Turkish Journal of Physical Medicine and Rehabilitation 2011 , Vol 57 , Num 2

Evaluation of Autonomic Nervous System Dysfunction in Fibromyalgia

Özlem Şahin 1 ,Serpil Yıldız 2 ,Nebi Yıldız 2 ,Mustafa Fatih Yaşar 3 ,Ece Kaptanoğlu 4
1 Cumhuriyet Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Sivas, Türkiye
2 Abant Izzet Baysal Üniversitesi, Izzet Baysal Tıp Fakültesi, Nöroloji Anabilim Dalı, Bolu, Türkiye
3 Abant Izzet Baysal Üniversitesi, Izzet Baysal Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Bolu, Türkiye
4 Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
DOI : 10.4274/tftr.57.13

Objective: There have been conflicting results of studies on autonomic nervous system (ANS) dysfunction in fibromyalgia (FM). The aim of this study was to evaluate the sympathetic nervous system dysfunction via sympathetic skin response (SSR) recordings in patients with FM.


Materials and Methods: Twenty-seven female patients with FM and 18 healthy volunteer females as controls were included in the study. All participant were administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) and were questioned about chronic symptoms that are characteristic for FM. Right palmar SSRs were evoked by electrical stimulation of the median nerve at the wrist.


Results: The FM patients had higher rates of most of the chronic symptoms of FM. There was no significant difference in SSR latency and amplitude between patients and controls (p>0.05). The patients with FM had no depression and anxiety according to the BDI and BAI mean scores.


Conclusion: We did not find ANS dysfunction in the patients with FM. SSR may be an insufficient way of determining the whole ANS dysfunction as it only evaluates the sudomotor component. ANS dysfunction may be responsible for some of the chronic symptoms of FM and accompanying depression and anxiety (not observed in the present study) rather than taking part in the etiopathogenesis. It can be possible to determine the role of ANS in FM etiopathogenesis by studies evaluating the subsystems of ANS (cardiovascular reflex pathway, sympathetic cholinergic activity etc.) in which chronic symptoms of FM, especially anxiety and depression, are also considered.

Keywords : Autonomic nervous system, sympathetic nervous system, fibromyalgia, sympathetic skin response