Exposure to Cold Unmasks Potential Biomarkers of Fibromyalgia Syndrome Reflecting Insufficient Sympathetic Responses to Stress

Jose V Pardo, Robert C. Larson, Rachel J. Spencer, Joel T. Lee, Jeffrey D. Pasley, Carolyn J Torkelson, Alice A Larson

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Fibromyalgia syndrome (FMS) is a chronically painful condition whose symptoms are widely reported to be exacerbated by stress. We hypothesized that female patients with FMS differ from pain-free female controls in their sympathetic responses, a fact that may unmask important biomarkers and factors that contribute to the etiology of FMS. Materials and Methods: In a pilot study, blood pressure (BP), skin temperature, thermogenic activity, circulating glucose, and pain sensitivity of 13 individuals with FMS and 11 controls at room temperature (24°C) were compared with that after exposure to cold (19°C). Results: When measured at 24°C, BP, skin temperature, blood glucose, and brown adipose tissue (BAT) activity, measured using 18 F-fluorodeoxyglucose positron-emission tomography/computed tomography, did not differ between controls and individuals with FMS. However, after cold exposure (19°C), BP and BAT activity increased in controls but not in individuals with FMS; skin temperature on the calf and arm decreased in controls more than in individiuals with FMS; and circulating glucose was lower in individiuals with FMS than in controls. Pain sensitivity did not change during the testing interval in response to cold. Discussion: The convergence of the effect of cold on 4 relatively simple measures of thermogenic, cardiovascular, and metabolic activity, each regulated by sympathetic activity, strongly indicate that individuals with FMS have impaired sympathetic responses to stress that are observable and highly significant even when measured in extraordinarily small sample populations. If insufficient sympathetic responses to stress are linked to FMS, stress may unmask and maximize these potential clinical biomarkers of FMS and be related to its etiology.

Original languageEnglish (US)
Pages (from-to)407-419
Number of pages13
JournalClinical Journal of Pain
Volume35
Issue number5
DOIs
StatePublished - May 1 2019

Bibliographical note

Funding Information:
Supported by a grant to A.A.L. and J.V.P. from NIH (Washington, DC) from the National Institutes on Arthritis and Musculoskeletal and Skin Diseases [AR056092], to J.V.P. from the Veterans Admin-istration [5I01CX000501] (Washington, DC), to J.V.P. from the Clinical and Translational Science Award (CTSA) UL1TR000114 (Washington, DC), the Department of Veterans Affairs (Minneapolis, MN), and to A.A.L., J.V.P., and J.D.P. from the University of Minnesota Graduate School (Minneapolis, MN). The remaining authors declare no conflict of interest.

Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.

Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.

Keywords

  • Glucose metabolism
  • adipose tissue
  • magnetic resonance imaging
  • positron-emission tomography
  • temperature regulation

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