Reyes Del Paso Gustavo A, Montoro Casandra I, Duschek Stefan
a Department of Psychology , University of Jaén , Jaén , Spain.
J Clin Exp Neuropsychol. 2015;37(4):414-28. doi: 10.1080/13803395.2015.1023265. Epub 2015 Mar 31.
The study investigated cerebral blood flow (CBF) and heart rate (HR) responses during a cued reaction time (RT) task in patients with fibromyalgia syndrome (FMS). CBF velocities in the middle (MCA) and anterior (ACA) cerebral arteries of both hemispheres were recorded in 46 patients and 32 healthy control participants using functional transcranial Doppler sonography (fTCD). Patients exhibited markedly longer RT than healthy participants. Group differences in CBF responses were mainly observed for both ACAs, with greater right hemispherical increases but lower left hemispherical increases in FMS patients than in healthy participants. HR deceleration around the imperative stimulus was more pronounced in healthy participants. RT was inversely related to increases in CBF in both right arteries and in the left ACA in the FMS group, but was positively associated with CBF responses in all four arteries in healthy participants. The magnitude of task-induced HR deceleration correlated negatively with RT in both groups. Patients' clinical pain severity was positively associated with RT and CBF responses; trait anxiety and insomnia were secondary negative predictors of CBF responses. The study provided evidence of a deficit in the alertness component of attention in FMS at behavioral, CBF, and autonomic levels. These results may be interpreted in terms of the neural efficiency hypothesis of intelligence (i.e., less efficient brain activation during cognition in FMS) and the interfering effect of clinical factors on cognition. Clinical factors such as pain, anxiety, and sleep disturbances can affect cognition in FMS by interfering with CBF adjustment to cognitive demands.
该研究调查了纤维肌痛综合征（FMS）患者在提示反应时间（RT）任务期间的脑血流量（CBF）和心率（HR）反应。使用功能性经颅多普勒超声（fTCD）记录了46例患者和32名健康对照参与者双侧半球大脑中动脉（MCA）和大脑前动脉（ACA）的CBF速度。患者的反应时间明显长于健康参与者。CBF反应的组间差异主要在双侧ACA中观察到，FMS患者右半球的增加幅度大于左半球，而健康参与者左半球的增加幅度较小。在健康参与者中，命令刺激周围的心率减速更为明显。在FMS组中，反应时间与右动脉和左ACA中CBF的增加呈负相关，但在健康参与者中，反应时间与所有四条动脉中的CBF反应呈正相关。两组中任务诱导的心率减速幅度与反应时间呈负相关。患者的临床疼痛严重程度与反应时间和CBF反应呈正相关；特质焦虑和失眠是CBF反应的次要负性预测因素。该研究提供了证据，表明FMS患者在行为、CBF和自主神经水平上注意力的警觉性成分存在缺陷。这些结果可以根据智力的神经效率假说（即FMS患者在认知过程中大脑激活效率较低）以及临床因素对认知的干扰作用来解释。疼痛、焦虑和睡眠障碍等临床因素可通过干扰CBF对认知需求的调整来影响FMS患者的认知。
