纤维肌痛症和双相情感障碍：新兴的流行病学协会和共同的病理生理学

Title:Fibromyalgia and Bipolar Disorder: Emerging Epidemiological Associations and Shared Pathophysiology

Volume: 16 Issue: 2

Author(s): B. Bortolato, M. Berk, M. Maes, R.S. McIntyre and A.F. Carvalho

Affiliation:

关键词: 双相情感障碍、纤维肌痛、炎症、氧化应激、脑源性神经营养因子，下丘脑-垂体-肾上腺轴、神经影像学、病理生理学、精神病学、神经病学。

摘要: Fibromyalgia (FM) is a prevalent disorder defined by the presence of chronic widespread pain in association with fatigue, sleep disturbances and cognitive dysfunction. Recent studies indicate that bipolar spectrum disorders frequently co-occur in individuals with FM. Furthermore, shared pathophysiological mechanisms anticipate remarkable phenomenological similarities between FM and BD. A comprehensive search of the English literature was carried out in the Pubmed/MEDLINE database through May 10th, 2015 to identify unique references pertaining to the epidemiology and shared pathophysiology between FM and bipolar disorder (BD). Overlapping neural circuits may underpin parallel clinical manifestations of both disorders. Fibromyalgia and BD are both characterized by functional abnormalities in the hypothalamic-pituitary-adrenal axis, higher levels of inflammatory mediators, oxidative and nitrosative stress as well as mitochondrial dysfunction. An over-activation of the kynurenine pathway in both illnesses drives tryptophan away from the production of serotonin and melatonin, leading to affective symptoms, circadian rhythm disturbances and abnormalities in pain processing. In addition, both disorders are associated with impaired neuroplasticity (e.g., altered brain-derived neurotrophic factor signaling). The recognition of the symptomatic and pathophysiological overlaping between FM and bipolar spectrum disorders has relevant etiological, clinical and therapeutic implications that deserve future research consideration.

Cite this article as:

B. Bortolato, M. Berk, M. Maes, R.S. McIntyre and A.F. Carvalho , Fibromyalgia and Bipolar Disorder: Emerging Epidemiological Associations and Shared Pathophysiology, Current Molecular Medicine 2016; 16 (2) . https://dx.doi.org/10.2174/1566524016666160126144027