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摘要
纤维肌痛(FM)是一种以慢性广泛性疼痛伴疲劳、睡眠障碍和认知功能障碍为症状的普遍疾病。最近的研究表明,双相谱系障碍常常与个体的纤维肌痛同时发生。此外,共同的病理生理机制预测了纤维肌痛和双相情感障碍之间显著现象学相似。全面的英语文献检索通过2015年5月10日在Pubmed / MEDLINE数据库颁布实施。以确定独特的关于流行病学与纤维肌痛和双相情感障碍之间的共同病理生理学的参考文献。重叠的神经回路,可以支持并行两种疾病的临床表现。纤维肌痛和双相情感障碍都是以下丘脑-垂体-肾上腺轴功能异常,炎症介质水平升高、氧化和亚硝化应激和线粒体功能障碍为特征的。两种疾病的犬尿氨酸途径的激活驱动了色氨酸远离血清素和褪黑激素的产生,导致情感症状、昼夜节律紊乱和疼痛处理异常。此外,这两种疾病均与受损的神经可塑性相关(例如,改变脑源性神经营养因子的信号)。对纤维肌痛和双相情感障碍之间的症状和病理生理学的认识已有相关的病因、临床和治疗意义并值得今后的进一步研究。
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。
Current Molecular Medicine
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.
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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
DOI https://dx.doi.org/10.2174/1566524016666160126144027 |
Print ISSN 1566-5240 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5666 |
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