Muscle and cerebral oxygenation during exercise in fibromyalgia: a near-infrared spectroscopy study, 2025, Lehto et al

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Muscle and cerebral oxygenation during exercise in fibromyalgia: a near-infrared spectroscopy study

Taneli Lehto, Teemu Zetterman, Dominique Gagnon, Ritva Markkula, Jari Arokoski, Eija Kalso & Juha E. Peltonen

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Purpose
We studied muscle and brain oxygenation during submaximal and peak exercise in patients with fibromyalgia (FM), a condition characterized by pain and fatigue, compared with age-matched healthy controls (CON).

Methods
The participants (FM, n = 16; CON, n = 17) undertook a step incremental cycle spiroergometry until exhaustion. Changes in oxyhemoglobin (O2Hb), deoxyhemoglobin (HHb), total hemoglobin (tHB), and tissue saturation index (TSI%) using near-infrared spectroscopy were assessed in the vastus lateralis (leg) and biceps brachii (arm) muscles as well as the brain prefrontal cortex. Vastus lateralis blood flow (Q̇VL) was calculated from whole-body oxygen consumption (V̇O2) and HHb values. We analyzed between-group differences at absolute workloads and relative to V̇O2peak.

Results
No significant between-group differences emerged in leg or arm oxygenation.

Q̇VL was lower in FM at 50% (0.066 [0.022] vs. 0.080 [0.028] a.u.), 75% (0.082 [0.020] vs. 0.106 [0.039] a.u.), and 100% (0.091 [0.036] vs. 0.111 [0.041] a.u.) of V̇O2peak, but similar at submaximal absolute workloads.

Cerebral HHb values were higher in FM at 75 (1.09 [2.23] vs. −0.18 [1.38] μM) and 100 W (2.20 [2.96] vs. 0.06 [1.92] μM) but not at relative workloads.

Cerebral TSI%, O2Hb and tHb were not significantly different between groups.

Conclusion
Leg oxygenation or peak exercise cerebral deoxygenation in FM do not differ from controls. Q̇VL was lower at peak exercise in FM. These results present evidence that exercise intolerance in FM may rely on other mechanisms than muscle oxygenation.

Trial registration ClinicalTrials.gov, NCT03300635. Registered 3 October 2017—retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03300635.

Web | PDF | European Journal of Applied Physiology | Open Access
 
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I wonder why they went for fibromyalgia rather than ME/CFS.
The work presented here is part of a larger study; Metabolism, Muscle Function, and Psychological Factors in Fibromyalgia, where the participants also underwent electromyography and cognitive stress studies, metabolomic panel, and an oral glucose tolerance test in addition to a cardiopulmonary exercise test (Zetterman et al. 2021a, b, 2023, 2024; Lehto et al. 2023).
 
It just struck me that fibromyalgia may be an easier name to get grant money for. It is a recognised area of study for rheumatologists whereas ME/CFS isn't. As to why that should be, goodness knows, except that fibromyalgia is a rheumatologists' invention and pain is legitimately rheumatological whereas fatigue is a bit dodgy.
 
There was a lot of selection of the data, specifically, data from a large percentage of the participants were discarded due to technical problems and being "out of physiological range". See Figure 1

That surely has to raise some questions about the accuracy of the data that was left.

 
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