University of Michigan Medical School.
Departments of Anesthesiology.
Clin J Pain. 2018 Oct;34(10):909-917. doi: 10.1097/AJP.0000000000000619.
The present study evaluated the relationship between the 2011 American College of Rheumatology fibromyalgia (FM) survey criteria and quantitative sensory testing (QST).
Patients with knee osteoarthritis scheduled to undergo knee arthroplasty completed the FM survey criteria and self-report measures assessing clinical symptoms. Patients also underwent a battery of QST procedures at the surgical knee and remote body sites, including pressure algometry, conditioned pain modulation, and temporal summation. All assessments were completed before surgery. FM survey criteria were used to calculate a continuous FM score indicating FM severity.
A total of 129 patients were analyzed. Of these, 52.7% were female, 93.8% were Caucasian, and 3.8% met the FM survey criteria for FM classification. Mean age for females (63.6 y) and males (64.7 y) was similar. Females and males differed significantly in nearly every outcome, including FM severity, clinical pain, anxiety, depression, and pressure pain sensitivity. In females, FM scores significantly correlated with pressure pain sensitivity, but not conditioned pain modulation or temporal summation, such that increased sensitivity was associated with greater FM severity at all body sites examined. In addition, as FM scores increased, the association between pain sensitivity at the surgical knee and pain sensitivity at remote body sites also increased. No relationship between FM score and QST was observed in males.
We demonstrated an association between diffuse hyperalgesia as measured by QST and FM severity in females with knee osteoarthritis. These results suggest that the FM survey criteria may represent a marker of pain centralization in females with potential utility in clinical decision making.
本研究评估了 2011 年美国风湿病学会纤维肌痛（FM）调查标准与定量感觉测试（QST）之间的关系。
计划接受膝关节置换术的膝骨关节炎患者完成了 FM 调查标准和自我报告措施，评估临床症状。患者还在手术膝关节和远程身体部位接受了一系列 QST 程序，包括压力测痛法、条件性疼痛调制和时间总和。所有评估均在手术前完成。FM 调查标准用于计算连续 FM 评分，以指示 FM 严重程度。
共分析了 129 例患者。其中，52.7%为女性，93.8%为白种人，3.8%符合 FM 调查标准的 FM 分类。女性（63.6 岁）和男性（64.7 岁）的平均年龄相似。女性和男性在几乎所有结果上存在显著差异，包括 FM 严重程度、临床疼痛、焦虑、抑郁和压痛敏感性。在女性中，FM 评分与压痛敏感性显著相关，但与条件性疼痛调制或时间总和无关，即敏感性增加与所有检查身体部位的 FM 严重程度相关。此外，随着 FM 评分的增加，手术膝关节疼痛敏感性与远程身体部位疼痛敏感性之间的相关性也增加。在男性中未观察到 FM 评分与 QST 之间的关系。
我们在膝骨关节炎女性中证明了 QST 测量的弥漫性痛觉过敏与 FM 严重程度之间存在关联。这些结果表明，FM 调查标准可能代表了女性疼痛集中化的标志物，在临床决策中有潜在的应用价值。
