MICROCIRCULATION IN SKIN AND MUSCLE DURING VENOUS STASIS, ARTERIAL ISCHEMIA AND ORTHOSTATIC CHALLENGE IN PATIENTS WITH FIBROMYALGIA AND HEALTHY CONTROLS 


S. Rehm, J. Sachau, J. Forstenpointner, J. Hellriegel, R. Baron
  
Division for Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel


Background and aims: Fibromyalgia syndrome (FMS) is a frequent and disabling pain disorder. Patients describe their pain similar to neuropathic pain characteristics.  Previous studies point to impaired sympathetic activity and reduced muscle-oxygenation as mechanism at play in this disease. We analyzed the blood flow in muscle and skin of patients and healthy controls (HC) during venous stasis, arterial ischemia and tilt table testing.

Methods: Using a combination of laser Doppler flowmetry and remission spectroscopy we examined 20 FMS patients and 10 HC. During tilt table testing, venous stasis and arterial ischemia blood flow in skin and muscle, heart rate and blood pressure were measured.

Results: In the first phase of orthostatic challenge patients demonstrated a significant increase in blood pressure and heart rate in comparison to HC. Blood flow in skin and muscle did not differ significantly during venous stasis, arterial ischemia and orthostatic challenge between patients and HC. Significant differences could be seen in the blood flow during the recovery phase after venous stasis. 

Conclusions: The observed increase in systolic blood pressure and heart rate in patients after orthostatic challenge supports the hypothesis of an increased activity of the sympathetic efferent system in FMS patients. No differences in muscular blood flow between patients and HC could be detected during the actual interventions, but the differences in muscular blood flow in the venous and arterial recovery phases might point to different regulation patterns in patients and HC.

MICROCIRCULATION IN SKIN AND MUSCLE DURING VENOUS STASIS, ARTERIAL ISCHEMIA AND ORTHOSTATIC CHALLENGE IN PATIENTS WITH FIBROMYALGIA AND HEALTHY CONTROLS