Increased incidence of a resonance in the phosphodiester region of ³¹p nuclear magnetic resonance spectra in the skeletal muscle of fibromyalgia patients

Abstract

Objective. To determine if patients with fibromyalgia syndrome (FMS) are more susceptible to activityinduced muscle damage than are healthy subjects.Methods. Eleven FMS patients and 10 healthy subjects performed concentric and eccentric exercise with their dominant and nondominant forearms, respectively. 3 1~ magnetic resonance spectroscopy (to assess inorganic phosphate [Pi] and phosphocreatine [PCr]) and dolorimetry (to assess pain) were performed before and 20 minutes after exercise and at 4 subsequent 24-hour intervals.Results. Neither group exhibited increased Pi/ PCr ratios or reduced dolorimetry scores following the exercise protocols. FMS patients did display a phosphodiester resonance at a higher rate than healthy subjects (37% versus 12%), but this was not related to the exercise.Conclusion. Unchanged Pi/PCr ratios and dolorimetry scores following acute exercise provide evidence against the hypothesis that FMS patients are more susceptible to activity-induced muscle damage than are healthy subjects, although P,/PCr and pain may not adequately document such damage. The frequent occurrence of phosphodiester in the spectra of FMS pa-

Evidence for metabolic abnormalities in the muscles of patients with fibromyalgia

“…In contrast to our findings of low ATP and PCr levels in FM muscles, several other laboratories did not show abnormalities in FM data obtained with P-31 MRS [29,[47][48][49][50]. These disparities may be explained by differences in technological and experimental design.…”

“…The results of other investigations may be valid for their particular calculations and experimental conditions. The P-31 MRS study by Jubrias et al [50] did demonstrate a quantitative difference between patients with FM and sedentary controls following strenuous exercise. The FM muscles showed increased levels of phosphodiesters (PDE), which are thought to reflect damaged membranes, possibly due to lipid peroxidation and altered calcium levels.…”

“…Diminished strength and endurance could also result in part from pain, which reflexly inhibits voluntary contraction. Damaged muscle membranes due to ischemia and lack of ATP may permit Ca 2+ influx into sarcomeres, producing even greater ATP deficits with further membrane damage, as evidenced by increased phosphodiesters (PDE) [50]. Ca 2+ influx is accompanied by K + efflux, which causes activation of the nociceptor pain pathway, thereby amplifying the peripheral cycle of metabolic abnormalities, induction of pain, weakness, and fatigue.…”

Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia

“…Thus, we have acquired additional parameters for confirming the detection of abnormalities in FMS. We do not in any way contest the results reported by the other investigators (15)(16)(17)(18)(19) but rather we believe that the data are accurate and valid for the particular experimental conditions used.…”

Muscle abnormalities in juvenile dermatomyositis patients: P-31 magnetic resonance spectroscopy studies

“…Increased PDE levels have been observed in a number of muscle disorders, including Duchenne's muscular dystrophy and fibromyalgia (37,39). However, in the case of JDM patients, no significant differences in PDE levels were observed in comparison with normal children.…”