Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement

Mario D Cordero, Francisco Javier Cano-García, Elísabet Alcocer-Gómez, Manuel De Miguel, José Antonio Sánchez-Alcázar, Mario D Cordero, Francisco Javier Cano-García, Elísabet Alcocer-Gómez, Manuel De Miguel, José Antonio Sánchez-Alcázar

Abstract

Background: Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10) (CoQ(10)) supplementation on biochemical markers and clinical improvement were also evaluated.

Methods: We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ(10), catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs.

Results: We found decreased CoQ(10), catalase and ATP levels in BMCs from FM patients as compared to normal control (P < 0.05 and P < 0.001, respectively) We also found increased level of LPO in BMCs from FM patients as compared to normal control (P < 0.001). Significant negative correlations between CoQ(10) or catalase levels in BMCs and headache parameters were observed (r = -0.59, P < 0.05; r = -0.68, P < 0.05, respectively). Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05). Oral CoQ(10) supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P < 0.001).

Discussion: The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Coenzyme Q 10 levels, catalase…
Figure 1. Coenzyme Q10 levels, catalase levels and lipid peroxidation (MDA levels) in blood mononuclear cells (BMCs) from fibromyalgia (FM) patients and healthy control individuals.
(A) CoQ10 levels were measured by HPLC, as described in Materials and Methods. (B) Catalase was analyzed in BMCs as described in Materials and Methods. (C) LPO was measured as described in Material and Methods. (D) ATP levels were analyzed in BMCs as described in Materials and Methods. Data represent the mean ± SD of three separate experiments.
Figure 2. Correlation of CoQ 10 ,…
Figure 2. Correlation of CoQ10, catalase or lipid peroxidation levels in BMCs from FM patients and HIT-6 levels.

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