Coskun Benlidayi, Ilke, Ornek, Ceren, Deniz, Volkan et al. · Rheumatology international · 2025 · DOI
This review suggests that doctors could better diagnose fibromyalgia by adding a simple physical test—checking how strongly your reflexes react when tapped—to the current diagnostic methods. Right now, fibromyalgia is diagnosed mainly based on what patients report about their pain and symptoms, which can lead to missed or incorrect diagnoses. The researchers found that people with fibromyalgia often have stronger-than-normal reflex responses, which could help doctors rule out fibromyalgia or confirm it alongside other tests.
For ME/CFS patients and researchers, this is relevant because fibromyalgia and ME/CFS share overlapping symptoms and are frequently misdiagnosed or comorbid. A more objective diagnostic biomarker for fibromyalgia could help clarify which patients have fibromyalgia versus ME/CFS or both, potentially improving clinical management and research cohort definition. Since diagnostic confusion between these conditions has hampered research progress, better differentiation tools may accelerate understanding of distinct pathophysiological mechanisms.
This review does not prove that DTR testing alone can diagnose fibromyalgia; the authors explicitly state that hyperreflexia has low specificity and is not definitive for diagnosis. The study is a narrative review, not a primary research study generating new data, so it cannot establish causation between the proposed mechanisms (CNS dysregulation, autonomic dysfunction) and increased DTR responses. The proposed integration of DTR into diagnostic criteria remains theoretical and requires prospective validation in clinical populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Coskun Benlidayi, Ilke, Ornek, Ceren, Deniz, Volkan, & Sariyildiz, Aylin (2025). Reevaluating fibromyalgia diagnosis: a proposal to integrate deep tendon reflex responses into current criteria.. Rheumatology international. https://doi.org/10.1007/s00296-025-05846-y
BibTeX
@article{mecfsatlas-coskun-benlidayi-2025-reevaluating-fibromyalgia,
author = {Coskun Benlidayi, Ilke and Ornek, Ceren and Deniz, Volkan and Sariyildiz, Aylin},
title = {Reevaluating fibromyalgia diagnosis: a proposal to integrate deep tendon reflex responses into current criteria.},
journal = {Rheumatology international},
year = {2025},
doi = {10.1007/s00296-025-05846-y},
note = {PubMed: 40172661},
url = {https://www.mecfsatlas.com/evidence/coskun-benlidayi-2025-reevaluating-fibromyalgia},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/coskun-benlidayi-2025-reevaluating-fibromyalgia
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