Unit of Rheumatology, Sapienza University of Rome, Rome, Italy.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5 Suppl 56):S75-8.
Fibromyalgia (FM) is a syndrome associated with widespread pain and various other signs and symptoms. Several of these multisystem features could be explained on the basis of autonomic nervous system (ANS) dysfunction.
The aim of the present study was to evaluate ANS dysfunction in FM based on time-domain heart rate variability (HRV) analysis and serum neuropeptide Y (NPY) levels in 51 patients with FM, 25 patients with systemic sclerosis (SSc), and 15 healthy controls (NHS).
Compared with the SSc and NHS groups, the FM group had significantly higher NPY levels, and in the FM subgroup subjected to HRV analysis (25/51 patients, 49%), certain HRV indices were significantly reduced. In this subgroup, NPY was significantly correlated with the SDANN index and the NN50, but neither NPY or HRV parameters showed any significant correlation with clinical aspects of the FM.
These findings suggest that autonomic dysfunction and NPY are crucial elements in the pathophysiology of FM. Additional studies are necessary to define the complex roles played by NPY and ANS in modulating pain and immunological functions of different diseases.
纤维肌痛(FM)是一种与广泛疼痛和各种其他体征和症状相关的综合征。这些多系统特征中的许多可以基于自主神经系统(ANS)功能障碍来解释。
本研究旨在基于时域心率变异性(HRV)分析和血清神经肽 Y(NPY)水平评估 FM 中的 ANS 功能障碍,研究对象为 51 例 FM 患者、25 例系统性硬化症(SSc)患者和 15 名健康对照者(NHS)。
与 SSc 和 NHS 组相比,FM 组的 NPY 水平明显更高,在接受 HRV 分析的 FM 亚组(25/51 例患者,49%)中,某些 HRV 指数明显降低。在该亚组中,NPY 与 SDANN 指数和 NN50 显著相关,但 NPY 或 HRV 参数与 FM 的临床特征均无显著相关性。
这些发现表明自主神经功能障碍和 NPY 是 FM 病理生理学中的关键因素。需要进一步的研究来确定 NPY 和 ANS 在调节不同疾病的疼痛和免疫功能方面的复杂作用。