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Rheumatology Advance Access published online on September 1, 2007
Rheumatology, doi:10.1093/rheumatology/kem204
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© 2007 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Somaesthetic disturbances in fibromyalgia are exaggerated by sensory–motor conflict: implications for chronicity of the disease?

C. S. McCabe, H. Cohen and D. R. Blake

The Royal National Hospital for Rheumatic Diseases in conjunction with The School for Health, University of Bath, Bath BA1 1RL, UK.

Correspondence to: Dr C. S. McCabe, The Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. E-mail: candy.mccabe{at}rnhrd-tr.swest.nhs.uk


  Abstract

Objectives. Conflict between sensory–motor central nervous processing generates somaesthetic disturbances, including pain, in healthy volunteers (HVs). Such conflict has been proposed as a potential cause of pain that occurs in the absence of injury or when the pain response is disproportionate to the injury. Fibromyalgia (FMS) exemplifies the former state. We hypothesized that the artificial generation of such conflict would exacerbate somaesthetic perceptions including pain in FMS greater than in HVs.

Methods. Twenty-nine adults with FMS took part in an established task that generates varied degrees of sensory–motor conflict during congruent/incongruent limb movements. A qualitative methodology recorded any changes in sensory experience. Data generated were compared with age and gender-matched HV data.

Results. Twenty-six subjects (89.7%) with FMS reported changes in sensory perception at some stage in the protocol in addition to, or worse than, baseline compared with 14 (48%) of HVs. All stages of the protocol generated a higher frequency of report in the FMS population than that of the maximum report in the HVs population. New perceptions included disorientation, pain, perceived changes in temperature, limb weight or body image.

Conclusions. Our findings support the hypothesis that motor–sensory conflict can exacerbate pain and sensory perceptions in those with FMS to a greater extent than in HVs.

KEY WORDS: Pain, fibromyalgia, sensory–motor conflict

Submitted 27 April 2007; Accepted 29 June 2007


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