Evaluation of Mitochondrial Function in Myofascial Trigger Points Cohort Pilot Study Using High-resolution Respirometry

Overview

This pilot study established a minimally invasive biopsy technique to obtain high-quality MTrP tissue samples to evaluate mitochondrial function via high-resolution respirometry.

Full Title of Study: “Evaluation of Mitochondrial Function in Chronic Myofascial Trigger Points – A Prospective Cohort Pilot Study Using High-resolution Respirometry”

Study Type

• Study Type: Interventional
• Study Design
  • Allocation: N/A
  • Intervention Model: Single Group Assignment
  • Primary Purpose: Basic Science
  • Masking: None (Open Label)
• Study Primary Completion Date: February 1, 2014

Detailed Description

Myofascial trigger points (MTrPs) are hyperirritable areas in the fascia of the affected muscle, possibly related to mitochondrial impairment. They can result in pain and hypoxic areas within the muscle. This pilot study established a minimally invasive biopsy technique to obtain high-quality MTrP tissue samples to evaluate mitochondrial function via high-resolution respirometry. Secondary objectives included the safety of the biopsy procedure assessed via clinical wound healing (number of patients with signs for local infection and inflammation). For this purpose, twenty healthy males participated in this study, 10 with a diagnosis of myofascial pain in the musculus (m.) trapezius MTrP (TTP group) and 10 with a diagnosis of myofascial pain in the m. gluteus medius (GTP group). The affected muscle was biopsied followed by a biopsy from the vastus lateralis to be used as a control. Measurements of oxygen consumption were carried out using high-resolution respirometry.

Interventions

• Procedure: Muscle biopsy
  • Local anesthesia was applied to the superficial skin covering the MTrP of each participant. Percutaneous biopsy sampling optimized with a suction-enhancement technique was used to obtain muscle biopsies of the m. trapezius MTrP or the m. gluteus medius MTrP from each participant using small Bergstrom muscle biopsy needle, 8 swg (4.0mm) x 100 mm (Dixons Surgical Instruments, Essex, United Kingdom).

Arms, Groups and Cohorts

• Experimental: Single
  • Evaluation of mitochondrial function after muscle biopsy and follow-up for surgical complications.

Clinical Trial Outcome Measures

Primary Measures

• Mitochondrial function in myofascial trigger points
  • Time Frame: Baseline measurement
  • Mitochondrial respiration was assessed from muscle biopsy samples obtained from trigger points of the musculus trapezius and the musculus gluteus medius

Secondary Measures

• Number of participants with biopsy-related impaired wound healing
  • Time Frame: Baseline and follow-up assessment (1 week after the baseline biopsy)
  • Clinical wound assessment (number of patients with signs for local infection and inflammation)

Participating in This Clinical Trial

Inclusion Criteria

• Male patients aged 18-45 years – Clinical diagnosis of myofascial pain syndrome within the region of the shoulder-neck muscles or the lumbogluteal region and the presence of an MTrP, defined as a firm palpation of a hard, tender nodule resulting in a spontaneous pain complaint – with symptoms present for 1 to 12 months Exclusion Criteria:

• Signs that the participant's prescriptive compliance was not expected (e.g., lack of cooperation) – Disorders of the respiratory tract – Neurological disorders, in particular neurodegenerative and neuromuscular diseases – Disorders of the cardiovascular system or the musculoskeletal system – Civil servants and military service personnel.

Gender Eligibility: Male

Minimum Age: 18 Years

Maximum Age: 45 Years

Are Healthy Volunteers Accepted: No

Investigator Details

• Lead Sponsor
  • Medical University Innsbruck
• Provider of Information About this Clinical Study
  • Sponsor
• Overall Official(s)
  • Michael J Fischer, MD, PhD, Principal Investigator, Medical University Innsbruck