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A Distorted Body Schema and Susceptibility to Experiencing Anomalous Somatosensory Sensations in Fibromyalgia Syndrome

Martínez, Endika PhD; Guillen, Virginia PhD; Buesa, Itsaso PhD; Azkue, Jon J. PhD

doi: 10.1097/AJP.0000000000000754
Original Articles

Objective: Evidence suggests that there is an association between chronic pain and disruption of the body schema. We tested the hypothesis in fibromyalgia syndrome (FMS).

Materials and Methods: We investigated distinct perceptual aspects of the body schema both in a sample of patients with FMS and in pain-free controls. Performances on the left/right judgment task were measured; tactile acuity was assessed by using the 2-point discrimination test. Furthermore, we evaluated sensations evoked by tactile stimulation with von Frey filaments to body parts that were experiencing pain. Anomalous sensations elicited by sensory-motor conflict (SMC) were also investigated.

Results: Patients with FMS showed inferior performance on the right/left judgment task, both in terms of correct matches (75.38% vs. 89.67%, respectively; P<0.05) and response time (2.58 s vs. 1.89 s, respectively; P<0.05). Effect sizes were large and very large, respectively. Two-point discrimination thresholds were significantly higher (P<0.05) in participants from the FMS sample (mean of 49.71 mm, SD: 12.09 mm) relative to controls (mean of 37.36 mm, SD: 7.81 mm). Nine of 14 participants with FMS, but no control participants, reported referred sensations upon tactile stimulation, including tingling, pins and needles, weight, and cramps. Referral sites included regions both adjacent and remote to stimulated sites. Patients with FMS scored across all items within the administered questionnaire addressing anomalous sensations on the mirror setup (Cohen d=1.04 to 2.42 across all items), and FMS patients perceived pain during the SMC (the required statistical power for it to be statistically significant was 96% and for it to be recognized as a difference of means in pain item).

Conclusion: Our present findings suggest a disrupted body schema and propensity to experiencing anomalous somatosensory sensations during SMC in people with FMS.

Department of Neurosciences, School of Medicine and Nursing, University of the Basque Country, UPV/EHU, Leioa, Bizkaia Province, Spain

Supported by the Basque Government (Euskal unibertsitate-sistemako ikerketa-taldeen jarduerak bultzatzeko diru-laguntzak, GIC15/25), Spain and the University of the Basque Country UPV/EHU (PPG17/06), Spain. The authors declare no conflict of interest.

Reprints: Itsaso Buesa, PhD, Department of Neurosciences, School of Medicine and Nursing, University of the Basque Country, UPV/EHU, Leioa, Bizkaia 48940, Spain (e-mail:

Received March 29, 2019

Received in revised form June 29, 2019

Accepted July 27, 2019

Online date: August 19, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.