Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Abstract Background Muscle fatigue and pain are key symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Although the pathophysiology is not yet fully understood, there is ample evidence for hypoperfusion which may result in electrolyte imbalance and sodium overload in muscles. T...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Journal of Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12967-022-03616-z |
| _version_ | 1797849891104358400 |
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| author | Elisabeth Petter Carmen Scheibenbogen Peter Linz Christian Stehning Klaus Wirth Titus Kuehne Marcus Kelm |
| author_facet | Elisabeth Petter Carmen Scheibenbogen Peter Linz Christian Stehning Klaus Wirth Titus Kuehne Marcus Kelm |
| author_sort | Elisabeth Petter |
| collection | DOAJ |
| description | Abstract Background Muscle fatigue and pain are key symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Although the pathophysiology is not yet fully understood, there is ample evidence for hypoperfusion which may result in electrolyte imbalance and sodium overload in muscles. Therefore, the aim of this study was to assess levels of sodium content in muscles of patients with ME/CFS and to compare these to healthy controls. Methods Six female patients with ME/CFS and six age, BMI and sex matched controls underwent 23Na-MRI of the left lower leg using a clinical 3T MR scanner before and after 3 min of plantar flexion exercise. Sodium reference phantoms with solutions of 10, 20, 30 and 40 mmol/L NaCl were used for quantification. Muscle sodium content over 40 min was measured using a dedicated plugin in the open-source DICOM viewer Horos. Handgrip strength was measured and correlated with sodium content. Results Baseline tissue sodium content was higher in all 5 lower leg muscle compartments in ME/CFS compared to controls. Within the anterior extensor muscle compartment, the highest difference in baseline muscle sodium content between ME/CFS and controls was found (mean ± SD; 12.20 ± 1.66 mM in ME/CFS versus 9.38 ± 0.71 mM in controls, p = 0.0034). Directly after exercise, tissue sodium content increased in gastrocnemius and triceps surae muscles with + 30% in ME/CFS (p = 0.0005) and + 24% in controls (p = 0.0007) in the medial gastrocnemius muscle but not in the extensor muscles which were not exercised. Compared to baseline, the increase of sodium content in medial gastrocnemius muscle was stronger in ME/CFS than in controls with + 30% versus + 17% to baseline at 12 min (p = 0.0326) and + 29% versus + 16% to baseline at 15 min (p = 0.0265). Patients had reduced average handgrip strength which was associated with increased average muscle tissue sodium content (p = 0.0319, R2 = 0.3832). Conclusion Muscle sodium content before and after exercise was higher in ME/CFS than in healthy controls. Furthermore, our findings indicate an inverse correlation between muscle sodium content and handgrip strength. These findings provide evidence that sodium overload may play a role in the pathophysiology of ME/CFS and may allow for potential therapeutic targeting. |
| first_indexed | 2024-04-09T18:51:27Z |
| format | Article |
| id | doaj.art-3ad57f4c28e244d29c548d3c339886e2 |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-04-09T18:51:27Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-3ad57f4c28e244d29c548d3c339886e22023-04-09T11:25:44ZengBMCJournal of Translational Medicine1479-58762022-12-0120111210.1186/s12967-022-03616-zMuscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue SyndromeElisabeth Petter0Carmen Scheibenbogen1Peter Linz2Christian Stehning3Klaus Wirth4Titus Kuehne5Marcus Kelm6Institute of Medical Immunology, Charité Universitätsmedizin BerlinInstitute of Medical Immunology, Charité Universitätsmedizin BerlinInstitute of Radiology, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU), University Hospital ErlangenPhilips HealthcareInstitute of General Pharmacology and Toxicology, University Hospital Frankfurt am Main, Goethe-UniversityInstitute of Computer-Assisted Cardiovascular Medicine, Charité Universitätsmedizin BerlinInstitute of Computer-Assisted Cardiovascular Medicine, Charité Universitätsmedizin BerlinAbstract Background Muscle fatigue and pain are key symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Although the pathophysiology is not yet fully understood, there is ample evidence for hypoperfusion which may result in electrolyte imbalance and sodium overload in muscles. Therefore, the aim of this study was to assess levels of sodium content in muscles of patients with ME/CFS and to compare these to healthy controls. Methods Six female patients with ME/CFS and six age, BMI and sex matched controls underwent 23Na-MRI of the left lower leg using a clinical 3T MR scanner before and after 3 min of plantar flexion exercise. Sodium reference phantoms with solutions of 10, 20, 30 and 40 mmol/L NaCl were used for quantification. Muscle sodium content over 40 min was measured using a dedicated plugin in the open-source DICOM viewer Horos. Handgrip strength was measured and correlated with sodium content. Results Baseline tissue sodium content was higher in all 5 lower leg muscle compartments in ME/CFS compared to controls. Within the anterior extensor muscle compartment, the highest difference in baseline muscle sodium content between ME/CFS and controls was found (mean ± SD; 12.20 ± 1.66 mM in ME/CFS versus 9.38 ± 0.71 mM in controls, p = 0.0034). Directly after exercise, tissue sodium content increased in gastrocnemius and triceps surae muscles with + 30% in ME/CFS (p = 0.0005) and + 24% in controls (p = 0.0007) in the medial gastrocnemius muscle but not in the extensor muscles which were not exercised. Compared to baseline, the increase of sodium content in medial gastrocnemius muscle was stronger in ME/CFS than in controls with + 30% versus + 17% to baseline at 12 min (p = 0.0326) and + 29% versus + 16% to baseline at 15 min (p = 0.0265). Patients had reduced average handgrip strength which was associated with increased average muscle tissue sodium content (p = 0.0319, R2 = 0.3832). Conclusion Muscle sodium content before and after exercise was higher in ME/CFS than in healthy controls. Furthermore, our findings indicate an inverse correlation between muscle sodium content and handgrip strength. These findings provide evidence that sodium overload may play a role in the pathophysiology of ME/CFS and may allow for potential therapeutic targeting.https://doi.org/10.1186/s12967-022-03616-zChronic Fatigue SyndromeSodiumMagnetic Resonance ImagingMuscle, skeletalMyalgiaExercise |
| spellingShingle | Elisabeth Petter Carmen Scheibenbogen Peter Linz Christian Stehning Klaus Wirth Titus Kuehne Marcus Kelm Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Journal of Translational Medicine Chronic Fatigue Syndrome Sodium Magnetic Resonance Imaging Muscle, skeletal Myalgia Exercise |
| title | Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome |
| title_full | Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome |
| title_fullStr | Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome |
| title_full_unstemmed | Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome |
| title_short | Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome |
| title_sort | muscle sodium content in patients with myalgic encephalomyelitis chronic fatigue syndrome |
| topic | Chronic Fatigue Syndrome Sodium Magnetic Resonance Imaging Muscle, skeletal Myalgia Exercise |
| url | https://doi.org/10.1186/s12967-022-03616-z |
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