Study protocol for microneurographic investigation of nociceptor sensitisation in fibromyalgia syndrome (MICRO-FMS).
- 1Anaesthesia, Pain, and Critical Care Sciences, School of Physiology, Pharmacology, & Neuroscience, University of Bristol, Bristol, United Kingdom.
- 2Population Health and Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom.
Abstract
Introduction
Chronic pain in fibromyalgia may be driven by abnormal ongoing activity in a subclass of C-fibre nociceptors known as Type1B or CMi nociceptors. As is common in C-nociceptor microneurography studies, the modest patient numbers in these prior studies generate large confidence intervals around the point estimate of the prevalence of this abnormal activity. This complicates the interpretation of the relative importance of this ongoing nociceptor activity as a pain generating mechanism in fibromyalgia. The study aims to improve precision via an adaptive Bayesian protocol that maximises the yield and quality of data collection whilst minimising patient burden. This study will clarify whether the prevalence of ongoing nociceptor activity is higher in the fibromyalgia patient population, and if this is correlated with their sensory phenotype and/or pain experience, providing much needed insight into the mechanisms of the condition.Methods
The study employs an optimised microneurography protocol with an adaptive study design. The microneurography protocol incorporates early identification of CMi nociceptors via an abbreviated activity dependent slowing protocol to increase yields enabling efficient collection of the primary outcome data. The adaptive study design will use Bayesian principles to iteratively assess the predictive probability of futility, and terminate early if there is high confidence that the hypothesis is false. Furthermore, the study will employ questionnaires to explore links with pain in the area under study to the electrophysiology data. Finally, quantitative sensory testing will be used to investigate whether the irritable nociceptor phenotype is associated with abnormalities in CMi nociceptor physiology.Ethics & dissemination
This study has received HRA REC approval in the UK. Participants will provide written informed consent, and may withdraw at any time without consequence. At the end of the study, the results will be disseminated through peer-reviewed publication, and the data made available via a data repository.
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BibTeX
@article{ajay2026study,
title = {{Study protocol for microneurographic investigation of nociceptor sensitisation in fibromyalgia syndrome (MICRO-FMS).}},
author = {Elise A Ajay and Faris Khan and Atanu Bhattacharjee and Anthony E Pickering and James P Dunham},
journal = {Frontiers in pain research (Lausanne, Switzerland)},
year = {2026},
month = oct,
doi = {10.3389/fpain.2026.1911020},
url = {https://europepmc.org/article/MED/42898500},
note = {CC BY},
}
RIS
TY - JOUR
TI - Study protocol for microneurographic investigation of nociceptor sensitisation in fibromyalgia syndrome (MICRO-FMS).
AU - Elise A Ajay
AU - Faris Khan
AU - Atanu Bhattacharjee
AU - Anthony E Pickering
AU - James P Dunham
PY - 2026
DA - 2026/10/05
JO - Frontiers in pain research (Lausanne, Switzerland)
DO - 10.3389/fpain.2026.1911020
UR - https://europepmc.org/article/MED/42898500
AB - Introduction Chronic pain in fibromyalgia may be driven by abnormal ongoing activity in a subclass of C-fibre nociceptors known as Type1B or CMi nociceptors. As is common in C-nociceptor microneurography studies, the modest patient numbers in these prior studies generate large confidence intervals around the point estimate of the prevalence of this abnormal activity. This complicates the interpretation of the relative importance of this ongoing nociceptor activity as a pain generating mechanism in fibromyalgia. The study aims to improve precision via an adaptive Bayesian protocol that maximises the yield and quality of data collection whilst minimising patient burden. This study will clarify whether the prevalence of ongoing nociceptor activity is higher in the fibromyalgia patient population, and if this is correlated with their sensory phenotype and/or pain experience, providing much needed insight into the mechanisms of the condition.Methods The study employs an optimised microneurography protocol with an adaptive study design. The microneurography protocol incorporates early identification of CMi nociceptors via an abbreviated activity dependent slowing protocol to increase yields enabling efficient collection of the primary outcome data. The adaptive study design will use Bayesian principles to iteratively assess the predictive probability of futility, and terminate early if there is high confidence that the hypothesis is false. Furthermore, the study will employ questionnaires to explore links with pain in the area under study to the electrophysiology data. Finally, quantitative sensory testing will be used to investigate whether the irritable nociceptor phenotype is associated with abnormalities in CMi nociceptor physiology.Ethics & dissemination This study has received HRA REC approval in the UK. Participants will provide written informed consent, and may withdraw at any time without consequence. At the end of the study, the results will be disseminated through peer-reviewed publication, and the data made available via a data repository.
SN - 2673-561X
ER -