Fibromyalgia (FM) as a disorder of perceptual organization? An analysis of acoustic stimulus processing in patients with widespread pain

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We examined to what extent patients with fibromyalgia differ from
painfree control subjects in the perception and processing not
only of somatosensory but also of external stimuli. For this
purpose the acoustic perception of 30 patients with
fibromyalgia was compared with that of 36 generally pain-free
age and gender matched subjects. The groups were also
controlled for organic disease of pathological dysfunction of
the ear and auditory nerves. Thresholds of unpleasantness and
hearing thresholds were determined autiometrically for various
frequencies. In addition the participants rated their
experience of daily noise, vulnerability to acoustic stress,
and functional and affective complaints associated with
fibromyalgia.

As expected the results show reduced unpleasantness
thresholds for all frequencies and a nonsymptomatic
hearing loss for higher frequencies. The elevated
hearing threshold correlated significantly with
experience of noise at the place of work, which was also
elevated in the fibromyalgia group. Generalized pain had a
high impact on the interaction between threshold of
unpleasantness and daily noise experience. We interpret the
differences in thresholds of hearing and of unpleasantness in
patients with fibromyalgia as a form of either preconscious or
conscious acts to protect against disturbing stimulation. Our
results support the notion of a generalized disturbancy of
perceptual thresholds in patients with fibromyalgia not
restricted to the perception of pain.

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