Supplementary data for: Prepulse inhibition of the blink reflex in functional neurological disorder and fibromyalgia

Supplementary data for the article "Prepulse inhibition of the blink reflex in functional neurological disorder and fibromyalgia" Abstract: Prepulse inhibition reflects subcortical sensory integration, where a low-intensity peripheral stimulus (prepulse) reduces the amplitude of a reflex response to a subsequent high-intensity stimulus. As a measure of pre-attentive sensory gating, prepulse inhibition has been found to be altered in small cohorts of patients with functional disorders, including functional motor disorder and fibromyalgia, suggesting a shared deficit in sensory information processing. However, prior studies have not demonstrated consistent associations between prepulse inhibition abnormalities and clinical measures. We hypothesized that widespread pain and somatic symptoms in somatic symptom disorders may result from a general deficit in the interpretation of bodily signals, potentially linked to abnormalities in sensory filtering as measured by prepulse inhibition. In this study, we examined 140 participants across four age- and sex-matched groups: 35 patients clinically categorized with functional motor disorder without fibromyalgia, 35 with both functional motor disorder and fibromyalgia, 35 with fibromyalgia only, and 35 healthy controls. A weak electrical stimulus to the index finger served as the prepulse, delivered 100 ms before supraorbital nerve stimulation to elicit the R2 component of the blink reflex. Prepulse inhibition was calculated as the percent reduction in R2 amplitude. Across all groups, lower prepulse was significantly associated with higher scores on the Fibromyalgia Severity Scale, consisting of Widespread Pain Index and Symptom Severity Scale. In patients with functional motor disorder, no association was found between prepulse inhibition size and objectively rated motor symptom severity. These findings suggest that impaired early sensory processing at subcortical level is related to “fibromyalgianess” in people with functional motor disorder and fibromyalgia. Abnormal prepulse inhibition may serve as an objective transdiagnostic marker of fibromyalgia symptomatology or fibromyalgianess, including widespread pain and other non-motor symptoms in functional disorders, highlighting a potential role of sensory gating deficits in the pathophysiology of fibromyalgia-spectrum manifestations.本数据集为论文《功能性神经疾病与纤维肌痛患者眨眼反射（blink reflex）的前脉冲抑制（prepulse inhibition）》的补充数据。 摘要： 前脉冲抑制（prepulse inhibition）反映皮层下感觉整合机制：低强度外周刺激（前脉冲）可降低后续高强度刺激引发的反射反应幅值。作为前注意感觉门控的衡量指标，前脉冲抑制在功能性运动障碍（functional motor disorder）、纤维肌痛（fibromyalgia）等功能性疾病的小型患者队列中已被证实存在异常，提示存在感觉信息处理的共同缺陷。然而，既往研究并未明确前脉冲抑制异常与临床评估指标间存在一致关联。 我们提出假说：躯体症状障碍（somatic symptom disorders）患者的广泛性疼痛与躯体症状，可能源于躯体信号解读的普遍性缺陷，该缺陷或与以前脉冲抑制为测量指标的感觉过滤异常相关。 本研究纳入140名受试者，分为4个年龄与性别匹配的组别：无纤维肌痛的功能性运动障碍（functional motor disorder）患者35例、同时罹患功能性运动障碍（functional motor disorder）与纤维肌痛（fibromyalgia）患者35例、仅患纤维肌痛（fibromyalgia）患者35例，以及健康对照35例。以食指施加弱电刺激作为前脉冲，于眶上神经（supraorbital nerve）刺激前100ms施加该刺激，以诱发眨眼反射（blink reflex）的R2成分。前脉冲抑制以R2幅值的降低百分比进行计算。 在所有组别中，更低的前脉冲抑制水平与纤维肌痛严重程度量表（Fibromyalgia Severity Scale）（涵盖广泛性疼痛指数（Widespread Pain Index）与症状严重程度量表（Symptom Severity Scale））的更高得分显著相关。在功能性运动障碍（functional motor disorder）患者中，未发现前脉冲抑制强度与客观评估的运动症状严重程度间存在关联。 上述研究结果表明，皮层下早期感觉加工受损与功能性运动障碍（functional motor disorder）及纤维肌痛（fibromyalgia）患者的"纤维肌痛特质"相关。异常的前脉冲抑制或可作为纤维肌痛症状或"纤维肌痛特质"（包括功能性疾病中的广泛性疼痛与其他非运动症状）的客观跨诊断标志物，凸显了感觉门控缺陷在纤维肌痛谱系表现的病理生理学中的潜在作用。