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Altered heat pain thresholds & cerebral event-related potentials following painful CO2 laser stimulation in subjects with fibromyalgia (FM syndrome)

  [ 78 votes ]   [ Discuss This Article ]
www.ProHealth.com • August 4, 1994


A decrease in mechanical pressure pain thresholds,
particularly over pre-designated tender points, is one of the
defining characteristics of fibromyalgia syndrome (FS);
however, changes in thermal pain sensitivity have not been
investigated. The present study examined heat pain thresholds
and cerebral event-related potentials following CO2 laser
stimulation in 10 subjects with FS and 10 age-matched control
volunteers. The results indicate that patients with FS exhibit
a significant reduction in heat pain threshold when tested on
the dorsal surface of the hand. In accordance with previous
research, we also found a decrease in mechanical pain
threshold over pre-designated tender points and at control
sites as well as a significantly larger mechanically induced
neurogenic flare response. These measures were highly
correlated with thermal pain threshold even though different
anatomical sites were stimulated. Hence, it seems likely that
FS patients display a multimodal change in pain sensitivity
which is generalized rather than anatomically restricted.
Patients with FS also displayed a significant increase in the
peak-to-peak amplitude of the cerebral potential evoked by CO2
laser stimulation at pain threshold intensity and 1.5 times
pain threshold intensity.

These findings suggest a greater activation of central
nervous system (CNS) pathways following noxious input.
Putative explanations for the increased CNS response are
discussed, including mechanisms of peripheral nociceptor
sensitization, altered CNS function and the role of
psychological factors.

Gibson SJ, Littlejohn GO, Gorman MM, Helme RD, Granges G




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