Measuring Slowly Repeated Evoked Pain Responses May Improve Accuracy of FM Diagnosis

Measuring Slowly Repeated Evoked Pain Responses May Improve Accuracy of FM Diagnosis
Adding a protocol to the standard tests used by physicians to diagnose fibromyalgia may improve the likelihood that the disorder will be diagnosed more accurately, a new study shows. Results of the study that makes recommendations about also measuring slowly repeated evoked pain response (SREP) — a progressive increase in perceived pain in response to slow, repeated pressure stimuli — were published in the journal Pain Medicine. It is titled “Addition of Slowly Repeated Evoked Pain Responses to Clinical Symptoms Enhances Fibromyalgia Diagnostic Accuracy.” Although the causes of fibromyalgia are currently unknown, some studies have suggested the disorder arises from a sensitization process taking place in the central nervous system (CNS, the brain and spinal cord). Sensitization refers to a phenomenon in which a repeated stimulus, such as pain, triggers a progressively stronger response of nerve cells in the CNS. Neuroimaging studies have shown that patients with fibromyalgia experience sensitization in response to evoked pain, such as pressure or very cold water. Evoked pain is typically measured by analyzing a patient’s pain threshold and tolerance. However, studies focused on evaluating the relationship between static evoked pain measures and a clinical diagnosis of fibromyalgia have yielded inconclusive findings. In addition, due to their static nature, pain threshold and tolerance may not be the best parameters to capture CNS sensitization that is thought to underlie fibromyalgia. In contrast, “a novel dynamic evoked pain index based on the increase in pain perception due to
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