Gerdle Björn, Ghafouri Bijar, Lund Eva, Bengtsson Ann, Lundberg Peter, Ettinger-Veenstra Helene van, Leinhard Olof Dahlqvist, Forsgren Mikael Fredrik
Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, SE 581 83 Linköping, Sweden.
Center for Medical Image Science and Visualization (CMIV), Linköping University, SE 581 83 Linköping, Sweden.
J Clin Med. 2020 Oct 31;9(11):3527. doi: 10.3390/jcm9113527.
In fibromyalgia (FM) muscle metabolism, studies are sparse and conflicting associations have been found between muscle metabolism and pain aspects. This study compared alterations in metabolic substances and blood flow in erector spinae and trapezius of FM patients and healthy controls. FM patients ( = 33) and healthy controls ( = 31) underwent a clinical examination that included pressure pain thresholds and physical tests, completion of a health questionnaire, participation in microdialysis investigations of the etrapezius and erector spinae muscles, and also underwent phosphorus-31 magnetic resonance spectroscopy of the erector spinae muscle. At the baseline, FM had significantly higher levels of pyruvate in both muscles. Significantly lower concentrations of phosphocreatine (PCr) and nucleotide triphosphate (mainly adenosine triphosphate) in erector spinae were found in FM. Blood flow in erector spinae was significantly lower in FM. Significant associations between metabolic variables and pain aspects (pain intensity and pressure pain threshold PPT) were found in FM. Our results suggest that FM has mitochondrial dysfunction, although it is unclear whether inactivity, obesity, aging, and pain are causes of, the results of, or coincidental to the mitochondrial dysfunction. The significant regressions of pain intensity and PPT in FM agree with other studies reporting associations between peripheral biological factors and pain aspects.
在纤维肌痛（FM）的肌肉代谢方面，研究较少，且肌肉代谢与疼痛因素之间的关联存在矛盾。本研究比较了FM患者与健康对照者竖脊肌和斜方肌中代谢物质及血流的变化。FM患者（n = 33）和健康对照者（n = 31）接受了临床检查，包括压痛阈值和体格检查、完成健康问卷、参与斜方肌和竖脊肌的微透析研究，还对竖脊肌进行了磷-31磁共振波谱分析。在基线时，FM患者两块肌肉中的丙酮酸水平均显著较高。在FM患者中，竖脊肌中的磷酸肌酸（PCr）和三磷酸核苷酸（主要是三磷酸腺苷）浓度显著较低。FM患者竖脊肌的血流显著较低。在FM患者中，发现代谢变量与疼痛因素（疼痛强度和压痛阈值PPT）之间存在显著关联。我们的结果表明，FM存在线粒体功能障碍，尽管尚不清楚不活动、肥胖、衰老和疼痛是线粒体功能障碍的原因、结果还是与之巧合。FM患者疼痛强度和PPT的显著回归与其他报道外周生物学因素与疼痛因素之间关联的研究一致。
