Fibromyalgia is a mysterious disorder that exemplifies all the complexities of chronic pain. Affecting the entire musculoskeletal system, the pain can occur throughout the body or at specific sites, while sufferers also experience sleep, memory, and mood disturbances. Fatigue is another signature symptom of the disorder. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, an estimated five million American adults, predominantly women, suffer from fibromyalgia.

Despite these numbers, little is known aout the biological basis of the condition and a simple way to diagnosis the disorder has long eluded doctors. Soon, quick and easy identification of fibromyalgia is on the horizon. Researchers from Ohio State have just discovered how to use a blood sample to detect the syndrome. Make no mistake as to how serious they are: They've already filed the patent.

Speed Is Key

"The importance of producing a faster diagnosis cannot be overstated, because patients experience tremendous stress during the diagnostic process. Just getting the diagnosis actually makes patients feel better and lowers costs because of reductions in anxiety," said lead author Dr. Kevin Hackshaw, associate professor of medicine, division of rheumatology and immunology, at Ohio State's Wexner Medical Center.

To detect the presence of fibromyalgia in blood-spot samples collected from patients, the scientists used infrared microspectroscopy, a technology that can recognize molecular bonds as they are struck by light. Molecules within the blood samples, then, could be identified as they appeared within the infrared spectrum.

First, researchers obtained blood samples from 14 patients diagnosed with fibromyalgia, 15 with rheumatoid arthritis, and 12 with osteoarthritis. The spectroscopy is able to read dried blood, so only a few drops of blood from each patient were needed to run these experiments. Because they often produce similar symptoms to those of fibromyalgia, these types of arthritis were chosen as comparisons within the test. Next, the scientists analyzed each sample with the infrared microspectroscopy and without a single misclassification, the technology separated the subjects into classes based on spectral information alone. In other words, the technology accurately identified, based on molecular patterns found in the blood samples, each patient's condition.

"It separated them completely, with no misclassifications," said Tony Buffington, professor of veterinary clinical sciences at Ohio State University and senior author of the study. "That's very important. It never mistook a patient with fibromyalgia for a patient with arthritis. Clearly we need more numbers, but this showed the technique is quite effective."

Following this first experiment, the researchers analyzed some other chemicals in the fibromyalgia blood samples, chemicals that could potentially function as biomarkers someday. Further studies, Buffington explained, would be needed to ascertain clear biomarkers.

Test Price And Availability

Although the technology would be prohibitively expensive for most physicians' offices, Buffington explained how a central lab could purchase the infrared microscope for affordable testing. The fact that dried blood samples are used in this process would also provide economic advantage, because such samples could be sent through the U.S. mail service. In fact, the authors believe this test, if refined and made available to physicians, could eliminate years of waiting for a definitive diagnosis, which is the circumstance for all too many patients today.

Buffington is a veterinarian and a renowned as an expert on domestic cats. His research focuses on a painful bladder disorder, suffered by both cats and humans, called interstitial cystitis (IC). The genesis of IC, just like fibromyalgia, cannot be traced within the body. Categorized as "medically unexplained" or "functional syndromes," these disorders suggest a common link exists among them, with origins in the central nervous system. This new test, then, might help explain these disorders and reveal the possible link between them. 

"We would like this to lead to an objective test for primary care doctors to use, which could produce a diagnosis as much as five years before it usually occurs," said Buffington.

 

Source: Hackshaw KV, Rodriguez-Saona L, Plans M, Bell LN, Buffington CAT. A bloodspot-based diagnostic test for fibromyalgia syndrome and related disorders. Analyst. 2013.