Central motor control failure in fibromyalgia: a surface electromyography study
Central motor control failure in fibromyalgia: a surface electromyography study
复制标题
DOI：
10.1186/1471-2474-10-78
复制
发表时间：
2009-07-01
影响因子：
2.3
通讯作者：
Rainoldi, Alberto
中科院分区：
文献类型：
--
作者：
Casale, Roberto;Sarzi-Puttini, Piercarlo;Rainoldi, Alberto
背景资料：纤维肌痛（FM）的特征是多个部位的弥漫性肌肉骨骼疼痛和僵硬，特征部位的压痛点，以及频繁出现疲劳等症状。本研究的目的是评估受FM影响的患者疲劳的肌电表现是中枢还是外周起源。8例女性患者，年龄55.6 ± 13.6岁（FM组）和8名年龄为50.3 ± 9.3岁（MCG）的健康女性志愿者进行了无创表面肌电图（s-EMG）研究包括放置在覆盖肱二头肌的皮肤上的16个电极的线性阵列，通过随意和不随意（电诱发）收缩引起肌肉疲劳。最大自主收缩（MVC），运动单位动作电位传导速度分布（平均值+/- SD和偏度）和频谱的平均功率频率（MNF）进行估计，以评估两组和收缩类型之间是否存在任何显著差异。在FM患者中，自主收缩期间的运动募集模式发生了改变，他们也表现出较少的疲劳肌电表现，（FM中的标准化传导速度变化率：-0.074 +/- 0.052%/s vs MCG中的-0.196 +/- 0.133%/s;标准化MNF变化率：FM为-0.29 +/- 0.16%/s，MCG为-0.66 +/- 0.34%/s）。FM组的平均传导速度分布和偏度值较高（p < 0.01）。从电引起的contractions.Conclusion获得的结果中没有组间差异：FM中疲劳的肌电表现较少的明显矛盾是肌肉重塑的电生理表达慢传导抗疲劳1型纤维的患病率。由于组间唯一的差异涉及自愿收缩，它们可能与中枢运动控制失败比肌肉膜改变更相关，这表明与超节段控制改变相关的病理性肌纤维重塑。
Background: Fibromyalgia (FM) is characterised by diffuse musculoskeletal pain and stiffness at multiple sites, tender points in characteristic locations, and the frequent presence of symptoms such as fatigue. The aim of this study was to assess whether the myoelectrical manifestations of fatigue in patients affected by FM are central or peripheral in origin.Methods: Eight female patients aged 55.6 +/- 13.6 years (FM group) and eight healthy female volunteers aged 50.3 +/- 9.3 years (MCG) were studied by means of non-invasive surface electromyography (s-EMG) involving a linear array of 16 electrodes placed on the skin overlying the biceps brachii muscle, with muscle fatigue being evoked by means of voluntary and involuntary (electrically elicited) contractions. Maximal voluntary contractions (MVCs), motor unit action potential conduction velocity distributions (mean +/- SD and skewness), and the mean power frequency of the spectrum (MNF) were estimated in order to assess whether there were any significant differences between the two groups and contraction types.Results: The motor pattern of recruitment during voluntary contractions was altered in the FM patients, who also showed fewer myoelectrical manifestations of fatigue (normalised conduction velocity rate of changes: -0.074 +/- 0.052%/s in FM vs -0.196 +/- 0.133%/s in MCG; normalised MNF rate of changes: -0.29 +/- 0.16%/s in FM vs -0.66 +/- 0.34%/s in MCG). Mean conduction velocity distribution and skewnesses values were higher (p < 0.01) in the FM group. There were no between-group differences in the results obtained from the electrically elicited contractions.Conclusion: The apparent paradox of fewer myoelectrical manifestations of fatigue in FM is the electrophysiological expression of muscle remodelling in terms of the prevalence of slow conducting fatigue-resistant type 1 fibres. As the only between-group differences concerned voluntary contractions, they are probably more related to central motor control failure than muscle membrane alterations, which suggests pathological muscle fibre remodelling related to altered suprasegmental control.