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Fibromyalgia


BMC Musculoskeletal Disorders 2009, 10:78 - doi:10.1186/1471-2474-10-78

 

Research article

 

Central motor control failure in fibromyalgia: a surface electromyography study

 

Roberto Casale (1), Piercarlo Sarzi-Puttini (2) , Fabiola Atzeni (2), Marco Gazzoni (3), Dan Buskila (4) and Alberto Rainoldi (5)

 

  1. Department of Clinical Neurophysiology and Pain Rehabilitation Unit, "Salvatore Maugeri" Foundation, IRCCS, Scientific Institute of Montescano, Montescano (PV), Italy
  2. Rheumatology Unit, Luigi Sacco University Hospital, Milan, Italy
  3. Laboratory for Neuromuscular System Engineering (LISiN), Department of Electronics, Polytechnic of Turin, Turin, Italy
  4. Department of Internal Medicine H, Soroka Medical Center, Ben Gurion University, BeerSheva, Israel
  5. Motor Science Research Centre, University School of Motor and Sport Sciences (SUISM), University of Turin, Turin, Italy

 

The electronic version of this article is the complete one and can be found online at:
http://www.biomedcentral.com/1471-2474/10/78

 

Published: 1 July 2009

 

© 2009 Casale et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

 

Background

Fibromyalgia (FM) is characterised by diffuse musculoskeletal pain and stiffness at multiple sites, tender points in characteristic locations, and the frequent presence of symptoms such as fatigue. The aim of this study was to assess whether the myoelectrical manifestations of fatigue in patients affected by FM are central or peripheral in origin.

Methods

Eight female patients aged 55.6 ± 13.6 years (FM group) and eight healthy female volunteers aged 50.3 ± 9.3 years (MCG) were studied by means of non-invasive surface electromyography (s-EMG) involving a linear array of 16 electrodes placed on the skin overlying the biceps brachii muscle, with muscle fatigue being evoked by means of voluntary and involuntary (electrically elicited) contractions. Maximal voluntary contractions (MVCs), motor unit action potential conduction velocity distributions (mean ± SD and skewness), and the mean power frequency of the spectrum (MNF) were estimated in order to assess whether there were any significant differences between the two groups and contraction types.

Results

The motor pattern of recruitment during voluntary contractions was altered in the FM patients, who also showed fewer myoelectrical manifestations of fatigue (normalised conduction velocity rate of changes: -0.074 ± 0.052%/s in FM vs -0.196 ± 0.133%/s in MCG; normalised MNF rate of changes: -0.29 ± 0.16%/s in FM vs -0.66 ± 0.34%/s in MCG). Mean conduction velocity distribution and skewnesses values were higher (p < 0.01) in the FM group. There were no between-group differences in the results obtained from the electrically elicited contractions.

Conclusion

The apparent paradox of fewer myoelectrical manifestations of fatigue in FM is the electrophysiological expression of muscle remodelling in terms of the prevalence of slow conducting fatigue-resistant type I fibres. As the only between-group differences concerned voluntary contractions, they are probably more related to central motor control failure than muscle membrane alterations, which suggests pathological muscle fibre remodelling related to altered suprasegmental control.

 

Full Text article at : http://www.biomedcentral.com/1471-2474/10/78

 

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