Orthostatic sympathetic derangement in subjects with fibromyalgia

J Rheumatol. 1997 Apr;24(4):714-8.


Objective: To assess the sympathetic-parasympathetic balance in individuals with fibromyalgia (FM), and its response to orthostatic stress, by power spectral analysis of heart rate variability.

Methods: We studied 19 women with FM and 19 age matched controls. A high resolution electrocardiogram was obtained in supine and standing postures after achieving a stable heart rate. Spectral analysis of R-R intervals was done by the fast Fourier transform algorithm.

Results: Analyses of the different frequency components revealed significant difference between the 2 groups in the low frequency (0.050-0.150 Hz) band, which reflects modulation of the sympathetic nervous system. Controls displayed an increased power spectral density upon standing (+0.081 +/- 0.217 Hz); individuals with FM had a discordant response (-0.057 +/- 0.097 Hz) (p = 0.018).

Conclusion: In FM, there is a deranged sympathetic response to orthostatic stress. This abnormality may have implications regarding the pathogenesis of FM.

MeSH terms

  • Adult
  • Baroreflex
  • Female
  • Fibromyalgia / physiopathology*
  • Heart Rate*
  • Humans
  • Middle Aged
  • Posture / physiology
  • Supine Position
  • Sympathetic Nervous System / physiopathology*
  • Tilt-Table Test