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Autonomic Dysfunction in Fibromyalgia Assessed by the Composite Autonomic Symptoms Scale (COMPASS) – Source: Journal of Clinical Rheumatology, Mar 31, 2009

  [ 23 votes ]   [ 1 Comment ]
By Carla Solana, MD, et al. • • April 9, 2009

[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.

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Article Comments Post a Comment

Fibromyalgia far more serious than COMPASS can grasp and or realize!
Posted by: lsobol
Apr 15, 2009
Autonomic Dysfunction in Fibromyalgia Assessed by the Composite ...(COMPASS) Strong evidence of multiple nonpain symptoms "suggests that autonomic dysfunction is inherent to FM. ... study was to investigate symptoms of autonomic ... RESPONSE FROM FM PATIENT WITH OTHER DISORDERS AFFILIATED TO IT: These researchers are on the tip of the iceberg regarding the conception of the mechanisms that surround FM. I have myself stepped in to the forum of Fibromyalgia awareness with my information delevery to Congress and Senators of the U.S. House and Senate members; whom I hope received their letters regarding the FM subject. I describe Fibromyalgia as COMPASS has with far more additional components. These components vary from patient to patient. I see from personal experience that FM has cycles, "flare-ups," redundancy, chronic frequency, disability of the body and its' dis-orders and dis-ease of otherwise healthy and normal body systems and functions...and great courage to deal with. The Fibromyalgia experience is one that for me has included mal-function of the nervous system, things that I believe put me in danger of sinking into further disease and disorders such as MS and Lupus. Fibromyalgia weakens the immune system, slows the metabolic system, wreaks havoc on the nervous system and the skeletal and muscular structures as well. COMPASS may well be on a path of genuine understanding of some root causes and effects involving Fibromyalgia; but to my understanding from personal experience...there is much more to Fibromyalgia than COMPASS is embracing, at least in this article. Signed, Living on the Edge with Fibromyalgia P.S. As in other disorders and conditions such as Fibromyalgia; understanding benefits of good health are vital to survival as is doctor and patient repore in managing the conditions. CHF (Congestive Heart Failure) is perhaps the one condition that should never be ignored especially for Fibromyalgia patients; as a malfunctional metabolic disorder (I.B.S.) for example may indanger patients with dangerous levels of weight that seems unvanquishable thus heart health failure may result as well as numerous other unhealthful conditgions. Take hope and fight Fibromyalgia with every resource possible, get help in losing weight safely with doctor assisted interaction. This may aid in fighting off many other conditions such as diabetes for one. I know through my research that numerous FM patients later develop MS; and that 48% of FM patients have sleep apnea.
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