EMG activity and pain development in fibromyalgia patients exposed to mental stress of long duration.
ABSTRACT To examine the distribution of stress-induced upper-body pain in fibromyalgia patients, and the possible association of pain with electromyographic activity in muscles near the sites of pain development.
Fifteen fibromyalgia patients and 15 pain-free subjects were exposed to low-level mental strain over a one-hour period. EMG was recorded from frontalis, temporalis, trapezius, and splenius capitis. Pain in the corresponding locations was recorded before the test, every 10 minutes during the test, and the 30-minute posttest period.
The fibromyalgia patients developed pain during the test in all the above body locations. Pain development in all locations associated with trapezius EMG activity, but not with EMG activity in underlying muscles for forehead, temples, and neck.
Stress-induced pain in fibromyalgia patients is not generally caused by muscle activity. The trapezius EMG response may be part of a general stress response that cause pain independently of motor activity in muscles.
- [show abstract] [hide abstract]
ABSTRACT: Stress and thermoregulation both activate the sympathetic nervous system (SNS) but might differently affect pain. Studies investigating possible interactions in patients are problematic because of the high prevalence of SNS disturbances in patients. We therefore analyzed the influence of these different sympathetic challenges on experimentally-induced pain in healthy subjects. SNS was activated in two different ways: by mental stress (Stroop task, mental arithmetic task), and by thermoregulatory stimulation using a water-perfused thermal suit (7 degrees C, 32 degrees C, or 50 degrees C). Attentional effects of the mental stress tasks were controlled by using easy control tasks. Both, stress and thermoregulatory stimuli, robustly activated SNS parameters. However, the patterns of activation were different. While stress co-activated heart rate, blood pressure, peripheral vasoconstriction and sweating, thermal stimulation either increased blood pressure (cold) or heart rate and sweating (warm). Only stress was able to induce a significant reduction of pain. The control tasks neither activated the SNS nor altered pain perception. Our results suggest that (1) different patterns of sympathetic activation can be recorded after stress and thermoregulatory challenges and (2) that only stress is able to interfere with sensation of experimental pain. Whether SNS activation is causally responsible for analgesia needs to be further investigated.European journal of pain (London, England) 02/2009; 13(9):935-41. · 3.37 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Asthenopia has been associated with reading under visually stressful conditions. However, it is not known whether increased cognitive load contributes to asthenopic symptoms. The purpose of this study was to evaluate the contribution of increased cognitive load (with or without visual stress inducing conditions) to asthenopic symptoms associated with prolonged near work. Thirty-three visually normal subjects, aged 18 to 30 years, participated in the study. Subjects read texts or watched videos under different visual stress and cognitive loads. Visual stress conditions were good visual quality, low contrast, and induced refractive error. The cognitive load levels were watching video, reading fairy tales, and reading technical articles. As an additional task, subjects also listened to technical articles. At the end of each condition, subjects rated the magnitude of any asthenopic symptoms, visual discomfort, and cognitive discomfort they experienced during the task. Electromyography potentials recorded from the lower orbicularis oculi muscle were used to obtain blink rate. Subjects reported greater internal symptoms for the refractive error condition coupled with higher cognitive load compared to good visual and low contrast conditions (p < 0.01). For the low contrast condition coupled with higher cognitive load, greater external symptoms were reported compared to good visual and refractive error conditions (p < 0.05). However, asthenopic symptoms were not reported for cognitively demanding tasks when the visual condition was good. Blink rates were not significantly different between the good visual and low contrast conditions within each cognitive load level. For the cognitively difficult reading conditions, blink rate was significantly decreased for the low contrast and good visual conditions compared to the refractive error condition. An interaction between cognitive and visual demands was observed. Greater cognitive loads accentuate the same differentiated symptoms normally caused by visual stressors.Optometry and vision science: official publication of the American Academy of Optometry 11/2011; 89(1):97-104. · 1.53 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: BACKGROUND: Muscle activity and pain development of fibromyalgia (FM) patients in response to mental stress show inconsistent results, when compared to healthy controls (HCs). A possible reason for the inconsistent results is the large variation in stress exposures in different studies. This study compares muscle responses of FM patients and HCs for different modes and levels of imposed stress, to elucidate features in stress exposures that distinguish stress responses of FM patients from HCs. METHODS: Upper trapezius (clavicular and acromial fibers), deltoid, and biceps surface electromyographic (sEMG) activity was recorded in FM patients (n=26) and HCs (n=25). Heart rate (HR) was recorded and used as indicator of autonomic activation. Tests included inspiratory breath holding (sympathetic activation procedure), mental stress tests (color-word test and backward counting; 28 min), instructed rest prior to stress test (30 min TV watching), and controlled arm movement. sEMG and HR was also recorded during an unrestrained evening stay at a patient hotel. The 5-min period with lowest trapezius muscle activity was determined. Pain (shoulder/neck, low back pain) and perceived tension were scored on VAS scales at the start and the end of the stress test and at bedtime. RESULTS: Trapezius sEMG responses of FM patients were significantly higher than HCs during sympathetic activation, mental stress, and instructed rest, but similar during arm movement and unrestrained evening activity. HR of FM patients and HCs was similar during mental stress and in the evening, including the 5-min period with lowest trapezius activity. Muscle activity of FM patients during the stress test (with shoulder/neck pain development) and the evening stay (no pain development) was similar. CONCLUSIONS: FM patients show elevated muscle activity (in particular trapezius activity) in situations with imposed stress, including sympathetic activation, and putative anticipatory stress. Muscle activity and HR were similar to HCs in instructed arm movement and in a situation approaching low-stress daily living. Pain development of FM patients during the stress test may be due to activation of several stress-associated physiological systems, and not obviously caused by muscle activity in isolation.BMC Musculoskeletal Disorders 03/2013; 14(1):97. · 1.88 Impact Factor