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Grayston, R, Czanner, G, Elhadd, K, Goebel, A, Frank, B, Uceyler, N, Malik, RA and Alam, U (2018) A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia: Implications for a new paradigm in fibromyalgia etiopathogenesis. Seminars in Arthritis and Rheumatism, 48 (5). pp. 933-940. ISSN 0049-0172
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A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia Implications for a new paradigm in fibromyalgia etiopathogenesis.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Objectives: Fibromyalgia is a condition which exhibits chronic widespread pain with neuropathic pain features and has a major impact on health-related quality of life. The pathophysiology remains unclear, however, there is increasing evidence for involvement of the peripheral nervous system with a high prevalence of small fiber pathology (SFP). The aim of this systematic literature review is to establish the prevalence of SFP in fibromyalgia.
Methods: An electronic literature search was performed using MEDLINE, EMBASE, PubMed, Web of Science, CINAHL and the Cochrane Library databases. Published full-text, English language articles that provide SFP prevalence data in studies of fibromyalgia of patients over 18years old were included. All articles were screened by two independent reviewers using a priori criteria. Methodological quality and risk of bias were evaluated using the critical appraisal tool by Munn et al. Overall and subgroup pooled prevalence were calculated by random-effects meta-analysis with 95% CI.
Results: Database searches found 935 studies; 45 articles were screened of which 8 full text articles satisfied the inclusion criteria, providing data from 222 participants. The meta-analysis demonstrated the pooled prevalence of SFP in fibromyalgia is 49% (95% CI: 38–60%) with a moderate degree of heterogeneity, (I2= 68%). The prevalence estimate attained by a skin biopsy was 45% (95% CI: 32–59%, I2= 70%) and for corneal confocal microscopy it was 59% (95% CI: 40–78%, I2= 51%).
Conclusion: There is a high prevalence of SFP in fibromyalgia. This study provides compelling evidence of a distinct phenotype involving SFP in fibromyalgia. Identifying SFP will aid in determining its relationship to pain and potentially facilitate the development of future interventions and pharmacotherapy.
| Item Type: | Article |
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| Uncontrolled Keywords: | 1103 Clinical Sciences |
| Subjects: | Q Science > QA Mathematics R Medicine > R Medicine (General) |
| Divisions: | Applied Mathematics (merged with Comp Sci 10 Aug 20) |
| Publisher: | Elsevier |
| Related URLs: | |
| Date Deposited: | 30 Jan 2020 13:39 |
| Last Modified: | 04 Sep 2021 08:00 |
| DOI or ID number: | 10.1016/j.semarthrit.2018.08.003 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/12147 |
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