Autonomic dysfunction in patients with fibromyalgia: Application of power spectral analysis of heart rate variability

https://doi.org/10.1016/S0049-0172(00)80010-4Get rights and content

Abstract

Objectives:To assess the interaction between the sympathetic and parasympatheticsystems in patients with fibromyalgia syndrome (FM), using power spectrum analysis (PSA) of heart rate variability (HRV). In addition, we explored the association between HRV, measures of tenderness, FM symptoms, physical function, psychological well being and quality of life.

Methods:

We studied 22 women with FM and 22 age-matched healthy women. Twenty-minute electrocardiogram recordings were obtained in a supine position during complete rest. Spectral analysis of R-R intervals was done by the fast-Fourier transform algorithm.

Results:

Heart rate was significantly higher in FM patients compared withcontrols (P < .006). FM patients had significantly lower HRV compared with controls (P = .001), and higher low-frequency (LF) and lower high-frequency (HF) components of PSA than controls (P < .001). Quality of life, physical function, anxiety, depression, and perceived stress were moderately to highly correlated with LF, HF (in normalized units), and LF/HF No association was observed between HRV parameters and measures of tenderness and FM symptoms.

Conclusions:

The basal autonomic state of patients with FM is characterized by increased sympathetic and decreased parasympathetic tones. Autonomic dysregulation may have implications regarding the symptornatology, physical and psychological aspects of health status.

References (59)

  • KleigerR.E. et al.

    Decreased heart rate variability and its association with increased mortality after acute myocardial infarction

    Am J Cardiol

    (1987)
  • WinchellR.J. et al.

    Spectral analysis of heart rate variability in the ICU: a measure of autonomic function

    J Surg Res

    (1996)
  • GoldenbergD.L.

    Fibromyalgia

  • WolfeF. et al.

    The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee

    Arthritis Rheum

    (1990)
  • YunusM.B.

    Towards a model of pathophysiology of fibromyalgia: aberrant central pain mechanisms with peripheral modulation

    J Rheumatol

    (1992)
  • RussellI.J.

    Neurohormonal aspects of fibromyalgia syndrome

    Rheum Dis Clin North Am

    (1989)
  • RussellI.J.

    Biochemical abnormalities in fibromyalgia syndrome

    J Musculoskel Pain

    (1994)
  • BennettR.M. et al.

    Low levels of somatomedin C in patients with the fibromyalgia syndrome: a possible link between sleep and muscle pain

    Arthritis Rheum

    (1992)
  • Bou-HolaigahI. et al.

    Provocation of hypotension and pain during upright tilt table testing in adults with fibromyalgia

    Clin Exp Rheum

    (1997)
  • Martinez-LavinM. et al.

    Orthostatic sympathetic derangement in subjects with fibromyalgia

    J Rheumatol

    (1997)
  • KelemanJ. et al.

    Orthostatic sympathetic derangement of baroreflex in patients with fibromyalgia

    J Rheumatol

    (1988)
  • AkselrodS. et al.

    Power spectral analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control

    Science

    (1981)
  • McCraryR. et al.

    The effects of emotions on short-term power spectrum analysis of heart-rate variability

    Am J Cardiol

    (1996)
  • ParatiG. et al.

    Sequential spectral analysis of 24-hour blood pressure and pulse interval in humans

    Hypertension

    (1990)
  • WheelerT. et al.

    Cardiac dernervation in diabetes

    Br Med J

    (1973)
  • RoccoM.B. et al.

    Circadian variations of transient myocardial ischemia in patients with coronary artery disease

    Circulation

    (1987)
  • MullerJ.E. et al.

    Circadian variation in the frequency of onset of acute myocardial infarction

    N Engl J Med

    (1985)
  • Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology

    Heart rate variability: standards of measurement, physiological interpretation and clinical use

    Circulation

    (1996)
  • OriZ. et al.

    Heart rate variability: frequency domain analysis

    Ambulatory Electrocardiography

    (1992)
  • Cited by (305)

    • Veterans’ Insights on Heart Rate Variability Biofeedback to Treat Fibromyalgia-Related Pain

      2022, Pain Management Nursing
      Citation Excerpt :

      Heart rate variability (HRV) reflects sympathetic and parasympathetic interactions between the cardiac autonomic nervous system (CANS) and autonomic nervous system (ANS) (McCraty & Tomasino, 2004). HRV incoherence, an erratic or chaotic waveform pattern (McCraty & Shaffer, 2015), reflects a dysfunctional ANS associated with the chronic pain, decreased physical functioning, and poor quality of life (QOL) as seen in individuals diagnosed with FM (Cohen et al., 2000; Kang et al., 2012; & Meeus et al. 2013). Conversely, HRV coherence, an ordered and harmonic sine-waveform (McCraty & Shaffer, 2015), reflects a healthy functioning ANS associated with minimal pain (Meeus et al., 2013), stress resistance, emotional adaptability (Tan et al., 2009), and self-regulation (McCraty & Shaffer, 2015).

    • The role of the vagus nerve in fibromyalgia syndrome

      2021, Neuroscience and Biobehavioral Reviews
    View all citing articles on Scopus
    View full text