# Evaluation of Oral Mucosa Capillaries in Fibromyalgia Patients

## TL;DR

This study found subtle microvascular changes in the oral mucosa of fibromyalgia patients compared to healthy individuals using a non-invasive imaging technique.

## Contribution

The study introduces videocapillaroscopy as a potential tool to detect microvascular alterations in fibromyalgia patients.

## Key findings

- Fibromyalgia patients had significantly shorter capillary length compared to healthy controls.
- Capillary orientation differed significantly between fibromyalgia patients and controls.
- Microvascular changes were observed but are not sufficient for diagnosis or early detection.

## Abstract

Background: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, unrefreshed sleep, and cognitive disturbances. Despite extensive research, its pathophysiology remains incompletely understood, and there are no validated biomarkers for diagnosis. Videocapillaroscopy is a non-invasive imaging technique that enables detailed visualization of microvascular structures and may provide insights into microcirculatory alterations associated with FM. Methods: Thirty patients with FM and 30 healthy controls underwent oral videocapillaroscopy at four sites: right and left buccal mucosa and upper and lower labial mucosa. Quantitative parameters, including capillary caliber, density, and length, were extracted using a validated neural-network-based software, while qualitative parameters, including visibility, orientation, and the presence of microhemorrhages, were assessed by the operator. Results: Capillary length was significantly reduced in fibromyalgia patients (297.49 ± 26.82 µm) compared to healthy controls (324.43 ± 37.59 µm; p = 0.002), and capillary orientation differed significantly between groups (p < 0.05). Capillary caliber, density, and visibility did not show statistically significant differences. Conclusions: These findings indicate subtle microvascular alterations in the oral mucosa of patients with fibromyalgia. Although the observed changes are not sufficient for diagnostic purposes or early detection, they provide preliminary evidence that videocapillaroscopy can detect microvascular features associated with FM in the oral mucosa. Further studies with larger cohorts and longitudinal designs are warranted to clarify the clinical relevance of these observations and to explore their potential association with symptom severity or disease progression.