Abstract Details

Title Reduction of Intraepidermal Nerve Fiber Density (IENFD) in the Skin Biopsies of Patients with Fibromyalgia: A Controlled Study

Topic Peripheral Nerve

Presentation(s) P01 - (-)

Poster/Presentation
Number 141

Objective

Background BACKGROUND: Fibromyalgia (FM) is one of the most common chronic pain syndromes. Various mechanisms have been implicated but none is proven, including psychogenic causes, amplification of pain perception within the CNS or impaired central pain inhibition.

Design/Methods DESIGN/METHODS: 19 symptomatic patients with FM without any underlying disorder, aged 29-76 (mean 53,3 years), diagnosed according to the ACR 2010 criteria, and 7 healthy volunteers, aged 19-54 (mean 32,4 years), underwent a 5mm punch skin biopsy above the right lateral malleolus, after signing informed consent. Samples were snapped- frozen, sectioned at 40[mu]m and stained with antibody to PGP 9.5 (Ultraclone).IENFD was counted by two independed observers, following the established EFNS/PNS 2010 guidelines. The number of Langerhans cells, the main Antigen Presenting Cells in the skin, were counted using monoclonal antibodies to Langerin (Abcam) in 5 FM and 5 healthy controls.

Results RESULTS: The IENFD in the FM patients ranged from 1,8 to 12,5 fibers/mm (mean: 5,1 +/- 2,76), whereas in the controls the IENFD ranged from 7,2 to 11,5 fibers/mm (mean: 8,4 +/- 1,58) [p=0.0013]. In 12 out of 19 FM patients (63%), the IFND was below the mean +/_2SD value of the controls. Langerhan's cell counts were not significantly different between FM and controls.

Conclusions CONCLUSIONS: Patients with FM demonstrate a SFN, based on the significant reduction of IENFD. Although FM remains a complex disorder causing diffuse pains, SFN appears to be a contributing factor. The cause of reduced IENFD is unclear but immune, chemokine/cytokine disturbances or cytotoxic factors are currently explored. The observations, if confirmed with a larger series, suggest that non-psychogenic factors may play a causative role for the pain syndrome in some FM patients.

Authors/Disclosures
PRESENTER	No disclosure on file
Lukia Koutsogeorgopoulou	No disclosure on file
	No disclosure on file
Haralambos Alexopoulos (University of Athens)	No disclosure on file
	No disclosure on file
	No disclosure on file
Kelly D. Foote, MD	Kelly D. Foote, MD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axio/Neurocrine Biosciences.
	No disclosure on file
	No disclosure on file

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