Correlation between Self-Perceived Voice Handicap and Symptoms of Autonomic Nervous System in Patients with Fibromyalgia Syndrome: A Questionnaire-based Observational Study.

OBJECTIVE

To report the prevalence of self-reported voice symptoms in a cohort of fibromyalgia syndrome (FMS) patients, to evaluate the severity of symptoms suggestive of autonomic nervous dysfunction (ANS), and to analyze the correlation between self-reported voice symptoms and ANS dysfunction.

STUDY

DESIGN

Questionnaire-based observational study METHODOLOGY: After obtaining Institutional Review Board approval, adult patients aged 18 to 65 years who presented to the Rheumatology Clinic with FMS between February 2025 and October 2025 were invited to participate. A control group without FMS, frequency matched by age and gender, was also included. Demographic data included age, gender, history of smoking, reflux disease, allergy, and voice abuse. All patients had filled the voice handicap index-10 (VHI-10), visual analogue scale (VAS), fibromyalgia (FM) rapid screening tool, the short-form McGill pain questionnaire and the questionnaire of autonomic dysfunction (QAD).

RESULTS

Seventy patients with FM and 70 controls were included in the study. All patients included were females. The mean age of the study group was 48.83 ± 11.11 years. There was a statistically significant difference in the mean VHI-10 scores (7.66 ± 8.33 vs 3.34 ± 4.05, P = 0.007) and VAS scores (2.90 ± 2.26 vs 1.50 ± 1.13, P < 0.001) between the two groups. There was a statistically significant difference in the total number of positive responses on the QAD questionnaire (18.93 ± 7.72 vs 9.97 ± 6.21, P < 0.001). There was a moderate positive significant correlation between the VHI-10 score and the number of positive responses on the QAD questionnaire (r = 0.486, P < 0.001). There was a strong positive correlation between VAS scores and the number of positive responses on the QAD questionnaire (r = 0.603, P < 0.001).

CONCLUSION

Results revealed significantly higher prevalence of self-perceived voice handicap and symptoms of ANS dysfunction in FMS patients compared to controls and the presence of a strong, positive, significant correlation between the VHI-10 score, the VAS score, and the number of positive responses on the QAD questionnaire.