Division of Mental Health, St. George's University of London, London, UK.
J Pain Symptom Manage. 2010 Dec;40(6):892-8. doi: 10.1016/j.jpainsymman.2010.03.023. Epub 2010 Sep 15.
Increased central serotonin sensitivity is hypothesized to contribute toward the development of cancer-related fatigue syndrome (CRFS).
To compare the responses of breast cancer survivors with or without CRFS to the buspirone challenge test (an index of central serotonin sensitivity).
Disease-free women who had successfully completed treatment for early-stage breast cancer were assessed. On the basis of the diagnostic interview for CRFS and a structured psychiatric interview, women were classified as either "cases" of CRFS or "controls." Women with comorbid psychiatric diagnoses were excluded. Volunteers underwent a challenge test using buspirone (a serotonin-selective agonist) using a double-blind, randomized, placebo-controlled protocol. Cortisol and prolactin responses were assessed at hourly intervals for the four hours after administration of buspirone.
Fourteen cases of CRFS and 28 controls participated in the study. There were no significant differences in baseline or stimulated cortisol release after buspirone challenge. There were differences neither in basal prolactin levels in the two groups nor in the total prolactin response to buspirone (as measured using the area under the curve). In patients with CRFS, peak prolactin response occurred at 120 minutes and sustained until 180 minutes post buspirone. In controls, peak prolactin response occurred at 60 minutes and then began to decline.
This study has demonstrated the utility and acceptability of buspirone as a probe of central serotonin sensitivity in this population. No evidence was found for alterations in central serotonin sensitivity in patients with CRFS. Conclusions are tentative, however, because poor recruitment resulted in a small sample and an underpowered comparison.
人们推测，中枢血清素敏感性增加可能导致癌症相关疲劳综合征（CRFS）的发生。
比较患有或不患有 CRFS 的乳腺癌幸存者对丁螺环酮挑战测试（中枢血清素敏感性的指标）的反应。
评估无疾病的、成功完成早期乳腺癌治疗的女性。根据 CRFS 的诊断性访谈和结构化精神科访谈，将女性分为 CRFS“病例”或“对照”。排除合并有精神科诊断的女性。志愿者使用丁螺环酮（一种血清素选择性激动剂）进行挑战测试，采用双盲、随机、安慰剂对照方案。在给予丁螺环酮后的四个小时内，每小时评估一次皮质醇和催乳素反应。
14 例 CRFS 和 28 例对照参加了研究。在丁螺环酮挑战后，基础或刺激的皮质醇释放没有显著差异。两组之间基础催乳素水平或丁螺环酮的总催乳素反应（通过曲线下面积测量）均无差异。在 CRFS 患者中，催乳素反应的峰值出现在丁螺环酮给药后 120 分钟，并持续到 180 分钟。在对照组中，催乳素反应的峰值出现在 60 分钟，然后开始下降。
本研究证明了丁螺环酮作为该人群中枢血清素敏感性探针的实用性和可接受性。在 CRFS 患者中未发现中枢血清素敏感性改变的证据。然而，由于招募情况不佳导致样本量小且比较效力不足，因此结论是暂定的。
