Department of Psychiatry, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
Psychiatry Res. 2012 Jun 30;202(3):252-6. doi: 10.1016/j.pscychresns.2011.11.006. Epub 2012 Jul 15.
It has been suggested that somatoform disorders are related to both the brain and the immune system, and that immune functions may be influenced by cerebral asymmetry. However, few studies have examined the relationship between brain activity and immune function in somatoform disorders. Thirty-two patients with non-medicated undifferentiated somatoform disorder were enrolled in this study. Blastogenic responses to phytohemagglutinin (PHA) were used to measure immunity. Regional cerebral perfusion was measured by 99m-Tc-ethyl cysteinate dimer single photon emission computed tomography (SPECT). Significant hypoperfusion was found at the left inferior parietal lobule and the left supramarginal gyrus in the more immune-suppressed (MIS) subgroup compared with the less immune-suppressed (LIS) subgroup. However, no regions of significant hyperperfusion were found in the MIS subgroup compared with the LIS subgroup. Decreased cerebral blood flow in the left inferior parietal lobule and the left supramarginal gyrus in the patient group was also significantly associated with reduced blastogenic responses to PHA regardless of sex and age. These results suggest that the left inferior parietal lobule and the left supramarginal gyrus might play an immunomodulating role in patients with undifferentiated somatoform disorder. In addition, these results suggest the role of cerebral asymmetry in altered immunity in the patients.
有人提出躯体形式障碍与大脑和免疫系统有关,并且免疫功能可能受大脑不对称的影响。然而,很少有研究检查躯体形式障碍患者大脑活动与免疫功能之间的关系。本研究纳入了 32 名未经药物治疗的未分化躯体形式障碍患者。使用植物血凝素(PHA)刺激的淋巴细胞转化试验来测量免疫功能。使用 99m-Tc-乙基半胱氨酸二聚体单光子发射计算机断层扫描(SPECT)来测量局部脑血流。与免疫抑制程度较轻(LIS)亚组相比,免疫抑制程度较高(MIS)亚组的左顶下小叶和左缘上回存在明显的低灌注。然而,与 LIS 亚组相比,MIS 亚组没有发现明显的高灌注区域。与性别和年龄无关,患者组左顶下小叶和左缘上回的脑血流量减少与 PHA 刺激的淋巴细胞转化试验反应降低显著相关。这些结果表明,左顶下小叶和左缘上回可能在未分化躯体形式障碍患者中发挥免疫调节作用。此外,这些结果提示大脑不对称在患者免疫改变中的作用。