Title:Clinical Assessment of Autonomic Function in Fibromyalgia by the
Refined and Abbreviated Composite Autonomic Symptom Score (COMPASS
31): A Case-Controlled Study
Volume: 17
Issue: 1
Author(s): Basant K. Puri*Gary S. Lee
Affiliation:
- Department of Molecular Biology and Medicine C.A.R. Cambridge and University of Winchester, UK
Keywords:
Autonomic dysfunction, fibromyalgia, COMPASS 31, FIQR, autonomic nervous system, case-controlled study.
Abstract:
Background: It has been shown that autonomic dysfunction in fibromyalgia can be assessed
by the Composite Autonomic Symptom Score (COMPASS) questionnaire. More recently, a
refined and much abbreviated 31-item version of the questionnaire has been developed, the COMPASS
31.
Objectives: First, to determine whether the COMPASS 31 can assess changes in autonomic function
in fibromyalgia. Second, to assess whether the COMPASS 31 values in fibromyalgia patients
are positively correlated with scores on the Revised Fibromyalgia Impact Questionnaire (FIQR).
Methods: A cross-sectional, case-controlled study was carried out with 25 fibromyalgia patients
and 26 healthy controls.
Results: The two groups were matched for age, sex and ethnicity, but not for body mass index
(BMI). The total mean (standard error) COMPASS 31 for the fibromyalgia patients, 37.2 (1.8), differentiated
the patients from the controls (9.5 (1.4); p < 0.00000001). The scores were greater in
the fibromyalgia patients across all COMPASS 31 autonomic domains, namely orthostatic intolerance
(p < 0.00000001), and vasomotor (p < 0.0001), secretomotor (p < 0.000001), gastrointestinal
(p < 0.000001), bladder (p < 0.00001) and pupillomotor functions (p < 0.00000001). The total
COMPASS 31 values were positively correlated with FIQR scores (rs = 0.45, p < 0.05). General linear
modelling of the COMPASS 31 scores showed that only group status (fibromyalgia or control)
was significant (p = 3.4 × 10-16), with age, sex and BMI being non-significant.
Conclusion: This study confirms that non-pain autonomic dysfunction symptoms occur in fibromyalgia
and can be assessed with the COMPASS 31.