Developing a non-invasive technique to diagnose small fibre nerve damage and study its contribution to pain in fibromyalgia

Disease – Fibromyalgia    

Lead applicant – Dr Uazman Alam 

Organisation – University of Liverpool   

Type of grant – Pain Challenge Full 2019  

Status of grant – Active from 30 October 2020   

Amount of the original award – £199,027.12 

Start date – 06 September 2020   

Reference – 22471

Public Summary

What are the aims of this research?

This research aims to determine if an eye test (using a technique called corneal confocal microscopy) can identify small nerve fibre damage in people with fibromyalgia. Small nerve fibre damage refers to the damage of pain-generating nerves. As well as identifying damage, researchers plan to explore if specific changes to these fibres contributes to changes in nerve function and perceived pain.

Why is this research important?

Fibromyalgia is a common type of arthritis which affects around 5-6% of the general population. It is characterised by debilitating widespread body pain and is considered to be due to a disturbance in the way the brain processes pain and sensation.

Previous research has confirmed that small nerve fibres are damaged in around half of people with fibromyalgia, but currently this can only be diagnosed using skin biopsies at specialist centres. This research aims to assess the accuracy of corneal confocal microscopy to diagnose small nerve fibre damage. This eye test allows direct visualisation of the small nerve fibres at the front of the eye, which are the same type of nerves involved in nerve-related pain. Researchers will also use a technique called microneurography to study the function of the small nerve fibres.

How will the findings benefit patients?  

This research could increase our understanding of how small fibre nerve damage contributes to pain in fibromyalgia. If proven to be as accurate as the current skin biopsy test, corneal confocal microscopy could provide a non-invasive, time-efficient alternative for diagnosis. The ability to detect people with small nerve fibre damage in fibromyalgia could help clinicians to predict response to pain treatment, and therefore help them to select the best treatment options or pain relief.