Key result
Fibromyalgia was associated with significantly higher autonomic dysfunction compared to healthy controls, with mean COMPASS-31 scores of 47.03 versus 21.55 (p<0.00001).
Why the study?
Autonomic dysfunction is a feature of fibromyalgia, but the utility of the COMPASS-31 tool to assess autonomic symptoms and its correlation with fibromyalgia severity measures required evaluation.
Does COMPASS-31 assessment identify autonomic dysfunction and correlate with disease severity in women with fibromyalgia compared to healthy controls?
Cross-Sectional (n=154)
No
Does COMPASS-31 assessment identify autonomic dysfunction and correlate with disease severity in women with fibromyalgia compared to healthy controls?
Absolute Event Rate: 47.03% vs 21.55%
p-value: p=<0.00001
The COMPASS-31 questionnaire is a reliable tool that identifies a high prevalence of autonomic dysfunction in women with fibromyalgia, which correlates significantly with disease severity.
COMPASS-31 may aid autonomic assessment in fibromyalgia; leaves open prospective validation and clinical utility.
OBJECTIVES: Autonomic dysfunction is a feature of fibromyalgia (FM). The Composite Autonomic Symptom Score-31 (COMPASS-31) is a validated tool to assess autonomic dysfunction. This study aimed to evaluate autonomic dysfunction in FM patients using COMPASS-31 and examine correlations with FM severity measures. METHODS: A cross-sectional study included women with FM and matched healthy controls. Participants completed COMPASS-31, the Revised Fibromyalgia Impact Questionnaire (FIQR), Polysymptomatic Distress Scale (PDS), Modified Fibromyalgia Assessment Status (FASmod), and PainDetect Questionnaire (PDQ). Correlations and severity analyses were performed. RESULTS: The study included 77 women with FM and 77 matched controls. Autonomic dysfunction was observed in 64.9% of FM patients and 3.5% of healthy controls. FM patients exhibited significantly higher COMPASS-31 scores (mean 47.03±17.27) compared to controls (21.55±11.48; p<0.00001). Internal consistency was good (Cronbach's α=0.74). A COMPASS-31 cut-off point of 38.28 (sensitivity 71.43%; specificity 91.86%; LR+ 8.78) distinguished FM patients from healthy controls. COMPASS-31 scores correlated positively with FIQR (rho=0.47, p<0.0001), PDS (rho=0.36, p<0.0001), FASmod (rho=0.32, p=0.004) and PDQ scores (rho=0.56, p<0.0001). Disease severity categories identified by FIQR were significantly associated with autonomic dysfunction symptoms (Kruskal-Wallis test: 18.77; p=0.00086). CONCLUSIONS: This study highlights the high prevalence of autonomic dysfunction in FM and supports the utility of COMPASS-31 as a reliable tool for assessing autonomic symptoms in FM patients. Future research should explore the causality and the impact of FM severity on autonomic dysfunction through longitudinal studies.
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Salaffi et al. (2025) conducted a cross-sectional in Fibromyalgia (n=154). Fibromyalgia vs. Healthy controls was evaluated on COMPASS-31 total score (p=<0.00001). Fibromyalgia was associated with significantly higher autonomic dysfunction compared to healthy controls, with mean COMPASS-31 scores of 47.03 versus 21.55 (p<0.00001).
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