Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
A consistent line of investigation suggests that dysautonomia may explain the multisystem fibromyalgia features, and that fibromyalgia is a sympathetically maintained neuropathic pain syndrome. The sympathetic nervous network is the main component of the stress response system (Arthritis Res Ther. 2007;9:216).
The ACR 2010 preliminary fibromyalgia diagnostic criteria is based on the Polysymptomatic Distress Scale. According to its developers, this scale is able to assess illness severity while still allowing a dichotomous diagnosis (Arthritis Care Res. 2010;62:600). We noted that Polysymptomatic Distress Scale items have clear dysautonomia connotations.
COMPASS-31 is a newly developed questionnaire to appraise dysautonomia. In contrast to the old COMPASS questionnaire, this new version has simplified scoring algorithm, and is suitable for widespread use in autonomic research and practice (Mayo Clin Proc. 2012;87:1196).
The objectives of our study were: 1) To correlate COMPASS-31 with the Polysymptomatic Distress Scale and with the Fibromyalgia Impact Questionnaire in 3 different groups of adult women: patients with fibromyalgia, patients with rheumatoid arthritis or healthy controls. 2) To compare the burden of dysautonomia symptoms in these 3 groups of individuals.
To date, we have studied 25 women with fibromyalgia (ACR 1990 + ACR 2010 criteria), 19 with active rheumatoid arthritis (ACR criteria) and 24 healthy controls. All participants filled out the following questionnaires: COMPASS-31, Fibromyalgia Impact Questionnaire, and Polysymptomatic Distress Scale.
Age was similar in the 3 studied groups (mean: 41 years). In fibromyalgia patients there was correlation between COMPASS-31 scores and Polysymptomatic Distress Scale (Spearman Rho = 0.583, p = 0.002) and between COMPASS-31 and Fibromyalgia Impact Questionnaire (Rho = 0.525, p = 0.007). Remarkably, there was a strong correlation between COMPASS-31 scores and pain VAS values (Rho = 0.721, p <0.0001). Patients with rheumatoid arthritis did not display such COMPASS 31 – pain VAS values correlation (Rho = – 0.024, p = 0.92). Patients suffering from fibromyalgia had much higher COMPASS-31 values (39.7 ± 15.3) when compared with rheumatoid arthritis patients (9.5 ± 8.5) and healthy controls (9.05 ± 8.7) p <0.0001.
Patients suffering from fibromyalgia have much more dysautonomia symptoms when compared to rheumatoid arthritis patients. In fibromyalgia, but not in rheumatoid arthritis, pain is closely related to autonomic dysfunction. There is correlation between the Polysymptomatic Distress Scale and COMPASS-31. Therefore, dysautonomia rather than “polysymptomatic distress” may be fibromyalgia’s underlying pathogenesis. COMPASS-31 may become a useful clinical instrument to evaluate fibromyalgia’s multisystem features.
To cite this abstract in AMA style:Martinez-Martinez LA, Chacón Pérez M, Reyes-Loyola P, Martínez-Lavín M. Fibromyalgia Dysautonomia and Distress. Correlation Between the Newly Developed Composite Autonomic Symptoms (COMPASS-31) Questionnaire and the Fibromyalgia Polysymptomatic Distress Scale [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/fibromyalgia-dysautonomia-and-distress-correlation-between-the-newly-developed-composite-autonomic-symptoms-compass-31-questionnaire-and-the-fibromyalgia-polysymptomatic-distress-scale/. Accessed December 11, 2019.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/fibromyalgia-dysautonomia-and-distress-correlation-between-the-newly-developed-composite-autonomic-symptoms-compass-31-questionnaire-and-the-fibromyalgia-polysymptomatic-distress-scale/