Department of Health, Exercise, and Sport Sciences, Texas Tech University, Lubbock, TX, USA.
Rheumatol Int. 2013 Sep;33(9):2365-72. doi: 10.1007/s00296-013-2725-0. Epub 2013 Apr 4.
Fibromyalgia syndrome (FMS) is a widespread musculoskeletal pain condition with unclear physiologic mechanisms. The purpose of this investigation was to compare the responsiveness of nociceptive flexion reflex (NFR) pathways between women with and without FMS. A secondary purpose was to examine the influence of depression, fibromyalgia symptom severity, and cardiovascular health on NFR responses among women with FMS. Fifteen women with FMS and 14 healthy controls participated in an experimental session to assess NFR responses to sural nerve stimulation, resting mean arterial pressure (MAP) and heart rate (HR), and scores on the Beck Depression Inventory (BDI) and Fibromyalgia Impact Questionnaire (FIQ). NFR responses were successfully elicited from all healthy individuals, but only eight (53 %) of the women with FMS. These women did not differ in the minimum stimulus intensity required to elicit an NFR response compared to healthy controls (p ≥ 0.35). Further, these women had lower BDI (p = 0.04) and FIQ (p = 0.02) scores compared to women with FMS from whom NFR responses could not be elicited. Resting HR was higher in both groups of women with FMS compared to healthy individuals (p < 0.05), and MAP was strongly associated with NFR thresholds only among women with FMS (r = 0.88, p < 0.01). Findings from this preliminary investigation suggest that NFR pathways are impaired in women who are more severely impacted by symptoms of depression and fibromyalgia, potentially due to desensitization of NFR pathways with chronic autonomic arousal.
纤维肌痛综合征（FMS）是一种广泛存在的肌肉骨骼疼痛疾病，其生理机制尚不清楚。本研究的目的是比较有和无 FMS 的女性的伤害性屈肌反射（NFR）通路的反应性。次要目的是研究抑郁、纤维肌痛症状严重程度和心血管健康对 FMS 女性 NFR 反应的影响。15 名患有 FMS 的女性和 14 名健康对照者参加了一个实验会议，以评估对腓肠神经刺激、静息平均动脉压（MAP）和心率（HR）的 NFR 反应，以及贝克抑郁量表（BDI）和纤维肌痛影响问卷（FIQ）的评分。所有健康个体均成功引出 NFR 反应，但仅有 8 名（53%）FMS 女性。与健康对照组相比，这些女性引出 NFR 反应所需的最小刺激强度没有差异（p≥0.35）。此外，这些女性的 BDI（p=0.04）和 FIQ（p=0.02）评分均低于无法引出 NFR 反应的 FMS 女性。两组 FMS 女性的静息 HR 均高于健康个体（p<0.05），而 MAP 仅与 FMS 女性的 NFR 阈值强烈相关（r=0.88，p<0.01）。这项初步研究的结果表明，在那些受抑郁和纤维肌痛症状影响更严重的女性中，NFR 通路受损，这可能是由于慢性自主唤醒导致 NFR 通路脱敏。
