Gur A, Karakoc M, Erdogan S, Nas K, Cevik R, Sarac A J
Department of Physical Therapy and Rehabilitation, School of Medicine, Dicle University, Diyarbakir, Turkey.
Clin Exp Rheumatol. 2002 Nov-Dec;20(6):753-60.
To determine whether there is any difference in regional cerebral blood flow (rCBF) and serum cytokine levels and association between clinical parameters and rCBF and serum cytokine levels in young females with fibromyalgia (FM). The other aim was to search whether the depression state has any effect on these two parameters.
Nineteen women with FM and 20 healthy women had 99mTc-HMPAO brain single-photon-emission computed tomography (SPECT) to evaluate rCBF. Serum interleukin (IL) levels (IL 1 beta, IL 2r, IL 6 and IL 8) were measured. Clinical and psychological evaluation was also carried out in FM patients and healthy controls.
The patients with FM had significantly higher radioactivity uptake ratio in right and left caudate nucleus (p = 0.009, p = 0.001, respectively) than healthy controls. There was statistically significant decrease in the 99mTc-HMPAO uptake in the right superior parietal (p = 0.041), gyrus rectalis (p = 0.036) and pons (p = 0.023). FM patients had significantly higher serum IL 2r and IL 8 levels (p = 0.023, p = 0.011, respectively) than controls. Additionally, FM patients had significantly higher Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), and Hamilton Depression Rate scale (HDRS) scores (p = 0.000) than controls. Interestingly, the patients with mild depressive symptoms or without (i.e. HDRS-score < or = 16) had significantly higher serum IL 8 levels (p = 0.027) and increased radioactivity uptake ratio in the pons (P = 0.036) than the patients with more severe depressive symptoms (i.e. HDRS-score > 16). With regard to regional cerebral blood flow, significant correlations were detected between RSP and morning stiffness (r = 0.70, p < 0.01) and sleep disturbance (r = -0.53, p < 0.05), and between gyrus rectalis and FIQ score. There were significant correlations between LCN and IL-2 (P = 0.025), between RSP and morning stiffness (P = 0.006), sleep disturbance (P = 0.021) according to multiple regression analysis test.
This study shows a significant increase in rCBF of caudate nuclei, a reduction in the pons, some cortical regions activity and a increase in IL 8, IL2r levels of young female patients with FM. These findings are more prominent in patients with low HDRS scores.
确定纤维肌痛（FM）年轻女性的局部脑血流量（rCBF）和血清细胞因子水平是否存在差异，以及临床参数与rCBF和血清细胞因子水平之间的关联。另一个目的是探究抑郁状态是否对这两个参数有影响。
19名FM女性患者和20名健康女性接受了99mTc-HMPAO脑单光子发射计算机断层扫描（SPECT）以评估rCBF。检测血清白细胞介素（IL）水平（IL 1β、IL 2r、IL 6和IL 8）。还对FM患者和健康对照进行了临床和心理评估。
FM患者左右尾状核的放射性摄取率显著高于健康对照（分别为p = 0.009，p = 0.001）。右侧顶上叶（p = 0.041）、直肠回（p = 0.036）和脑桥（p = 0.023）的99mTc-HMPAO摄取有统计学显著下降。FM患者的血清IL 2r和IL 8水平显著高于对照组（分别为p = 0.023，p = 0.011）。此外，FM患者的纤维肌痛影响问卷（FIQ）、健康评估问卷（HAQ）和汉密尔顿抑郁量表（HDRS）得分显著高于对照组（p = 0.000）。有趣的是，轻度抑郁症状患者或无抑郁症状患者（即HDRS评分≤16）的血清IL 8水平显著高于重度抑郁症状患者（即HDRS评分>16）（p = 0.027），脑桥放射性摄取率增加（P = 0.036）。关于局部脑血流量，右侧顶上叶与晨僵（r = 0.70，p < 0.01）和睡眠障碍（r = -0.53，p < 0.05）之间，以及直肠回与FIQ评分之间存在显著相关性。根据多元回归分析测试，左侧尾状核与IL-2之间（P = 0.025）、右侧顶上叶与晨僵之间（P = 0.006）、睡眠障碍之间（P = 0.021）存在显著相关性。
本研究表明，FM年轻女性患者尾状核的rCBF显著增加，脑桥、一些皮质区域活动减少，IL 8、IL2r水平升高。这些发现在HDRS评分低的患者中更为突出。
