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

Park, Jane H.; Phothimat, Phomma; Oates, Carolyn; Hernanz‐Schulman, Marta; Olsen, Nancy J.

doi:10.1002/1529-0131(199803)41:3<406::aid-art5>3.3.co;2-c

Cited by 24 publications

(48 citation statements)

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“…Thereby, an alternative explanation is that some alterations may occur at the actin–myosin cross‐bridge level at a low‐ but not high‐force level in FMS patients. Muscle structural abnormalities (42, 43), alterations of phosphorylation and oxidative capacities (44), and neuroendocrine disorders (45) might be potential mechanisms to explain impaired muscle contractility in FMS patients during the quadriceps fatigue test. Finally, the number of submaximal contractions was not different between the groups, suggesting that task failure during the quadriceps fatigue test may depend on factors other than peripheral contractile fatigue, as discussed elsewhere (46).…”

Section: Discussionmentioning

confidence: 99%

“…Figure 2A showed that the extrapolated V O 2 max is still lower than V O 2 max measured in controls (mean ± SD 28.6 ± 8.8 versus 36.1 ± 7.1 ml/minute/kg; P < 0.05). Therefore, we proposed that the reduced V O 2 max measured in FMS patients compared to controls is the consequence of exercise submaximality (e.g., due to increased pain perception [8]; see below) and metabolic impairments (44). The significant correlation between V O 2 max and the percentage reduction in evoked muscular responses during the quadriceps fatigue test (Figure 3A) supports the involvement of increased quadriceps fatigability in the reduced exercise capacity of FMS patients.…”

Section: Discussionmentioning

confidence: 99%

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Neuromuscular fatigue and exercise capacity in fibromyalgia syndrome

Bachasson¹,

Guinot²,

Wuyam³

et al. 2013

Arthritis Care & Research

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Objective. To assess quadriceps strength and fatigability by using femoral nerve magnetic stimulation (FNMS) and their relationship to exercise capacity in patients with fibromyalgia syndrome (FMS) and healthy controls. Methods. Twenty-two women (11 with FMS, 11 controls) performed a maximal incremental cycling test and a quadriceps fatigue test on 2 separate visits. For quadriceps assessment, we used FNMS during and after maximum voluntary contraction (MVC) to evaluate central and peripheral factors of neuromuscular fatigue. Subjects performed sets of 10 intermittent (5 seconds on/5 seconds off ) isometric contractions starting at 10% MVC, in 10% MVC increments from one set to another until exhaustion. Neuromuscular fatigue was assessed with FNMS after each set. Results. FMS patients had reduced initial MVC compared to controls (mean ؎ SD 102 ؎ 18 versus 120 ؎ 24 Nm; P < 0.05) without significant impairment of voluntary activation (mean ؎ SD 93.5% ؎ 3.0% versus 93.1% ؎ 3.4%; P ‫؍‬ 0.74). During the fatigue task, FMS patients exhibited a greater fall in evoked muscular responses (mean ؎ SD ؊26% ؎ 6% versus ؊16% ؎ 8% at set 50% MVC; P < 0.05), but not in MVC (mean ؎ SD ؊24% ؎ 7% versus ؊19% ؎ 4% at set 50% MVC; P ‫؍‬ 0.12). During the cycling test, FMS patients had lowered maximal exercise capacity and an enhanced rate of perceived exertion (RPE) compared to controls. The percent reduction in evoked muscular responses during the quadriceps fatigue test correlated with maximum oxygen consumption (r ‫؍‬ 0.56, P < 0.05) and RPE at submaximal intensity (r ‫؍‬ 0.84, P < 0.05) during cycling. Conclusion. Greater impairment in muscle contractility is associated with enhanced perception of exertion and reduced maximal exercise capacity in FMS patients. Neuromuscular impairments should be considered as an important factor underlying functional limitations in FMS patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neuromuscular fatigue and exercise capacity in fibromyalgia syndrome

Bachasson¹,

Guinot²,

Wuyam³

et al. 2013

Arthritis Care & Research

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“…The investigation of muscle pathology (109) has led to many clinically oriented 31 P‐MRS studies of skeletal muscle in McArdle's disease (3, 17, 19, 124), glycogen storage disease type XIII (172), phosphofructokinase deficiency (4, 5), adenylosuccinate lyase deficiency (173), dermatomyositis (174, 175), fibromyalgia (176), muscular dystrophy (177), Friedreich ataxia (178), poliomyelitis (179), mitochondrial disease (180–182), Parkinson's disease (183, 184), peripheral arterial disease (PAD) (150, 185), severe burn trauma (186), cardiomyopathy (187), type 2 diabetes (188), malignant hyperthermia (189), and aging (53, 190, 191).…”

