{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T22:30:19Z","timestamp":1792881019864,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T00:00:00Z","timestamp":1456444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with joint hypermobility syndrome\/Ehlers\u2013Danlos syndrome, hypermobility type (<jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>) commonly suffer from pain. How this hereditary connective tissue disorder causes pain remains unclear although previous studies suggested it shares similar mechanisms with neuropathic pain and fibromyalgia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective study seeking information on the mechanisms underlying pain in patients with <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, we enrolled 27 consecutive patients with this connective tissue disorder. Patients underwent a detailed clinical examination, including the neuropathic pain questionnaire <jats:styled-content style=\"fixed-case\">DN<\/jats:styled-content>4 and the fibromyalgia rapid screening tool. As quantitative sensory testing methods, we included thermal\u2010pain perceptive thresholds and the wind\u2010up ratio and recorded a standard nerve conduction study to assess non\u2010nociceptive fibres and laser\u2010evoked potentials, assessing nociceptive fibres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical examination and diagnostic tests disclosed no somatosensory nervous system damage. Conversely, most patients suffered from widespread pain, the fibromyalgia rapid screening tool elicited positive findings, and quantitative sensory testing showed lowered cold and heat pain thresholds and an increased wind\u2010up ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While the lack of somatosensory nervous system damage is incompatible with neuropathic pain as the mechanism underlying pain in <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, the lowered cold and heat pain thresholds and increased wind\u2010up ratio imply that pain in <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> might arise through central sensitization. Hence, this connective tissue disorder and fibromyalgia share similar pain mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>What does this study add?<\/jats:title><jats:p>In patients with <jats:styled-content style=\"fixed-case\">JHS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EDS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, the persistent nociceptive input due to joint abnormalities probably triggers central sensitization in the dorsal horn neurons and causes widespread pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.856","type":"journal-article","created":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T11:39:50Z","timestamp":1456486790000},"page":"1319-1325","source":"Crossref","is-referenced-by-count":98,"title":["Central sensitization as the mechanism underlying pain in joint hypermobility syndrome\/Ehlers\u2013Danlos syndrome, hypermobility 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