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Bengtsson, Ann
Publications (10 of 14) Show all publications
Gerdle, B., Ghafouri, B., Lund, E., Bengtsson, A., Lundberg, P., Veenstra, H., . . . Forsgren, M. (2020). Evidence of Mitochondrial Dysfunction in Fibromyalgia: Deviating Muscle Energy Metabolism Detected Using Microdialysis and Magnetic Resonance. Journal of Clinical Medicine, 9(11), Article ID 3527.
Open this publication in new window or tab >>Evidence of Mitochondrial Dysfunction in Fibromyalgia: Deviating Muscle Energy Metabolism Detected Using Microdialysis and Magnetic Resonance
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2020 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, no 11, article id 3527Article in journal (Refereed) Published
Abstract [en]

In fibromyalgia (FM) muscle metabolism, studies are sparse and conflicting associations have been found between muscle metabolism and pain aspects. This study compared alterations in metabolic substances and blood flow in erector spinae and trapezius of FM patients and healthy controls. FM patients (n = 33) and healthy controls (n = 31) underwent a clinical examination that included pressure pain thresholds and physical tests, completion of a health questionnaire, participation in microdialysis investigations of the etrapezius and erector spinae muscles, and also underwent phosphorus-31 magnetic resonance spectroscopy of the erector spinae muscle. At the baseline, FM had significantly higher levels of pyruvate in both muscles. Significantly lower concentrations of phosphocreatine (PCr) and nucleotide triphosphate (mainly adenosine triphosphate) in erector spinae were found in FM. Blood flow in erector spinae was significantly lower in FM. Significant associations between metabolic variables and pain aspects (pain intensity and pressure pain threshold PPT) were found in FM. Our results suggest that FM has mitochondrial dysfunction, although it is unclear whether inactivity, obesity, aging, and pain are causes of, the results of, or coincidental to the mitochondrial dysfunction. The significant regressions of pain intensity and PPT in FM agree with other studies reporting associations between peripheral biological factors and pain aspects.

Place, publisher, year, edition, pages
MDPI, 2020
Keywords
fibromyalgia; chronic pain; muscle; microdialysis; ATP; PCr; magnetic resonance spectroscopy; magnetic resonance imaging
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-172085 (URN)10.3390/jcm9113527 (DOI)000594010500001 ()33142767 (PubMedID)
Note

Funding Agencies|Swedish Research CouncilSwedish Research Council [2018-02470]; County Council of Ostergotland (Research-ALF) [LIO-700931]

Available from: 2020-12-28 Created: 2020-12-28 Last updated: 2023-09-29Bibliographically approved
Gerdle, B., Forsgren, M., Bengtsson, A., Dahlqvist Leinhard, O., Sören, B., Karlsson, A., . . . Lundberg, P. (2013). Decreased muscle concentrations of ATP and PCR in the quadriceps muscle of fibromyalgia patients – A 31P-MRS study. European Journal of Pain, 17(8), 1205-1215
Open this publication in new window or tab >>Decreased muscle concentrations of ATP and PCR in the quadriceps muscle of fibromyalgia patients – A 31P-MRS study
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2013 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 17, no 8, p. 1205-1215Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND METHODS:

Fibromyalgia (FMS) has a prevalence of approximately 2% in the population. Central alterations have been described in FMS, but there is not consensus with respect to the role of peripheral factors for the maintenance of FMS. 31P magnetic resonance spectroscopy (31P-MRS) has been used to investigate the metabolism of phosphagens in muscles of FMS patients, but the results in the literature are not in consensus. The aim was to investigate the quantitative content of phosphagens and pH in resting quadriceps muscle of patients with FMS (n = 19) and in healthy controls (Controls; n = 14) using (31) P-MRS. It was also investigated whether the concentrations of these substances correlated with measures of pain and/or physical capacity.

RESULTS:

Significantly lower concentrations of adenosine triphosphate (ATP) and phosphocreatinine (PCr; 28-29% lower) were found in FMS. No significant group differences existed with respect to inorganic phosphate (Pi), Pi/PCr and pH. The quadriceps muscle fat content was significantly higher in FMS than in Controls [FMS: 9.0 ± 0.5% vs. Controls: 6.6 ± 0.6%; (mean ± standard error); P = 0.005]. FMS had significantly lower hand and leg capacity according to specific physical test, but there were no group differences in body mass index, subjective activity level and in aerobic fitness. In FMS, the specific physical capacity in the leg and the hand correlated positively with the concentrations of ATP and PCr; no significant correlations were found with pain intensities.

CONCLUSIONS:

Alterations in intramuscular ATP, PCr and fat content in FMS probably reflect a combination of inactivity related to pain and dysfunction of muscle mitochondria.

