[Note: The COMPASS questionnaire, developed by Mayo Clinic neurologists, includes 169 items covering different aspects of autonomic symptoms (problems with regulation of unconscious body functions such as heart rate, blood pressure, etc.). Responses are weighted to produce a composite score. See also “Symptoms of autonomic dysfunction in chronic fatigue syndrome.”]
Background: It has been suggested that autonomic nervous system dysfunction may explain all of fibromyalgia (FM) multisystem features. Such proposal is based mostly on the results of diverse heart rate variability analyses.
The Composite Autonomic Symptom Scale (COMPASS) is a different validated method to recognize dysautonomia.
• The main objective of our study was to investigate symptoms of autonomic dysfunction in FM patients by means of COMPASS.
• A secondary objective was to define whether there is a correlation between COMPASS and Fibromyalgia Impact Questionnaire (FIQ) scores in FM patients.
Methods: Design, analytical cross-sectional study. Our study population included 3 different groups of women:
• 30 patients with FM,
• 30 patients with rheumatoid arthritis,
• And 30 women who considered themselves healthy.
All participants filled out COMPASS and FIQ questionnaires.
• FM patients had significantly higher values in all COMPASS domains. COMPASS total score (54.6 +/- 20.9; mean +/- standard deviation) clearly differentiated FM patients from the other 2 groups (21.6 +/- 16.5 and 9.5 +/- 10.2, respectively). P < 0.0001. [Probability that score resulted by chance less than one in 10,000.]
• The majority of FM patients gave affirmative answers to questions related to orthostatic, digestive, sleep, sudomotor [sweat gland stimulation], or mucosal dysfunction. There was a significant correlation between COMPASS and FIQ scores (Spearman r = 0.5, P < 0.005).
• Patients with FM have multiple nonpain symptoms related to different expressions of autonomic dysfunction.
• There is a correlation between a questionnaire that measures FM severity (FIQ) and an autonomic dysfunction questionnaire (COMPASS).
• Such correlation suggests that autonomic dysfunction is inherent to FM.
Source: Journal of Clinical Rheumatology, Mar 31, 2009. 15(2), PMID: 19342959, by Solano C, Martinez A, Becerril L, Vargas A, Figueroa J, Navarro C, Ramos-Remus C, Martinez-Lavin M. National Institute of Cardiology, Mexico City, Mexico; National Institute of Respiratory Diseases, Mexico City, Mexico; Hospital General Regional 45, Guadalajara, Mexico.