Muscle energy metabolism, nuclear magnetic resonance spectroscopy and their potential in the study of fibromyalgia.

The fields of muscle physiology and biochemistry have already identified some of the key components of ATPase hydrolysis products that are involved in muscle fatigue. The concentration of the relevant chemical species can be readily measured by nuclear magnetic resonance techniques in muscle. Now the question is: is alteration of cellular energy balance and the normal balance between supply and demand disturbed in fibromyalgia? Since these chemical events account for a very large amount of muscle reduced performance as well as reduction in both velocity and force, at the very least one ought to identify how large these changes are in any patient in whom we are trying to assess the degree to which these chemical changes might be associated with muscle fatigue. An objective chemical criteria for muscle performance is possible with modern noninvasive phosphorus magnetic resonance spectroscopy.