title: Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement.
abstract: BACKGROUND
  Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10) (CoQ(10)) supplementation on biochemical markers and clinical improvement were also evaluated.
  
  
  METHODS
  We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ(10), catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs.
  
  
  RESULTS
  We found decreased CoQ(10), catalase and ATP levels in BMCs from FM patients as compared to normal control (P < 0.05 and P < 0.001, respectively) We also found increased level of LPO in BMCs from FM patients as compared to normal control (P < 0.001). Significant negative correlations between CoQ(10) or catalase levels in BMCs and headache parameters were observed (r  = -0.59, P < 0.05; r  =  -0.68, P < 0.05, respectively). Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05). Oral CoQ(10) supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P < 0.001).
  
  
  CONCLUSIONS
  The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.
authors.affiliation: Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-Junta de Andalucía and Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Sevilla, Spain. mdcormor@upo.es
authors.forename: Mario D
authors.initials: MD
authors.lastname: Cordero
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Cano-García
authors.forename: Elísabet
authors.initials: E
authors.lastname: Alcocer-Gómez
authors.forename: Manuel
authors.initials: M
authors.lastname: De Miguel
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sánchez-Alcázar
mesh_terms: D000255:Adenosine Triphosphate / Q000097:blood; D000328:Adult; D002374:Catalase / Q000097:blood; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy / Q000378:metabolism*; D006261:Headache / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D015227:Lipid Peroxidation / Q000187:drug effects; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D010147:Pain Measurement / Q000187:drug effects; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D014815:Vitamins / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014451:Ubiquinone; D000255:Adenosine Triphosphate; D002374:Catalase; C024989:coenzyme Q10