Place, publisher, year, edition, pages
John Wiley & Sons, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-90364 (URN)10.1002/j.1532-2149.2013.00284.x (DOI)000322723600012 ()23364928 (PubMedID)
Available from: 2013-03-25 Created: 2013-03-25 Last updated: 2019-06-14Bibliographically approved
Forsgren, M., Bengtsson, A., Dahlqvist Leinhard, O., Sören, B., Brandejsky, V., Lund, E. & Lundberg, P. (2012). 31P MRS as a Potential Biomarker for Fibromyalgia. In: Proceedings of the 20th Annaal Meeting & Exhibition, 5-11 May, Melbourne, Australia: . Paper presented at ISMRM, 20th Annaal Meeting & Exhibition, 5-11 May, Melbourne, Australia (pp. 1493-1493).
Open this publication in new window or tab >>31P MRS as a Potential Biomarker for Fibromyalgia
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2012 (English)In: Proceedings of the 20th Annaal Meeting & Exhibition, 5-11 May, Melbourne, Australia, 2012, p. 1493-1493Conference paper, Published paper (Refereed)
Abstract [en]

Major clinical symptoms in fibromyalgia (FM) are muscle pain, stiffness and fatigue. Studies have shown reduced voluntary strength and exercise capacity, lower endurance and more muscular pain even at low workload. An impaired muscle energy metabolism has therefore been proposed as a result of the disease. An earlier study using magnetic resonance spectroscopy (MRS) showed that at maximal dynamic and static contractions the concentration of inorganic phosphate was lower in FM [1]. A decrease in ATP, ADP and PCr and an increase in AMP and creatine was found in FM biopsies [2]. The purpose of this study was to non-invasively analyze the quantitative content of  phosphagens in the resting muscle in FM in comparison to healthy controls using 31P MRS of the quadriceps muscle.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91387 (URN)
Conference
ISMRM, 20th Annaal Meeting & Exhibition, 5-11 May, Melbourne, Australia
Available from: 2013-04-23 Created: 2013-04-23 Last updated: 2019-06-14Bibliographically approved
Cöster, L., Kendall, S., Gerdle, B., Henriksson, C., Henriksson, K.-G. & Bengtsson, A. (2008). Chronic widespread musculoskeletal pain - A comparison of those who meet criteria for fibromyalgia and those who do not. European Journal of Pain, 12(5), 600-610
Open this publication in new window or tab >>Chronic widespread musculoskeletal pain - A comparison of those who meet criteria for fibromyalgia and those who do not
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2008 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 12, no 5, p. 600-610Article in journal (Refereed) Published
Abstract [en]

Fibromyalgia is currently classified as chronic widespread pain with widespread allodynia to pressure pain. There are few data describing pain characteristics, quality of life, consequences for daily living, and psychosocial status in patients who meet the classification criteria for fibromyalgia proposed by the American College of Rheumatology compared with patients with chronic widespread pain but not widespread allodynia. This study used a randomly selected sample from the general population. A postal questionnaire and a pain mannequin were sent to 9952 people. The response rate was 76.7%. The pain drawings showed that 345 people had widespread pain, that is, they noted pain in all four extremities and axially. Clinical examination, which included a manual tender point examination, was performed in 125 subjects. These people answered commonly used questionnaires on pain, quality of life, coping strategies, depression, and anxiety. Compared with chronic widespread pain without widespread allodynia, fibromyalgia was associated with more severe symptoms/consequences for daily life and higher pain severity. Similar coping strategies were found. Chronic widespread pain without widespread allodynia to pressure pain was found in 4.5% in the population and fibromyalgia in 2.5%. © 2007 European Federation of Chapters of the International Association for the Study of Pain.

Keywords
Activities of Daily Living Adaptation, Psychological Adult Aged Anxiety/epidemiology Chronic Disease Creatine Kinase, MM Form/blood Depression/epidemiology Diagnosis, Differential Female Fibromyalgia/classification/*diagnosis/psychology Humans Male Middle
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-43334 (URN)10.1016/j.ejpain.2007.10.001 (DOI)73539 (Local ID)73539 (Archive number)73539 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Gerdle, B., Björk, J., Cöster, L., Henriksson, K.-G., Henriksson, C. & Bengtsson, A. (2008). Prevalence of widespread pain and associations with work status: A population study. BMC Musculoskeletal Disorders, 9
Open this publication in new window or tab >>Prevalence of widespread pain and associations with work status: A population study
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2008 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 9Article in journal (Refereed) Published
Abstract [en]

