Chronic Tension Type Headache,Fibromyalgia Syndrome and Major Depression Disorder,Are They Belong to a Same SpectrumDisorder?
Background:Chronic tension type headache(TTH),fibromyalgia syndrome(FMs)and major depression disorder (MDD) are all chronic diseases and have high morbidity.They often lead to poor quality of life even disability.The three diseases” origin and pathogenesis is unclear, but they have many demographic and clinical similarities.The three diseases also have some similarities in pathological mechanisms.So we suspect whether chronicTTH, FMs and MDD are belong to a same spectrum disorder.Objective:We want to evaluate the common and the difference of the three diseases from clinic features and pathological mechanisms.Although we have not exhausted the list of possible mechanisms, we focused on 2 mechanistic possibilities (neuroendocrinesystem and inflammatory pathways).Methods: ChronicTTH, FMs and MDD patients were recruited from neurology clinic of the first affiliated hospital of Anhuimedical university.Meanwhile, healthy subjects were selected as controls.We compared the sleep quality, depression mood and cognitive function of all subjects.We analyze the alterations in the hypothalamus-pituitary-adrenal (HPA) axis, hypothalamus-pituitary-thyroid (HPT) axis at multiplelevels and GnRH, pro-inflammatory cytokines of chronic TTH, FMs and MDD patients.The serum levels of corticotrophin-releasinghormone (CRH), adrenocorticotropic hormone (ACTH),cortisol, thyrotrophin releasing hormone (TRH), thyroid stimulating hormone (TSH), total triiodothyronine(TT3), total thyroxine (TT4), gonadotrophin releasing hormone (GnRH), pro-inflammatory cytokinestumor necrosis factor-α (TNF-α) and interleukin-1β(IL-1β) were tested to reveal the change of neuroendocrinesystem and inflammatory pathways which are thought to be linked with these diseases.Results: Our results showed that compared to controls, the HAMD-D (17), PSQI scores were significant higher (P<O.O01) in chronic TTH, FMs and MDD groups and the MOCA-C scores were significant lower (p=0.029) in chronic TTH, FMs and MDD groups.The patients with the chronicTTH, FMs and MDD have different degrees of damage in spatial memory test, the difference was significant (P<0.05).The changes of the HPA and HPT axes, GnRH and pro-inflammatory cytokines in chronic TTH, FMs and MDD patients are similarly.Compared to controls, the serum levels of CRH, cortisol, GnRH, TRH,IL-1β and TNF-α were significantly higher (P<0.001) while TT3, TT4 were significantly lower (P<0.001) in chronicTTH, FMs and MDD groups.FMs patients showed low value in the pituitary level of HPA and HPT axis, the reason is not clear.Conclusion: The results revealed that chronic TTH, FMs and MDD have the similar clinic features and the similar changes of the HPA and HPT axes, GnRH and pro-inflammatory cytokines.The three diseases are probably belong to a same spectrum disorder.
Qu Ping Wang Fang Li Xue-Wei Wei Qi-Guo Gui-Hai Chen
Department of Neurology,the First Affiliated Hospital of Anhui Medical University Department of Neurology,the First People”s Hospital of Chenzhou
国内会议
北京
英文
16-17
2014-06-13（万方平台首次上网日期，不代表论文的发表时间）