Evidence of reduced sympatho-adrenal and hypothalamic-pituitary activity during static muscular work in patients with fibromyalgia.
OBJECTIVE
To assess activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenocortical axis during static exercise in patients with fibromyalgia.


METHODS
Sixteen patients with fibromyalgia and 16 healthy controls performed a static knee extension until exhaustion. Plasma catecholamines, adrenocorticotropic hormone and cortisol, as well as blood pressure and heart rate, were assessed before, during and following contraction. Plasma C reactive protein was analysed at baseline.


RESULTS
Blood pressure and heart rate increased during contraction (p < 0.001) and decreased following contraction (p < 0.001) in both groups alike. Compared with baseline, plasma catecholamines increased during contraction in both groups (p < 0.001), but patients with fibromyalgia had lower levels of plasma adrenaline (p < 0.04) and noradrenaline (p < 0.08) at all times. Adrenocorticotropic hormone increased at exhaustion in controls (p < 0.001), but not in patients with fibromyalgia, who also had lower adrenocorticotropic hormone at exhaustion (p < 0.02) compared with controls. There were no group differences, or changes over time in plasma cortisol. High sensitivity C reactive protein was higher in patients with fibromyalgia compared with controls (p < 0.02).


CONCLUSIONS
Patients with fibromyalgia exhibited a hypoactive sympatho-adrenal system as well as a hypo-reactive hypothalamic-pituitary axis during static exercise.
Kadetoff
Diana
D
Osher Center For Integrative Medicine, Stockholm Brain Institute, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Kosek
Eva
E
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis; D004837:Epinephrine / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005260:Female; D005356:Fibromyalgia / Q000097:blood / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology* / Q000503:physiopathology; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D010913:Pituitary-Adrenal System / Q000502:physiology* / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000502:physiology / Q000503:physiopathology
D000324:Adrenocorticotropic Hormone; D002097:C-Reactive Protein; D006854:Hydrocortisone; D004837:Epinephrine