Section: Structural Aspects Of Skeletal Muscle That Influence Mr Spectramentioning

confidence: 99%

Musculoskeletal spectroscopy

Boesch

2007

Magnetic Resonance Imaging

111

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Magnetic resonance spectroscopy (MRS) of skeletal muscle has been successfully applied by physiologists over several decades, particularly for studies of high-energy phosphates (by (31)P-MRS) and glycogen (by (13)C-MRS). Unfortunately, the observation of these heteronuclei requires equipment that is typically not available on clinical MR scanners, such as broadband capability and a second channel for decoupling and nuclear Overhauser enhancement (NOE). On the other hand, (1)H-MR spectra of skeletal muscle can be acquired on many routine MR systems and also provide a wealth of physiological information. In particular, studies of intramyocellular lipids (IMCL) attract physiologists and endocrinologists because IMCL levels are related to insulin resistance and thus can lead to a better understanding of major health problems in industrial countries. The combination of (1)H-, (13)C-, and (31)P-MRS gives access to the major long- and short-term energy sources of skeletal muscle. This review summarizes the technical aspects and unique MR-methodological features of the different nuclei. It reviews clinical studies that employed MRS of one or more nuclei, or combinations of MRS with other MR modalities. It also illustrates that MR spectra contain additional physiological information that is not yet used in routine clinical applications.

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“…There is evidence suggesting that abnormal muscle bioenergetics may underlie the physiopathology of fibromyalgia (). In this respect, Park et al () used 31 P magnetic resonance spectroscopy ( 31 P‐MRS) to show that patients with fibromyalgia present reduced intramuscular ATP and phosphorylcreatine content when compared to healthy peers. Furthermore, the authors reported that patients had lower oxidative potential and total oxidative capacity than controls, as estimated by the concentration of phosphagen metabolites.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the authors reported that patients had lower oxidative potential and total oxidative capacity than controls, as estimated by the concentration of phosphagen metabolites. In theory, low ATP and phosphorylcreatine concentration could explain muscle dysfunction (), which is often associated with other common clinical features seen in fibromyalgia, including poor quality of life, pain, and fatigue (). The putative role of creatine supplementation in restoring the phosphagen reservoir could attenuate muscle dysfunction and possibly confer clinical benefits to fibromyalgia patients.…”

Section: Introductionmentioning

confidence: 99%

Creatine Supplementation in Fibromyalgia: A Randomized, Double‐Blind, Placebo‐Controlled Trial

Alves

Santiago

Lima

et al. 2013

Arthritis Care & Research

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Objective. To investigate the efficacy and safety of creatine supplementation in fibromyalgia patients. Methods. A 16-week, randomized, double-blind, placebo-controlled, parallel-group trial was conducted. Fibromyalgia patients were randomly assigned to receive either creatine monohydrate or placebo in a double-blind manner. The patients were evaluated at baseline and after 16 weeks. Muscle function, aerobic conditioning, cognitive function, quality of sleep, quality of life, kidney function, and adverse events were assessed. Muscle phosphorylcreatine content was measured through 31 P magnetic resonance spectroscopy. Results. After the intervention, the creatine group presented higher muscle phosphorylcreatine content when compared with the placebo group (؉80.3% versus ؊2.7%; P ‫؍‬ 0.04). Furthermore, the creatine group presented greater muscle strength than the placebo group in the leg press and chest press exercises (؉9.8% and ؉1.2% for creatine versus ؊0.5% and ؊7.2% for placebo, respectively; P ‫؍‬ 0.02 and P ‫؍‬ 0.002, respectively). Isometric strength was greater in the creatine group than in the placebo group (؉6.4% versus ؊3.2%; P ‫؍‬ 0.007). However, no general changes were observed in aerobic conditioning, pain, cognitive function, quality of sleep, and quality of life. Food intake remained unaltered and no side effects were reported. Conclusion. Creatine supplementation increased intramuscular phosphorylcreatine content and improved lower-and upper-body muscle function, with minor changes in other fibromyalgia features. These findings introduce creatine supplementation as a useful dietary intervention to improve muscle function in fibromyalgia patients.

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

Cited by 24 publications

References 0 publications

Neuromuscular fatigue and exercise capacity in fibromyalgia syndrome

Neuromuscular fatigue and exercise capacity in fibromyalgia syndrome

Musculoskeletal spectroscopy

Creatine Supplementation in Fibromyalgia: A Randomized, Double‐Blind, Placebo‐Controlled Trial

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