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Catecholamines and heart rate in female fibromyalgia patients
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Norwegian University of Science and Technology, Human Movement Science Programme.
Norwegian University of Science and Technology, Department of Industrial Economics and Technology.
Norwegian University of Science and Technology, Department of Neuroscience.
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2012 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 72, no 1, 51-57 p.Article in journal (Refereed) Published
Abstract [en]

Background: Fibromyalgia syndrome is a disease of unknown pathogenesis characterised by widespread chronic musculoskeletal pain. Fibromyalgia has been associated with dysregulation of the stress systems, but results are inconsistent.

Purpose: To investigate autonomic nervous system activity (urinary noradrenaline, adrenaline, dopamine, and heart rate) of fibromyalgia patients and healthy controls.

Methods: Urinary catecholamines and heart rate were assessed for a 24-hour period in a controlled hospital setting (including relaxation, a test with prolonged mental stress, and sleep), and during daily activity in 29 female fibromyalgia patients and 29 age-matched female healthy controls.

Results: With repeated measures ANOVAs, catecholamine levels were lower in patients than controls (P = .035 for noradrenaline; P = .005 for adrenaline; P = .001 for dopamine). One-way ANOVAs for the single periods showed that patients compared to controls had significantly lower adrenaline levels during the night (P = .010) and the second day (P = .010), significantly lower dopamine levels during the first day (P = .008), the night (P = .001), and the second day (P = .004). However, single time point noradrenaline levels were not significantly different between the groups. Overall, heart rate was significantly higher in patients than controls (P = .014). Specifically, significant differences emerged during relaxation (P = .016) and sleep (P = .011), but not during stress provocation or daily activities.

Conclusions: The results indicate an altered regulation of the autonomic nervous system in fibromyalgia patients, with attenuated activity of both the sympathetic (adrenal medulla component) and the parasympathetic branch.

Place, publisher, year, edition, pages
Elsevier, 2012. Vol. 72, no 1, 51-57 p.
Keyword [en]
chronic musculoskeletal pain, stress, noradrenaline, adrenaline, dopamine, autonomic imbalance
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-65010DOI: 10.1016/j.jpsychores.2011.09.010ISI: 000298936400011OAI: oai:DiVA.org:su-65010DiVA: diva2:460493
Note
This research was supported by grants to Professor Ulf Lundberg from the Swedish Research Council and the Swedish Council for Working Life and Social Research. Support was also obtained from the Centre for Musculoskeletal Research at the University of Gävle. Thanks to Associate Professor Petra Lindfors for her comments on the preliminary manuscript, to Eva Kosek, MD, for her comments on the preliminary data, to Mrs Ann-Christine Sjöbeck for performing the catecholamine analysis, and to Mr Håvard Wuttudal Lorås for assisting during data collection.Available from: 2011-11-30 Created: 2011-11-30 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Psychobiological responses in women with regional or widespread musculoskeletal pain conditions
Open this publication in new window or tab >>Psychobiological responses in women with regional or widespread musculoskeletal pain conditions
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Musculoskeletal disorders (MSDs) are very common. Regional chronic shoulder and neck pain (SNP) and widespread chronic pain due to fibromyalgia syndrome (FMS) are examples of MSDs characterized by altered physiology of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. The aims of this thesis are to compare the cortisol awakening response (CAR) in SNP women, FMS patients and healthy controls, and to compare salivary cortisol levels, urinary catecholamine levels (adrenaline, noradrenaline, and dopamine), and cardiovascular responses in FMS patients and healthy controls. Self-ratings of sleep, anxiety, perceived stress, and pain were also investigated. In Study I, CAR tended to be higher in SNP women than in healthy controls, whereas it was significantly higher than in FMS patients. Moreover, CAR was significantly lower in FMS patients than in healthy controls. Study II showed that cortisol levels were lower in FMS patients than in healthy controls during the rest of the day as well. In Study III, adrenaline and dopamine (but not noradrenaline) levels were significantly lower in FMS patients than in healthy controls. Resting heart rate was significantly higher in FMS patients than in healthy controls, but no differences emerged during stress provocation or unconstrained daily activities. Finally, SNP women and FMS patients reported more pain and health complaints than did healthy controls, but SNP women were less affected. Potential confounders (e.g., age, obesity, physical exercise) had no effects on the findings. Taken together, the findings show altered ANS and HPA axis regulation in FMS patients. Specifically, the hyperactive HPA axis found in SNP women (i.e., higher cortisol levels) might constitute a preliminary stage of a hypoactive HPA axis in FMS patients (i.e., lower cortisol levels). In view of this, an altered regulation of the HPA axis in the progression from regional to widespread MSDs may follow a temporal development.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2012. 96 p.
Keyword
fibromyalgia, shoulder and neck pain, salivary cortisol, urinary catecholamines, cardiovascular responses
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-65011 (URN)978-91-7447-420-6 (ISBN)
Public defence
2012-02-10, David Magnussonsalen (U31), Frescati Hagväg 8, Stockholm, 10:00 (English)
Opponent
Supervisors
Note
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Epub ahead of print. Paper 2: Epub ahead of print.Available from: 2012-01-19 Created: 2011-11-30 Last updated: 2011-12-21Bibliographically approved

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