Background. This population study based on a representative sample from a Swedish county investigates the prevalence, duration, and determinants of widespread pain (WSP) in the population using two constructs and estimates how WSP affects work status. In addition, this study investigates the prevalence of widespread pain and its relationship to pain intensity, gender, age, income, work status, citizenship, civil status, urban residence, and health care seeking. Methods. A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, 18-74 years) in a county (Östergötland) in the southern Sweden. The questionnaire was mailed and followed by two postal reminders when necessary. Results. The participation rate was 76.7% (n = 7637), the non-participants were on the average younger, earned less money, and male. Women had higher prevalences of pain in 10 different predetermined anatomical regions. WSP was generally chronic (90-94%) and depending on definition of WSP the prevalence varied between 4.8-7.4% in the population. Women had significantly higher prevalence of WSP than men and the age effect appeared to be stronger in women than in men. WSP was a significant negative factor - together with age 50-64 years, low annual income, and non-Nordic citizen - for work status in the community and in the group with chronic pain. Chronic pain but not the spreading of pain was related to health care seeking in the population. Conclusion. This study confirms earlier studies that report high prevalences of widespread pain in the population and especially among females and with increasing age. Widespread pain is associated with prominent effects on work status. © 2008 Gerdle et al, licensee BioMed Central Ltd.

Keywords
Adolescent Adult Aged Chronic Disease Cross-Sectional Studies Demography Employment/*statistics & numerical data Female Humans Male Middle Aged Occupational Diseases Pain/diagnosis/*epidemiology/physiopathology *Population Surveillance Prevalence Question
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-43153 (URN)10.1186/1471-2474-9-102 (DOI)72100 (Local ID)72100 (Archive number)72100 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2024-01-17
Bengtsson, A., Henriksson, C. & Henriksson, K.-G. (2006). Fibromyalgi (1ed.). In: Jörgen Borg (Ed.), Rehabiliteringsmedicin: (pp. 156-161). Lund: Studentlitteratur
Open this publication in new window or tab >>Fibromyalgi
2006 (Swedish)In: Rehabiliteringsmedicin / [ed] Jörgen Borg, Lund: Studentlitteratur , 2006, 1, p. 156-161Chapter in book (Other academic)
Abstract [sv]

Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat  stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.

Place, publisher, year, edition, pages
Lund: Studentlitteratur, 2006 Edition: 1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-36555 (URN)31619 (Local ID)91-44-04507-7 (ISBN)978-91-44-04507-8 (ISBN)31619 (Archive number)31619 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-02Bibliographically approved
Gerdle, B., Björk, J., Henriksson, C. & Bengtsson, A. (2004). Prevalence of current and chronic pain and their influences upon work and healthcare-seeking: A population study. Journal of Rheumatology, 31(7), 1399-1406
Open this publication in new window or tab >>Prevalence of current and chronic pain and their influences upon work and healthcare-seeking: A population study
2004 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 31, no 7, p. 1399-1406Article in journal (Refereed) Published
Abstract [en]

Objective. To investigate the prevalence of current and chronic pain and their relationship to pain intensity, sex, age, income, employment status, citizenship, marital status, urban residence, occupational activity, and healthcare-seeking based on a representative sample from a Swedish county. Methods. A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, age 18-74 yrs) in a county (Östergötland) in southern Sweden. A questionnaire was mailed and followed by 2 postal reminders if necessary. Results. The participation rate was 76.7% (n = 7637), nonparticipants were on average younger, male, and earned less money. The overall point prevalence of pain was 48.9%. The corresponding one-month period prevalence was 63.0%, and pain on several occasions during the previous 3 months was reported by 61.3% of participants. The prevalence of chronic pain (pain > 3 months) was 53.7%. Female sex, age, and sick leave/early retirement were generally of significant importance in the regressions of pain. No sex factor was found in the regressions of pain frequency and pain intensity. Chronic pain - especially frequent and intensive pain - showed clear associations with healthcare-seeking and occupational activity. Conclusion. High prevalence of current pain (48.9%) and chronic pain (53.7%) were found in this community-based study. Being female, older, and on sick leave or early retirement were generally of significant importance in the regressions of pain. Chronic pain showed clear associations with healthcare-seeking and occupational activity, indicating considerable socioeconomic costs.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-22432 (URN)1654 (Local ID)1654 (Archive number)1654 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
Aspegren Kendall, S., Henriksson, K.-G., Hurtig, I., Raak, R., Bengtsson, A., Sören, B., . . . Gerdle, B. (2003). Differences in sensory thresholds in the skin of women with fibromyalgia syndrome: A comparison between ketamine responders and ketamine non-responders. Journal of Musculoskeletal Pain, 11(2), 3-9
Open this publication in new window or tab >>Differences in sensory thresholds in the skin of women with fibromyalgia syndrome: A comparison between ketamine responders and ketamine non-responders
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2003 (English)In: Journal of Musculoskeletal Pain, ISSN 1058-2452, E-ISSN 1540-7012, Vol. 11, no 2, p. 3-9Article in journal (Refereed) Published
Abstract [en]

Objectives: To compare detection and pain thresholds in the skin of female fibromyalgia patients who were either ketamine responders or ketamine nonresponders.

