Background At present, the lack of an objective laboratory test or an imaging technique hampers fibromyalgia (FM) recognition and hence treatment (Lerma et al., 2012). The most agonizing symptom in FM is pain and the most accepted theory in explaining this pain is the central sensitization theory (Bennett et al., 2012). Hypervigilance is a component of central sensitization pain which was reported in FM patients (González et al., 2010). Auditory evoked Potentials (AEPs) are brain waves generated upon stimulation with sounds. They reflect the ability of the brain to discriminate, classify, and memorize the significance of exogenous stimuli (Giaquinto, 2004).
Objectives Was to assess the role of AEPs as an objective diagnostic tool for hypervigilance and cognitive function of FM.
Methods This study was conducted on thirty FM female patients, fulfilling the 1990 ACR criteria and a group age matched female controls. All subjects undertook thorough clinical examination, psychiatric and functional assessment (Sleep score, Fibromyalgia impact questionnaire and hospital anxiety and depression scale) as well as measurement of AEPs elicited by tones of increasing intensity (60, 70, 80, and 90 dB) known as late cortical responses and cognitive auditory potentials known as (Event Related Potentials) ERPs (P300).
Results Patients had significantly shorter latencies than controls of N1 at (60 and 70dB) (p<0.001) and they also showed significantly shorter P2 latencies at all the studied intensities (p<0.001). Patients had increased P300 latency and decreased P300 amplitude compared to controls (p<0.05, p<0.001 respectively). The diagnostic performance of different AEPs in FM patients as regard sensitivity and specificity between patients and controls varied. The best performance was by the measurement of N160dB with the cutoff point values at 102 msec, specificity was 80% and sensitivity 90%.
Conclusions This study emphasizes the diagnostic value of AEPs for hypervigilance and cognitive ability in FM. This report applies to both components of AEPs (late cortical and cognitive) which proved to be relatively sensitive and specific tests for FM.
References Bennett R, Russell IJ, Choy E, et al., 2012: Evaluation of patient-rated stiffness associated with fibromyalgia. Clin Ther. Apr;34(4):824-37.
Giaquinto S (2004): Evoked potentials in rehabilitation. Funct Neurol. 19 (4):219-25.
González JL, Mercado F, Barjola P, et al.,(2010): Generalized hypervigilance in fibromyalgia patients: an experimental analysis with the emotional Stroop paradigm. J Psychosom Res.;69(3).
Lerma C, Martinez A, Ruiz N, et al., 2011: Nocturnal heart rate variability parameters as potential fibromyalgia biomarker: correlation with symptoms severity Arthritis Res Ther.;13(6):R185.
Disclosure of Interest None Declared
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