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Associations of Cognitive Fusion and Pain Catastrophizing with Fibromyalgia Impact through Fatigue, Pain Severity, and Depression: An Exploratory Study Using Structural Equation Modeling
Open AccessArticle

Automated Nociceptive Withdrawal Reflex Measurements Reveal Normal Reflex Thresholds and Augmented Pain Ratings in Patients with Fibromyalgia

1
Department of Clinical Neurophysiology, Linköping University, 58185 Linköping, Sweden
2
Center for Social and Affective Neuroscience, Linköping University, 58185 Linköping, Sweden
3
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
4
Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, 58185 Linköping, Sweden
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(6), 1992; https://doi.org/10.3390/jcm9061992
Received: 21 May 2020 / Revised: 11 June 2020 / Accepted: 22 June 2020 / Published: 25 June 2020
The nociceptive withdrawal reflex (NWR) is used to probe spinal cord excitability in chronic pain states. Here, we used an automated and unbiased procedure for determining the NWR threshold and compared the reflex thresholds and corresponding pain ratings in a well-characterized cohort of fibromyalgia (n = 29) and matched healthy controls (n = 21). Surface electrical stimuli were delivered to the foot in a stepwise incremental and decremental manner. The surface electromyographic activity was recorded from the ipsilateral tibialis anterior muscle. Fibromyalgia patients reported significantly higher scores for psychological distress and pain-related disability and a significantly lower score for perceived state of health compared to the matched controls. The subjective pain ratings were significantly higher in patients. The NWR thresholds were similar to the controls. In the patients, but not in controls, the NWR thresholds and subjective pain ratings were significantly correlated. Our results showed an increased subjective pain sensitivity in fibromyalgia, but we found no evidence for spinal sensitization based on the reflex measures. View Full-Text
Keywords: chronic pain; electromyography; fibromyalgia; nociceptive withdrawal reflex; sensitization chronic pain; electromyography; fibromyalgia; nociceptive withdrawal reflex; sensitization
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MDPI and ACS Style

Ydrefors, J.; Karlsson, T.; Wentzel Olausson, U.; Ghafouri, B.; Johansson, A.-C.; Olausson, H.; Gerdle, B.; Nagi, S.S. Automated Nociceptive Withdrawal Reflex Measurements Reveal Normal Reflex Thresholds and Augmented Pain Ratings in Patients with Fibromyalgia. J. Clin. Med. 2020, 9, 1992.

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