Highlights
- •Heat and sound stimuli were adjusted to each individuals’ sensitivity.
- •Pseudo-random levels of sound pressure were tested in all participants.
- •For same loudness ratings, FM patients required lower sound pressures than HC.
- •Sound sensitivity of FM patients did not correlate with nociceptive sensitivity.
Abstract
Fibromyalgia is a chronic widespread pain syndrome associated with hypersensitivity
to nociceptive stimuli. This increased sensitivity of FM patients has been associated
with central sensitization of dorsal horn neurons. Increasing evidence, however, suggests
that the mechanisms of FM hypersensitivity not only affect pain but include light,
smell, and sound. We hypothesized that supraspinal augmentation of sensory input including
sound represent a hallmark of FM. We tested 23 FM patients and 28 healthy controls
(HC) for sensory augmentation of nociceptive and non-nociceptive sensations: For assessment
of nociceptive augmentation we used sensitivity adjusted mechanical and heat ramp
& hold stimuli and for assessment of sound augmentation, we applied wideband noise
stimuli using a random-staircase design. Quantitative sensory testing demonstrated
increased heat and mechanical pain sensitivity in FM participants (P < .001). The sound pressures needed to report mild, moderate, and intense sound levels
were significantly lower in FM compared to HC (P < .001), consistent with auditory augmentation.
FM patients are not only augmenting noxious sensations but also sound, suggesting
that FM augmentation mechanisms are not only operant in the spinal cord but also in
the brain. Whether the central nervous system mechanisms for auditory and nociceptive
augmentation are similar, needs to be determined in future studies.
Perspective
This study presents QST evidence that the hypersensitivity of FM patients is not limited
to painful stimuli but also to innocuous stimuli like sound. Our results suggest that
abnormal brain mechanisms may be responsible for the increased sensitivity of FM patients.
Key Words
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Article info
Publication history
Published online: February 23, 2021
Accepted:
February 15,
2021
Received in revised form:
January 21,
2021
Received:
October 29,
2020
Footnotes
This work was funded by the University of Florida.
None of the authors has any conflict of interest.
Identification
Copyright
© 2021 by United States Association for the Study of Pain, Inc.
