title: Muscle fatigue, lactate, and pyruvate in mitochondrial myopathy with progressive external ophthalmoplegia.
abstract: We studied muscle fatigue and serum lactate and pyruvate levels in 20 patients with mitochondrial myopathy with progressive external ophthalmoplegia (PEO). Fatigue was assessed in the adductor pollicis muscle (AP) using a low-intensity exercise protocol (20 min). Forces (TFs) and relaxation times of ulnar nerve evoked twitches, compound muscle action potentials (CMAPs), and maximal voluntary contractions (MVCs) were monitored. Serum lactate and pyruvate levels were independently measured at rest and after exercise on a bicycle (15 min, 30 W). Most patients showed abnormal fatigue of the AP with a reduction of TFs and MVCs and normal CMAPs. The reduced TFs were significantly correlated with lactate levels at rest (r= - 0.60, P<0.05) and less so with those after exercise (r=- 0.47,P<0.05). Pyruvate levels revealed a similar correlation although they were widely scattered. We conclude that abnormal fatigue in PEO is metabolic, is localized beyond the muscle fiber membrane, and involves the electrome-chanical coupling and the contractile apparatus. Serum lactate levels at rest are good predictors of fatigue in PEO.
authors.affiliation: Department of Neurology of the Medical University Hanover, Hanover, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Dengler
authors.forename: K
authors.initials: K
authors.lastname: Wohlfarth
authors.forename: S
authors.initials: S
authors.lastname: Zierz
authors.forename: M
authors.initials: M
authors.lastname: Jobges
authors.forename: M
authors.initials: M
authors.lastname: Schubert
mesh_terms: D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D006801:Humans; D007773:Lactates / Q000097:blood*; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D017240:Mitochondrial Myopathies / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D009119:Muscle Contraction; D018763:Muscle Fatigue; D017246:Ophthalmoplegia, Chronic Progressive External / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D011773:Pyruvates / Q000097:blood*; D019289:Pyruvic Acid
chemical_list: D007773:Lactates; D011773:Pyruvates; D019344:Lactic Acid; D019289:Pyruvic Acid