Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms

Introduction:. Fibromyalgia has a high female predominance and research work has been focussing mainly on women. Objectives:. We aimed to answer (1) gender differences in pain scores and quality of life, (2) any gender-specific subgroups defined by quantitative sensory testing (QST), and (3) correla...

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Main Authors: Min Liu, Stephany Harris, Anna P. Andreou, Xuenong Bo, Adnan Al-Kaisy
Format: Article
Language:English
Published: Wolters Kluwer 2025-02-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001229
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author Min Liu
Stephany Harris
Anna P. Andreou
Xuenong Bo
Adnan Al-Kaisy
author_facet Min Liu
Stephany Harris
Anna P. Andreou
Xuenong Bo
Adnan Al-Kaisy
author_sort Min Liu
collection DOAJ
description Introduction:. Fibromyalgia has a high female predominance and research work has been focussing mainly on women. Objectives:. We aimed to answer (1) gender differences in pain scores and quality of life, (2) any gender-specific subgroups defined by quantitative sensory testing (QST), and (3) correlations of QST parameters with pain intensity and questionnaire scores. Methods:. We evaluated clinical presentations and QST profiles from 38 male and 38 age-matched female patients. Results:. Women reported significantly higher scores in average daily pain, daily sleep interference score, average weekly pain, weekly sleep interference score, and revised fibromyalgia impact questionnaire (rFIQ). Based on LOGA classification, L0G2, mechanical allodynia or hyperalgesia without abnormal sensory loss, was the most common QST subtype which accounted for 28.9% of men and 26.3% of women. Approximately 34.2% of men and 26.3% of women displayed loss of function of small fibres with an increased cold or warm detection threshold. Cold detection threshold was negatively correlated with pain intensity and functional impairment, suggesting a peripheral mechanism. Central sensitization, defined as allodynia and hyperalgesia to thermal or mechanical stimuli, was found in two-thirds of male and female patients. Mechanical pain sensitivity was positively correlated with the severity of pain and associated symptoms in women, but not men. Conclusion:. There was a marked gender difference in reported pain and quality of life. We have confirmed that central sensitization is a major mechanism for women. Our data suggested an important role of small fibre pathology in both men and women.
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spelling doaj-art-46d9bd147d144336a1af9b99ff5102362025-01-24T09:20:44ZengWolters KluwerPAIN Reports2471-25312025-02-01101e122910.1097/PR9.0000000000001229PR90000000000001229Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanismsMin Liu0Stephany Harris1Anna P. Andreou2Xuenong Bo3Adnan Al-Kaisy4a Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United Kingdoma Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United Kingdoma Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United Kingdomb Centre for Neuroscience, Surgery and Trauma, Queen Mary University of London, London, United Kingdoma Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United KingdomIntroduction:. Fibromyalgia has a high female predominance and research work has been focussing mainly on women. Objectives:. We aimed to answer (1) gender differences in pain scores and quality of life, (2) any gender-specific subgroups defined by quantitative sensory testing (QST), and (3) correlations of QST parameters with pain intensity and questionnaire scores. Methods:. We evaluated clinical presentations and QST profiles from 38 male and 38 age-matched female patients. Results:. Women reported significantly higher scores in average daily pain, daily sleep interference score, average weekly pain, weekly sleep interference score, and revised fibromyalgia impact questionnaire (rFIQ). Based on LOGA classification, L0G2, mechanical allodynia or hyperalgesia without abnormal sensory loss, was the most common QST subtype which accounted for 28.9% of men and 26.3% of women. Approximately 34.2% of men and 26.3% of women displayed loss of function of small fibres with an increased cold or warm detection threshold. Cold detection threshold was negatively correlated with pain intensity and functional impairment, suggesting a peripheral mechanism. Central sensitization, defined as allodynia and hyperalgesia to thermal or mechanical stimuli, was found in two-thirds of male and female patients. Mechanical pain sensitivity was positively correlated with the severity of pain and associated symptoms in women, but not men. Conclusion:. There was a marked gender difference in reported pain and quality of life. We have confirmed that central sensitization is a major mechanism for women. Our data suggested an important role of small fibre pathology in both men and women.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001229
spellingShingle Min Liu
Stephany Harris
Anna P. Andreou
Xuenong Bo
Adnan Al-Kaisy
Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms
PAIN Reports
title Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms
title_full Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms
title_fullStr Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms
title_full_unstemmed Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms
title_short Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms
title_sort gender differences in clinical presentations and sensory profiles in patients with fibromyalgia implications of peripheral and central mechanisms
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001229
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