Noninvasive optical characterization of muscle blood flow, oxygenation, and metabolism in women with fibromyalgiaReport as inadecuate

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Arthritis Research and Therapy

, 14:R236

First Online: 01 November 2012Received: 16 May 2012Revised: 24 August 2012Accepted: 25 October 2012


IntroductionWomen with fibromyalgia FM have symptoms of increased muscular fatigue and reduced exercise tolerance, which may be associated with alterations in muscle microcirculation and oxygen metabolism. This study used near-infrared diffuse optical spectroscopies to noninvasively evaluate muscle blood flow, blood oxygenation and oxygen metabolism during leg fatiguing exercise and during arm arterial cuff occlusion in post-menopausal women with and without FM.

MethodsFourteen women with FM and twenty-three well-matched healthy controls participated in this study. For the fatiguing exercise protocol, the subject was instructed to perform 6 sets of 12 isometric contractions of knee extensor muscles with intensity steadily increasing from 20 to 70% maximal voluntary isometric contraction MVIC. For the cuff occlusion protocol, forearm arterial blood flow was occluded via a tourniquet on the upper arm for 3 minutes. Leg or arm muscle hemodynamics, including relative blood flow rBF, oxy- and deoxy-hemoglobin concentration HbO2 and Hb, total hemoglobin concentration THC and blood oxygen saturation StO2, were continuously monitored throughout protocols using a custom-built hybrid diffuse optical instrument that combined a commercial near-infrared oximeter for tissue oxygenation measurements and a custom-designed diffuse correlation spectroscopy DCS flowmeter for tissue blood flow measurements. Relative oxygen extraction fraction rOEF and oxygen consumption rate rVO2 were calculated from the measured blood flow and oxygenation data. Post-manipulation fatiguing exercise or cuff occlusion recovery in muscle hemodynamics was characterized by the recovery half-time, a time interval from the end of manipulation to the time that tissue hemodynamics reached a half-maximal value.

ResultsSubjects with FM had similar hemodynamic and metabolic response-recovery patterns as healthy controls during exercise and during arterial occlusion. However, tissue rOEF during exercise in subjects with FM was significantly lower than in healthy controls, and the half-times of oxygenation recovery ΔHbO2 and ΔHb were significantly longer following fatiguing exercise and cuff occlusion.

ConclusionsOur results suggest an alteration of muscle oxygen utilization in the FM population. This study demonstrates the potential of using combined diffuse optical spectroscopies i.e., NIRS-DCS to comprehensively evaluate tissue oxygen and flow kinetics in skeletal muscle.

AbbreviationsBMIbody mass index

CARcentral activation ratio

CFSchronic fatigue syndrome

DCSdiffuse correlation spectroscopy

ΔHbchange in deoxyhemoglobin concentration

ΔHbO2change in oxyhemoglobin concentration

ESelectrical stimulation


Hbdeoxyhemoglobin concentration

HbO2oxyhemoglobin concentration

HChealthy control

IPAQinternational physical activity questionnaire

MVICmaximal voluntary isometric contraction

NIRSnear-infrared diffuse optical spectroscopy

P-31 MRSphosphorus magnetic resonance spectroscopy

PO2partial pressure of oxygen

rBFrelative blood flow

rOEFrelative oxygen extraction fraction

rVO2relative oxygen consumption rate

SEstandard error

StO2tissue blood oxygen saturation

THCtotal hemoglobin concentration

VASvisual analog scale.

Electronic supplementary materialThe online version of this article doi:10.1186-ar4079 contains supplementary material, which is available to authorized users.

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Author: Yu Shang - Katelyn Gurley - Brock Symons - Douglas Long - Ratchakrit Srikuea - Leslie J Crofford - Charlotte A Peterson -


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