Laske Christoph, Stransky Elke, Eschweiler Gerhard W, Klein Reinhild, Wittorf Andreas, Leyhe Thomas, Richartz Elke, Köhler Niklas, Bartels Matthias, Buchkremer Gerhard, Schott Klaus
Department of Psychiatry and Psychotherapy, University of Tuebingen, Osianderstrasse 24, D-72076 Tuebingen, Germany.
J Psychiatr Res. 2007 Oct;41(7):600-5. doi: 10.1016/j.jpsychires.2006.02.007. Epub 2006 Apr 4.
Fibromyalgia (FM) is still often viewed as a psychosomatic disorder. However, the increased pain sensitivity to stimuli in FM patients is not an "imagined" histrionic phenomena. Pain, which is consistently felt in the musculature, is related to specific abnormalities in the CNS pain matrix. Brain-derived neurotrophic factor (BDNF) is an endogenous protein involved in neuronal survival and synaptic plasticity of the central and peripheral nervous system (CNS and PNS). Several lines of evidence converged to indicate that BDNF also participates in structural and functional plasticity of nociceptive pathways in the CNS and within the dorsal root ganglia and spinal cord. In the latter, release of BDNF appears to modulate or even mediate nociceptive sensory inputs and pain hypersensitivity. We were interested, if BDNF serum concentration may be altered in FM. The present pilot study assessed to our knowledge for the first time BDNF serum concentrations in 41 FM patients in comparison to 45 age-matched healthy controls. Mean serum levels of BDNF in FM patients (19.6 ng/ml; SD 3.1) were significantly increased as compared to healthy controls (16.8 ng/ml; SD 2.7; p<0.0001). In addition, BDNF serum concentrations in FM patients were independent from age, gender, illness duration, preexisting recurrent major depression and antidepressive medication in low doses. In conclusion, the results from our study indicate that BDNF may be involved in the pathophysiology of pain in FM. Nevertheless, how BDNF increases susceptibility to pain is still not known.
纤维肌痛（FM）仍常被视为一种身心障碍。然而，FM患者对刺激的疼痛敏感性增加并非“想象”出来的夸张现象。在肌肉组织中持续感觉到的疼痛与中枢神经系统（CNS）疼痛矩阵中的特定异常有关。脑源性神经营养因子（BDNF）是一种内源性蛋白质，参与中枢和外周神经系统（CNS和PNS）的神经元存活和突触可塑性。多条证据表明，BDNF还参与CNS以及背根神经节和脊髓中伤害性感受通路的结构和功能可塑性。在后者中，BDNF的释放似乎调节甚至介导伤害性感觉输入和疼痛超敏反应。我们感兴趣的是，FM患者的BDNF血清浓度是否会发生改变。本初步研究据我们所知首次评估了41名FM患者与45名年龄匹配的健康对照者的BDNF血清浓度。与健康对照者（16.8 ng/ml；标准差2.7）相比，FM患者的BDNF平均血清水平（19.6 ng/ml；标准差3.1）显著升高（p<0.0001）。此外，FM患者的BDNF血清浓度与年龄、性别、病程、既往复发性重度抑郁症以及低剂量抗抑郁药物无关。总之，我们的研究结果表明BDNF可能参与FM疼痛的病理生理学。然而，BDNF如何增加疼痛易感性仍不清楚。
