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Norepinephrine-evoked pain in fibromyalgia. A randomized pilot study [ISRCTN70707830].

Martinez-Lavin M, Vidal M, Barbosa RE, Pineda C, Casanova JM, Nava A - BMC Musculoskelet Disord (2002)

Bottom Line: Norepinephrine-evoked pain was diagnosed when norepinephrine injection induced greater pain than placebo injection.Intensity of norepinephrine-evoked pain was calculated as the difference between norepinephrine minus placebo-induced VAS scores.Intensity of norepinephrine-evoked pain was greater in FM patients (mean +/- SD 2.5 +/- 2.5) when compared to rheumatoid arthritis patients (0.3 +/- 0.7), and healthy controls (0.3 +/- 0.8) p < 0.0001.

View Article: PubMed Central - HTML - PubMed

Affiliation: Rheumatology Department Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, 14080 Mexico D.F. México. mmlavin@infosel.net.mx

ABSTRACT

Background: Fibromyalgia syndrome displays sympathetically maintained pain features such as frequent post-traumatic onset and stimuli-independent pain accompanied by allodynia and paresthesias. Heart rate variability studies showed that fibromyalgia patients have changes consistent with ongoing sympathetic hyperactivity. Norepinephrine-evoked pain test is used to assess sympathetically maintained pain syndromes. Our objective was to define if fibromyalgia patients have norepinephrine-evoked pain.

Methods: Prospective double blind controlled study.

Participants: Twenty FM patients, and two age/sex matched control groups; 20 rheumatoid arthritis patients and 20 healthy controls. Ten micrograms of norepinephrine diluted in 0.1 ml of saline solution were injected in a forearm. The contrasting substance, 0.1 ml of saline solution alone, was injected in the opposite forearm. Maximum local pain elicited during the 5 minutes post-injection was graded on a visual analog scale (VAS). Norepinephrine-evoked pain was diagnosed when norepinephrine injection induced greater pain than placebo injection. Intensity of norepinephrine-evoked pain was calculated as the difference between norepinephrine minus placebo-induced VAS scores.

Results: Norepinephrine-evoked pain was seen in 80 % of FM patients (95% confidence intervals 56.3 - 94.3%), in 30 % of rheumatoid arthritis patients and in 30 % of healthy controls (95% confidence intervals 11.9 - 54.3) (p < 0.05). Intensity of norepinephrine-evoked pain was greater in FM patients (mean +/- SD 2.5 +/- 2.5) when compared to rheumatoid arthritis patients (0.3 +/- 0.7), and healthy controls (0.3 +/- 0.8) p < 0.0001.

Conclusions: Fibromyalgia patients have norepinephrine-evoked pain. This finding supports the hypothesis that fibromyalgia may be a sympathetically maintained pain syndrome.

No MeSH data available.


Related in: MedlinePlus

Norepinephrine-evoked pain
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Figure 1: Norepinephrine-evoked pain

Mentions: Eighty percent of FM patients had NE-evoked pain according to our definition, in contrast 30% of RA patients and 30% of normal controls had such response (p < 0.05) (figure 1). Likewise NE-evoked pain intensity was greater in FM group (mean +/- SD 2.5 +/- 2.5) when compared to RA patients (0.3 +/- 0-7) and healthy controls (0.3 +/- 0.8) p < 0.0001. (Figure 2).


Norepinephrine-evoked pain in fibromyalgia. A randomized pilot study [ISRCTN70707830].

Martinez-Lavin M, Vidal M, Barbosa RE, Pineda C, Casanova JM, Nava A - BMC Musculoskelet Disord (2002)

Norepinephrine-evoked pain
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC65524&req=5

Figure 1: Norepinephrine-evoked pain
Mentions: Eighty percent of FM patients had NE-evoked pain according to our definition, in contrast 30% of RA patients and 30% of normal controls had such response (p < 0.05) (figure 1). Likewise NE-evoked pain intensity was greater in FM group (mean +/- SD 2.5 +/- 2.5) when compared to RA patients (0.3 +/- 0-7) and healthy controls (0.3 +/- 0.8) p < 0.0001. (Figure 2).

Bottom Line: Norepinephrine-evoked pain was diagnosed when norepinephrine injection induced greater pain than placebo injection.Intensity of norepinephrine-evoked pain was calculated as the difference between norepinephrine minus placebo-induced VAS scores.Intensity of norepinephrine-evoked pain was greater in FM patients (mean +/- SD 2.5 +/- 2.5) when compared to rheumatoid arthritis patients (0.3 +/- 0.7), and healthy controls (0.3 +/- 0.8) p < 0.0001.

View Article: PubMed Central - HTML - PubMed

Affiliation: Rheumatology Department Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, 14080 Mexico D.F. México. mmlavin@infosel.net.mx

ABSTRACT

Background: Fibromyalgia syndrome displays sympathetically maintained pain features such as frequent post-traumatic onset and stimuli-independent pain accompanied by allodynia and paresthesias. Heart rate variability studies showed that fibromyalgia patients have changes consistent with ongoing sympathetic hyperactivity. Norepinephrine-evoked pain test is used to assess sympathetically maintained pain syndromes. Our objective was to define if fibromyalgia patients have norepinephrine-evoked pain.

Methods: Prospective double blind controlled study.

Participants: Twenty FM patients, and two age/sex matched control groups; 20 rheumatoid arthritis patients and 20 healthy controls. Ten micrograms of norepinephrine diluted in 0.1 ml of saline solution were injected in a forearm. The contrasting substance, 0.1 ml of saline solution alone, was injected in the opposite forearm. Maximum local pain elicited during the 5 minutes post-injection was graded on a visual analog scale (VAS). Norepinephrine-evoked pain was diagnosed when norepinephrine injection induced greater pain than placebo injection. Intensity of norepinephrine-evoked pain was calculated as the difference between norepinephrine minus placebo-induced VAS scores.

Results: Norepinephrine-evoked pain was seen in 80 % of FM patients (95% confidence intervals 56.3 - 94.3%), in 30 % of rheumatoid arthritis patients and in 30 % of healthy controls (95% confidence intervals 11.9 - 54.3) (p < 0.05). Intensity of norepinephrine-evoked pain was greater in FM patients (mean +/- SD 2.5 +/- 2.5) when compared to rheumatoid arthritis patients (0.3 +/- 0.7), and healthy controls (0.3 +/- 0.8) p < 0.0001.

Conclusions: Fibromyalgia patients have norepinephrine-evoked pain. This finding supports the hypothesis that fibromyalgia may be a sympathetically maintained pain syndrome.

No MeSH data available.


Related in: MedlinePlus