Relationship between sympathetic activity and pain intensity in fibromyalgia

被引:0
作者
Zamuner, A. R. [1 ]
Barbic, F. [2 ]
Dipaola, F. [2 ]
Bulgheroni, M. [2 ]
Diana, A. [3 ]
Atzeni, F. [4 ]
Marchi, A. [5 ,6 ,7 ]
Sarzi-Puttini, P. [8 ]
Porta, A. [9 ,10 ]
Furlan, R. [2 ,10 ]
机构
[1] Univ Fed Sao Carlos, Dept Phys Therapy, BR-13565905 Sao Carlos, SP, Brazil
[2] Humanitas Clin & Res Ctr, BIOMETRA Dept, Internal Med, Rozzano, Italy
[3] Legnano Gen Hosp, Emergency Med, Legnano, Italy
[4] IRCCS Galeazzi Orthopaed Inst, Milan, Italy
[5] Humanitas Clin & Res Ctr, Dept Anesthesia, Rozzano, Italy
[6] Humanitas Clin & Res Ctr, Intens Care Unit, Rozzano, Italy
[7] Politecn Milan, Dept Elect Informat & Bioengn, I-20133 Milan, Italy
[8] L Sacco Hosp Vialba, Dept Rheumatol, Milan, Italy
[9] IRCCS Galeazzi Orthopaed Inst, Dept Biomed Sci Hlth, Milan, Italy
[10] Univ Milan, Milan, Italy
关键词
fibromyalgia; sympathetic activity; pain intensity; AUTONOMIC CARDIOVASCULAR CONTROL; POWER SPECTRAL-ANALYSIS; BLOOD-PRESSURE; NERVE ACTIVITY; HEART-RATE; RESPONSES; STIMULATION; PATHOPHYSIOLOGY; MULTICENTER; MECHANISMS;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. Fibromyalgia (FM) is a syndrome characterised by chronic musculoskeletal pain, hyperalgesia on specific areas of tenderness (tender points) and by an autonomic nervous system dysfunction consistent with sympathetic overactivity. It is not known whether there is any relationship between the amount of cardiovascular sympathetic activity and the magnitude of pain. Our objective was to assess this potential relationship in patients with FM. Methods. Electrocardiogram, finger blood pressure, respiration and postganglionic sympathetic discharge activity (muscle sympathetic nerve activity, MSNA) were continuously recorded at rest in 25 patients with primary FMS. The autonomic profile was assessed by MSNA and spectral indices of cardiac sympathetic (LF) and vagal (HFRR) modulation and of sympathetic vasomotor control (LF-(SAP)) computed by spectrum analysis of RR and systolic arterial pressure (SAP) variability. Cardiac baroreflex function was evaluated by the index a (a). Baroreceptor modulation of the sympathetic vasomotor control (sBRS) was assessed by the MSNA/diastolic pressure relationship. Results. Pain intensity was linearly correlated with LFRR/HFRR (r(2)=0.21; p=0.03), LFSAP (r(2)=0.26; p=0.02) and MSNA (burst rate) (r(2)=0.45; p=0.003). Pain intensity was inversely correlated with the alpha(LF) index (r(2)=0.24; p=0.02) and the sBRS (r(2)=0.28; p=0.03). Thus, the higher the sympathetic drive to the heart and vessels, the higher the magnitude of chronic pain. Also, the gains of both the cardiac and MSNA baroreceptor control were inversely related to the pain intensity. Conclusion. These findings raise the theoretical possibility that in FM patients the use of anti-adrenergic agents might lessen chronic pain intensity by reducing the underlying excessive sympathetic activity.
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页码:S53 / S57
页数:5
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