Methods: Detection thresholds to innocuous warmth, of cold, heat or cold pain, and touch and dynamic touch sensation were determined in the skin. Pressure pain thresholds, local and widespread pain intensity, and pain duration were also registered.

Results: Ketamine nonresponse was associated with more pronounced hypersensitivity for thermal pain [especially cold pain] than ketamine response.

Conclusions: Blockade of N-metyl-D-aspartic acid receptors by ketamine and the recording of pain thresholds in the skin, especially for cold pain, might reveal different mechanisms of allodynia.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26380 (URN)10.1300/J094v11n02_02 (DOI)10914 (Local ID)10914 (Archive number)10914 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Lund, E., Kendall, S., Janerot-Sjöberg, B. & Bengtsson, A. (2003). Muscle metabolism in fibromyalgia studied by P-31 magnetic resonance spectroscopy during aerobic and anaerobic exercise. Scandinavian Journal of Rheumatology, 32(3), 138-145
Open this publication in new window or tab >>Muscle metabolism in fibromyalgia studied by P-31 magnetic resonance spectroscopy during aerobic and anaerobic exercise
2003 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 32, no 3, p. 138-145Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate mechanisms underlying the reduced work capacity of fibromyalgia (FM) patients were compared to healthy controls at specified workloads, using P-31 magnetic resonance spectroscopy (MRS). Methods: The forearm flexor muscle group was examined with MRS at rest, at sub maximal and at maximal controlled dynamic work as well as at maximal isometric contraction. Aerobic fitness was determined by bicycle ergonometry. Results: Metabolite concentrations and muscle pH were similar for patients and controls at lower workloads. At maximal dynamic and static contractions the concentration of inorganic phosphate was lower and at static contractions the pH decrease was smaller in patients. The performed work by patients was only 50% compared to controls and the patients experienced more pain. Maximal oxygen uptake was lower in the fibromyalgia group. Expired gas-analysis in this group showed ventilatory equivalents at similar relative levels of maximal work capacity. Conclusion: Fibromyalgia patients seem to utilise less of the energy rich phosphorous metabolites at maximal work despite pH reduction. They seemed to be less aerobic fitted and reached the anaerobic threshold earlier than the controls.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26379 (URN)10.1080/03009740310002461 (DOI)10913 (Local ID)10913 (Archive number)10913 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
Lindvall, B., Bengtsson, A., Ernerudh, J. & Eriksson, P. (2002). Subclinical myositis is common in primary Sjögren's syndrome and is not related to muscle pain. Journal of Rheumatology, 29(4), 717-725
Open this publication in new window or tab >>Subclinical myositis is common in primary Sjögren's syndrome and is not related to muscle pain
2002 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 29, no 4, p. 717-725Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Although muscle pain is common in primary Sjögren's syndrome (SS), the underlying mechanisms are mainly unknown. We studied all patients with SS at our rheumatology unit with respect to muscle pain in general and to fibromyalgia (FM), and correlated clinical data to muscle biopsy findings.

METHODS: We investigated 48 patients with SS according to the modified European diagnostic criteria. The ACR criteria for FM were used to subgroup the patients. Muscle biopsy was performed in 36 patients. Light microscope morphology and immunohistochemical expression of MHC class I, MHC class II, and membrane attack complex (MAC) were studied.

RESULTS: We found 44% of patients complained of muscle pain; 27% fulfilled the ACR criteria for FM, whereas 17% had other forms of myalgia. Muscle pain could not be related to histopathological findings. Signs of inflammation were found in 26 of 36 biopsies (72%), and inflammation combined with degeneration/regeneration (i.e., histological signs of polymyositis) in 17 biopsies (47%). However, only 5 patients (14%) had clinical as well as histological signs of polymyositis. Eight muscle biopsies (22%) showed histological features of inclusion body myositis (IBM). However, no patient had clinical symptoms suggestive of this disease. Abnormal expression of MHC class I, MHC class II, and MAC was found in 18 (50%), 16 (44%), and 27 (75%) patients, respectively.

CONCLUSION: Muscle pain, especially FM, is common in SS. Histopathological signs of myositis are very common in SS. However, muscle symptoms are not related to histological signs of muscle inflammation. IBM-like findings may represent vacuolar myopathic degeneration due to previous subclinical muscle inflammation rather than a specific clinical entity.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26377 (URN)10911 (Local ID)10911 (Archive number)10911 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2020-01-16Bibliographically approved
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