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We enrolled women with FMS (n = 134) and SFN (n = 41) who underwent neurological examination, neurophysiology, prostaglandin analysis in tear fluid, and corneal confocal microscopy (CCM). Data were compared with those of 60 age\u2010matched female controls. After screening for dry eye disease, corneal LC were counted and sub\u2010classified as dendritic (dLC) and non\u2010dendritic (ndLC) cells with or without nerve fiber association. We further analyzed corneal nerve fiber density (CNFD), length (CNFL), and branch density (CNBD). Neurological examination indicated deficits of small fiber function in patients with SFN. Nerve conduction studies were normal in all participants. Dry eye disease was more prevalent in FMS (17%) and SFN (28%) patients than in controls (5%). Tear fluid prostaglandin levels did not differ between FMS patients and controls. While corneal LC density in FMS and SFN patients was not different from controls, there were fewer dLC in association with nerve fibers in FMS and SFN patients than in controls (<jats:italic>P<\/jats:italic> &lt;\u2009.01 each). Compared to controls, CNFL was lower in FMS and SFN patients (<jats:italic>P<\/jats:italic> &lt;\u2009.05 each), CNFD was lower only in FMS patients (<jats:italic>P<\/jats:italic> &lt;\u2009.05), and CNBD was lower only in SFN patients (<jats:italic>P<\/jats:italic> &lt;\u2009.001). There was no difference in any CCM parameter between patients with and without dry eyes. Our data indicate changes in corneal innervation and LC distribution in FMS and SFN, potentially based on altered LC signaling.<\/jats:p>","DOI":"10.1111\/jns.12360","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T16:28:47Z","timestamp":1576600127000},"page":"9-18","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Reduced association between dendritic cells and corneal sub\u2010basal nerve fibers in patients with fibromyalgia syndrome"],"prefix":"10.1111","volume":"25","author":[{"given":"Alexander","family":"Klitsch","sequence":"first","affiliation":[{"name":"Department of Neurology University of W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitar","family":"Evdokimov","sequence":"additional","affiliation":[{"name":"Department of Neurology University of W\u00fcrzburg  W\u00fcrzburg 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