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Increased interstitial concentrations of pyruvate and lactate in the trapezius muscle of patients with fibromyalgia – a microdialysis study
OBJECTIVE: The aim of this study was to compare the interstitial concentrations of pyruvate, lactate and glutamate in the trapezius muscle between patients with fibromyalgia syndrome and healthy controls.
DESIGN: Comparative cross-sectional study.
SUBJECTS: Patients with fibromyalgia (n = 19) and healthy controls (n = 19); all women.
METHODS: Subjects answered a questionnaire about different aspects of pain. Pressure pain thresholds over the trapezius and tibialis anterior muscles were determined. The interstitial concentrations of pyruvate, lactate and glutamate were determined in the resting trapezius muscle by the microdialysis technique, with samples collected every hour for 5 consecutive hours. Pain intensity was also rated.
RESULTS: Significantly higher interstitial concentrations of pyruvate and lactate were found in patients with fibromyalgia syndrome. The multivariate regression analyses of group membership and pressure pain thresholds of the trapezius confirmed the importance of pyruvate and lactate.
CONCLUSION: Different mechanisms that may increase pyruvate and lactate in patients with fibromyalgia syndrome are discussed. Improved understanding of peripheral muscle alterations in patients with fibromyalgia syndrome could lead to mechanism-based rehabilitation.
Björn Gerdle, Kristina Söderberg, Laia Salvador Puigvert, Lars Rosendal, Britt Larsson
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