{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T04:48:07Z","timestamp":1772081287610,"version":"3.50.1"},"reference-count":66,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005639","name":"Universidade de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005639","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The different phenotypic presentations of fibromyalgia (FM) have been infrequently studied and may have diagnostic and therapeutic implications. The aim of this study was to explore differences between FM patients with classical symmetric (s\u2010FM) presentation and FM patients with marked asymmetric (a\u2010FM) pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed two consecutive cross\u2010sectional studies on FM patients and matched healthy volunteers (HV). FM patients were divided into a\u2010FM (and s\u2010FM groups according to their score of pain intensity on each body side; patients with a difference of \u226540\u00a0mm in VAS between left and right sides were classified as a\u2010FM, otherwise classified as s\u2010FM. Participants (FM\u00a0=\u00a032; HV\u00a0=\u00a031) were assessed for clinical, cortical excitability (CE), quantitative sensory testing (QST; study 1), and intraepidermal nerve fibre density (IENFD) determinations (study 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While pain intensity did not significantly differ between s\u2010FM and a\u2010FM patients, pain interference in daily activities was significantly higher in the a\u2010FM as compared to the s\u2010FM group (54.7\u00a0\u00b1\u00a08.9 and 37.6\u00a0\u00b1\u00a013.5; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001). PPT was significantly lower in the more painful side of a\u2010FM as compared to the HV (27.7\u00a0\u00b1\u00a07.9 and 49.9\u00a0\u00b1\u00a013.0; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001), while PPT in the less painful side of a\u2010FM was significantly higher than PPT values in the s\u2010FM (35.8\u00a0\u00b1\u00a08.3 and 27.7\u00a0\u00b1\u00a05.5; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.031). S\u2010FM and a\u2010FM had significantly abnormal intracortical inhibition values on CE measurements compared to HV. There were no significant differences in IENFD between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Within the current FM criteria, there exist different phenotypes with clinical, psychophysics, and neurophysiological findings that are not related to peripheral IENFD abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Current fibromyalgia criteria may contain different phenotypes of fibromyalgia based on the lateralization of pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1620","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T20:05:58Z","timestamp":1592078758000},"page":"1635-1647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Sifting the wheat from the chaff? Evidence for the existence of an asymmetric fibromyalgia phenotype"],"prefix":"10.1002","volume":"24","author":[{"given":"Helena","family":"H. Kaziyama","sequence":"first","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Instituto de Ortopedia e Traumatologia Division of Physical Medicine and Rehabilitation University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Barbour","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Galhardoni","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"School of Medicine University of City of S\u00e3o Paulo (UNICID)  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valqu\u00edria","family":"Aparecida da Silva","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"R. 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Tesseroli de Siqueira","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarice","family":"Listik","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Jos\u00e9","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin T.","family":"Yeng","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Division of Physical Medicine and Rehabilitation University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Antonio","family":"Marcolin","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Raicher","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Pain Center Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoel J.","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Pain Center Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Ciampi de Andrade","sequence":"additional","affiliation":[{"name":"Pain Center Department of Neurology University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Pain Center Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2012.02.016"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.838"},{"key":"e_1_2_8_4_1","first-page":"728","article-title":"The fibromyalgia impact questionnaire: Development and validation","volume":"18","author":"Burckhardt C. 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