Composite Autonomic Symptom Score 31 (COMPASS-31) for the assessment of symptoms of autonomic dysfunction in fibromyalgia.

OBJECTIVES

Autonomic dysfunction is a feature of fibromyalgia (FM). The Composite Autonomic Symptom Score-31 (COMPASS-31) is a validated tool to assess autonomic dysfunction. This study aimed to evaluate autonomic dysfunction in FM patients using COMPASS-31 and examine correlations with FM severity measures.

METHODS

A cross-sectional study included women with FM and matched healthy controls. Participants completed COMPASS-31, the Revised Fibromyalgia Impact Questionnaire (FIQR), Polysymptomatic Distress Scale (PDS), Modified Fibromyalgia Assessment Status (FASmod), and PainDetect Questionnaire (PDQ). Correlations and severity analyses were performed.

RESULTS

The study included 77 women with FM and 77 matched controls. Autonomic dysfunction was observed in 64.9% of FM patients and 3.5% of healthy controls. FM patients exhibited significantly higher COMPASS-31 scores (mean 47.03±17.27) compared to controls (21.55±11.48; p<0.00001). Internal consistency was good (Cronbach's α=0.74). A COMPASS-31 cut-off point of 38.28 (sensitivity 71.43%; specificity 91.86%; LR+ 8.78) distinguished FM patients from healthy controls. COMPASS-31 scores correlated positively with FIQR (rho=0.47, p<0.0001), PDS (rho=0.36, p<0.0001), FASmod (rho=0.32, p=0.004) and PDQ scores (rho=0.56, p<0.0001). Disease severity categories identified by FIQR were significantly associated with autonomic dysfunction symptoms (Kruskal-Wallis test: 18.77; p=0.00086).

CONCLUSIONS

This study highlights the high prevalence of autonomic dysfunction in FM and supports the utility of COMPASS-31 as a reliable tool for assessing autonomic symptoms in FM patients. Future research should explore the causality and the impact of FM severity on autonomic dysfunction through longitudinal studies.