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Pain matters for central sensitization: sensory and psychological parameters in patients with fibromyalgia syndrome, 2021, Rehm et al

Discussion in ''Conditions related to ME/CFS' news and research' started by Andy, Mar 16, 2021.

  1. Andy

    Andy Committee Member

    Messages:
    21,810
    Location:
    Hampshire, UK
    Introduction:
    Patients suffering from fibromyalgia syndrome (FMS) are heterogenous. They often present with sensory abnormalities and comorbidities.

    Objectives:
    We aimed to answer the following questions: (1) Is there a specific somatosensory profile in our patient cohort? (2) Can we detect subgroups characterized by a specific combination of sensory and psychological features? and (3) Do psychological parameters influence sensory signs?

    Methods:
    In 87 patients with FMS quantitative sensory testing was performed on the hand and evaluated in combination with questionnaire results regarding pain, psychological comorbidities, sleep, and functionality.

    Results:
    Patients presented different somatosensory patterns, but no specific subgroups regarding sensory signs and psychological features were detected. Hypersensitivity for noxious mechanical and thermal stimuli and hyposensitivity for nonnoxious mechanical stimuli were the most prominent features. Thirty-one percent of patients showed signs of central sensitization as indicated by abnormally increased pinprick hyperalgesia or dynamic mechanical allodynia. Central sensitization was associated with higher pain intensities (P < 0.001). Only a small influence of psychiatric comorbidities on mechanical pain sensitivity (P = 0.044) and vibration detection (P = 0.028) was found, which was partly associated with high pain intensities. A small subgroup of patients (11.4%) demonstrated thermal hyposensitivity (loss of small-fiber function).

    Conclusion:
    Patients with FMS showed various somatosensory abnormalities. These were not significantly influenced by psychological comorbidities. Signs for central sensitization were detected in about one-third of patients and associated with higher pain intensities. This supports the notion of central sensitization being a major pathophysiological mechanism in FMS, whereas small-fiber loss may be less important.

    Open access, https://journals.lww.com/painrpts/F...rs_for_central_sensitization__sensory.37.aspx
     
    Snowdrop, shak8, spinoza577 and 2 others like this.
  2. Sphyrna

    Sphyrna Established Member (Voting Rights)

    Messages:
    71
    Location:
    Germany
    >Finally, because of the purely explorative approach, P values were not corrected for multiple testing, resulting in a less stringent statistical analysis.

    I'm sorry, but could someone better versed in medical statistics explain why this is OK to omit in exploratory research? Why even bother with significance testing at all, then, if the p-values don't actually mean anything? I guess they just wanted to generate as many hypotheses as possible, so mitigating type 1 errors isn't that important, but isn't the CSS hypothesis of fibromyalgia already fairly well established?
     
    Last edited: Mar 16, 2021
    Michelle, alktipping, Sean and 2 others like this.

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