OBJECTIVE: Fibromyalgia (FM) is a prevalent and poorly understood disorder associated with a significant amount of disability. Some clinical characteristics are common to both FM and vasovagal syncope (which is caused by dysautonomia). We assessed the response of patients with FM to a head up tilt table test (HUT). We also examined sympathovagal balance by assessing heart rate variability (HRV). METHODS: We studied 17 women with FM and 14 female control subjects. After baseline functional assessments, they underwent a 3 stage HUT (with isoproterenol). HRV was assessed over a 24 h period and also before and during HUT. Quality of life was assessed using the Medical Outcomes Study SF-36 Short Form Health Survey. RESULTS: HUT was positive in 64.7% of the patients with FM compared with 21.3% of controls (p = 0.016). FM patients had less HRV, as measured by either time domain or frequency domain analysis. The FM group had a different response to HUT than controls. Quality of life was significantly lower in patients with FM compared to controls (p < or = 0.001 in all domains). CONCLUSION: Patients with FM have abnormal responses to 2 tests of autonomic nervous system function. Further research is needed to determine if dysautonomia plays a role in the pathogenesis of FM or is a result of FM.
OBJECTIVE:Fibromyalgia (FM) is a prevalent and poorly understood disorder associated with a significant amount of disability. Some clinical characteristics are common to both FM and vasovagal syncope (which is caused by dysautonomia). We assessed the response of patients with FM to a head up tilt table test (HUT). We also examined sympathovagal balance by assessing heart rate variability (HRV). METHODS: We studied 17 women with FM and 14 female control subjects. After baseline functional assessments, they underwent a 3 stage HUT (with isoproterenol). HRV was assessed over a 24 h period and also before and during HUT. Quality of life was assessed using the Medical Outcomes Study SF-36 Short Form Health Survey. RESULTS: HUT was positive in 64.7% of the patients with FM compared with 21.3% of controls (p = 0.016). FM patients had less HRV, as measured by either time domain or frequency domain analysis. The FM group had a different response to HUT than controls. Quality of life was significantly lower in patients with FM compared to controls (p < or = 0.001 in all domains). CONCLUSION:Patients with FM have abnormal responses to 2 tests of autonomic nervous system function. Further research is needed to determine if dysautonomia plays a role in the pathogenesis of FM or is a result of FM.
Authors: William Maixner; Joel D Greenspan; Ronald Dubner; Eric Bair; Flora Mulkey; Vanessa Miller; Charles Knott; Gary D Slade; Richard Ohrbach; Luda Diatchenko; Roger B Fillingim Journal: J Pain Date: 2011-11 Impact factor: 5.820
Authors: C Sommer; W Häuser; K Gerhold; P Joraschky; F Petzke; T Tölle; N Uçeyler; A Winkelmann; K Thieme Journal: Schmerz Date: 2008-06 Impact factor: 1.107
Authors: Larissa Resende Oliveira; Vitor Ulisses de Melo; Fabricio Nunes Macedo; Andre Sales Barreto; Daniel Badaue-Passos; Marcio Roberto Viana dos Santos; Daniel Penteado Martins Dias; Kathleen A Sluka; Josimari M DeSantana; Valter J Santana-Filho Journal: Auton Neurosci Date: 2012-01-21 Impact factor: 3.145