Decreased muscle concentrations of ATP and PCR in the quadriceps muscle of fibromyalgia patients – A 31P-MRS study

Authors

  • B. Gerdle,

    Corresponding author
    1. Pain and Rehabilitation Centre, UHL, Linköping, Sweden
    • Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Sweden
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  • M.F. Forsgren,

    1. Center for Medical Image Science and Visualization, CMIV, Linköping University, Sweden
    2. Radiation Physics, Department of Medicine and Health Sciences, Linköping University, Sweden
    3. Department of Radiation Physics, UHL, Linköping, Sweden
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  • A. Bengtsson,

    1. Rheumatology, Department of clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
    2. Clinical Department of Rheumatology, UHL, Linköping, Sweden
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  • O. Dahlqvist Leinhard,

    1. Center for Medical Image Science and Visualization, CMIV, Linköping University, Sweden
    2. Radiation Physics, Department of Medicine and Health Sciences, Linköping University, Sweden
    3. Department of Radiation Physics, UHL, Linköping, Sweden
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  • B. Sören,

    1. Rheumatology, Department of clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden
    2. Clinical Department of Rheumatology, UHL, Linköping, Sweden
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  • A. Karlsson,

    1. Center for Medical Image Science and Visualization, CMIV, Linköping University, Sweden
    2. Department of Biomedical Engineering (IMT), Linköping University, Sweden
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  • V. Brandejsky,

    1. Center for Medical Image Science and Visualization, CMIV, Linköping University, Sweden
    2. Radiation Physics, Department of Medicine and Health Sciences, Linköping University, Sweden
    3. Department of Radiation Physics, UHL, Linköping, Sweden
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  • E. Lund,

    1. Radiation Physics, Department of Medicine and Health Sciences, Linköping University, Sweden
    2. Department of Radiation Physics, UHL, Linköping, Sweden
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  • P. Lundberg

    1. Center for Medical Image Science and Visualization, CMIV, Linköping University, Sweden
    2. Radiation Physics, Department of Medicine and Health Sciences, Linköping University, Sweden
    3. Department of Radiation Physics, UHL, Linköping, Sweden
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  • Funding sources

    The Swedish Research Council, the Swedish Council for Working Life and Social Research and the regional Research Council of Southeastern Sweden.

  • Conflicts of interest

    None declared.

Correspondence

Björn Gerdle

E-mail: bjorn.gerdle@liu.se

Abstract

Background and Methods

Fibromyalgia (FMS) has a prevalence of approximately 2% in the population. Central alterations have been described in FMS, but there is not consensus with respect to the role of peripheral factors for the maintenance of FMS. 31P Magnetic Resonance Spectroscopy (31P-MRS) has been used to investigate the metabolism of phosphagens in muscles of FMS patients, but the results in the literature are not in consensus. The aim was to investigate the quantitative content of phosphagens and pH in resting quadriceps muscle of patients with FMS (n = 19) and in healthy controls (Controls; n = 14) using 31P-MRS. It was also investigated whether the concentrations of these substances correlated with measures of pain and/or physical capacity.

Results

Significantly lower concentrations of adenosine triphosphate (ATP) and phosphocreatinine (PCr; 28–29% lower) were found in FMS. No significant group differences existed with respect to inorganic phosphate (Pi), Pi/PCr and pH. The quadriceps muscle fat content was significantly higher in FMS than in Controls [FMS: 9.0 ± 0.5% vs. Controls: 6.6 ± 0.6%; (mean ± standard error); P = 0.005]. FMS had significantly lower hand and leg capacity according to specific physical test, but there were no group differences in body mass index, subjective activity level and in aerobic fitness. In FMS, the specific physical capacity in the leg and the hand correlated positively with the concentrations of ATP and PCr; no significant correlations were found with pain intensities.

Conclusions

Alterations in intramuscular ATP, PCr and fat content in FMS probably reflect a combination of inactivity related to pain and dysfunction of muscle mitochondria.

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