisms contributing to symptoms like fatigue, headache, and cognitive dysfunction. Additionally, these findings implicate heightened functional impairment, CS, headache, and fatigue in FMS patients with IIH.

 

Idiopathic translates as we do not have a clue and are not interested enough to investigate further.

 

Here is the background of optic nerve sheath ultrasound. It is correlated with intracranial pressure (if done right). https://www.ncbi.nlm.nih.gov/books/NBK554479/

Upper limit normal for adults is 5.0mm average (ultra sound optic nerve sheath measurement)

54 out of 80 FM patients were in the group measuring 5.5mm or more (2nd group of under 5.5mm) and were more likely to have certain symptoms. There isn't free access to the article, so the actual measurements are not available.

"This study unveils a substantial occurrence (67.5%) of IIH in FMS patients, suggesting shared pathophysiological mechanisms contributing to symptoms like fatigue, headache, and cognitive dysfunction. Additionally, these findings implicate heightened functional impairment, CS, headache, and fatigue in FMS patients with IIH." bolding is mine

But as causative mechanism? Or is this just noise, artifact?

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Cleveland Clinic article about idiopathic intracranial hypertension for background on who has it: besides running much higher incidence in females, and the obese, thyroid disorders, etc.

.https://my.clevelandclinic.org/health/diseases/21968-idiopathic-intracranial-hypertension.