Project: Research project

Project Details


Fibromyalgia (FM) is a syndrome of unknown cause and poorly understood
pathophysiology. It has been estimated to have a prevalence rate of up to
10% in some populations. Previous studies have suggested that the fatigue
and muscle pain associated with this syndrome can be correlated with
anatomic and physiologic changes in skeletal muscle. We propose to apply
the techniques of magnetic resonance imaging (MRI) and P-31 magnetic
resonance spectroscopy (MRS) to the study of patients with FM. In previous
investigations, we have shown that the fatigue associated with other
musculoskeletal syndromes, such as amyopathic dermatomyositis, may be
explained by changes in the biochemical and physiological responses of
muscle. We propose to apply these techniques to the study of patients with
FM, with three specific aims. First, a cross-sectional study of 20 to 25
FM patients will be carried out using our previously reported MR and P-31
MRS protocols for: (l) MR images of thigh muscles acquired with a Carr-
Purcell-Meiboom-Gill sequence to visualize abnormalities and calculate T1
and T2 values and (2) P-31 MR spectra to determine levels of ATP,
phosphocreatine (PCr), inorganic phosphate (Pi), phosphomonoesters and
phosphodiesters during rest, graded exercise and recovery. These data will
be compared to ongoing and previous results in patients with inflammatory
myopathies, and to age- and sex-matched normal controls. Second, 10 of
these individuals will have more intensive studies using (A) localized
spectroscopy of areas of muscle adjacent to painful trigger points, to
include direct measurement of P-31 metabolites and intracellular
concentrations of lactic acid and creatine, and (B) imaging and
spectroscopy of the upper extremities. The third aim will be to study 10
to 12 newly diagnosed FM patients who are beginning standard treatment
with tricyclic medications and/or physical therapy. These patients will be
followed longitudinally for up to 18 months. Findings will be correlated
with responses of each patient on self-assessment questionnaires covering
daily activities, work-related activities and more vigorous recreational
exercise. With the use of these sensitive techniques, we expect to be able
to determine definitively whether or not anatomic or biochemical
abnormalities of muscle are associated with FM. These data in turn may
suggest new approaches to diagnosis and treatment of this disorder.
Effective start/end date9/25/945/31/98


  • National Institute of Arthritis and Musculoskeletal and Skin Diseases
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases


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