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纤维肌痛综合征患者静息脑电图中的θ振荡改变。

Altered theta oscillations in resting EEG of fibromyalgia syndrome patients.

机构信息

Department Psychological Sciences, Institute of Psychology, Health, and Society, University of Liverpool, UK.

Wirral University Teaching Hospital NHS Foundation Trust, UK.

出版信息

Eur J Pain. 2018 Jan;22(1):49-57. doi: 10.1002/ejp.1076. Epub 2017 Jul 31.


DOI:10.1002/ejp.1076
PMID:28758313
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5763419/
Abstract

BACKGROUND: Fibromyalgia syndrome (FM) is a chronic pain disorder characterized by widespread pain, sleep disturbance, fatigue and cognitive/affective symptoms. Functional imaging studies have revealed that FM and other chronic pain syndromes can affect resting brain activity. This study utilized electroencephalographic (EEG) recordings to investigate the relative power of ongoing oscillatory activity in the resting brain. METHODS: A 64-channel EEG was recorded at rest in 19 female FM patients and 18 healthy, age-matched, control subjects. The Manual Tender Point Scale (MTPS) examination was performed to quantify tonic pain and tenderness on the day of testing along with measures of mood, arousal and fatigue. Oscillations in delta, theta, alpha, beta and gamma frequency bands were analysed using Standardised Low-Resolution Brain Electromagnetic Tomography to evaluate sources of spectral activity throughout the whole brain. RESULTS: FM patients exhibited greater pain, tiredness and tension on the day of testing relative to healthy control participants and augmented theta activity in prefrontal and anterior cingulate cortices. No significant differences were seen in other frequency bands. Augmented frontal theta activity in FM patients significantly correlated with measures of tenderness and mean tiredness scores. CONCLUSIONS: The findings indicate that alterations to resting-state oscillatory activity may relate to ongoing tonic pain and fatigue in FM, and manifest in brain regions relevant for cognitive-attentional aspects of pain processing and endogenous pain inhibition. Enhanced low-frequency oscillations were previously seen in FM and other chronic pain syndromes, and may relate to pathophysiological mechanisms for ongoing pain such as thalamocortical dysrhythmia. SIGNIFICANCE: Increased prefrontal theta activity may contribute to persistent pain in fibromyalgia or represent the outcome of prolonged symptoms. The findings point to the potential for therapeutic interventions aimed at normalizing neural oscillations, while further research utilizing quantitative analysis of resting EEG could benefit our understanding of fibromyalgia pathophysiology.

摘要

背景:纤维肌痛综合征(FM)是一种以广泛疼痛、睡眠障碍、疲劳和认知/情感症状为特征的慢性疼痛障碍。功能影像学研究表明,FM 和其他慢性疼痛综合征会影响静息状态下的大脑活动。本研究利用脑电图(EEG)记录来研究静息状态下大脑持续活动的相对功率。

方法:在 19 名女性 FM 患者和 18 名年龄匹配的健康对照者中,在静息状态下记录了 64 通道 EEG。在测试当天进行手动压痛点量表(MTPS)检查,以量化紧张性疼痛和压痛程度,以及情绪、觉醒和疲劳的测量。使用标准化低分辨率脑电磁层析成像分析 delta、theta、alpha、beta 和 gamma 频带中的振荡,以评估整个大脑中光谱活动的来源。

结果:与健康对照组相比,FM 患者在测试当天表现出更多的疼痛、疲劳和紧张,并且在前额和前扣带回皮质中出现增强的 theta 活动。在其他频带中没有观察到显著差异。FM 患者的额部 theta 活动增强与压痛和平均疲劳评分显著相关。

结论:这些发现表明,静息状态下振荡活动的改变可能与 FM 中的持续疼痛和疲劳有关,并在与疼痛处理和内源性疼痛抑制的认知注意方面相关的大脑区域表现出来。在 FM 和其他慢性疼痛综合征中之前观察到低频振荡增强,可能与持续疼痛的病理生理机制有关,例如丘脑皮质节律紊乱。

意义:前额叶 theta 活动增加可能导致纤维肌痛持续疼痛,或者代表长期症状的结果。这些发现表明,针对正常神经振荡的治疗干预可能具有潜力,而利用静息 EEG 的定量分析进行进一步研究可能有助于我们理解纤维肌痛的病理生理学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f7a/5763419/7e85e65be677/EJP-22-49-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f7a/5763419/6419adf78f02/EJP-22-49-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f7a/5763419/7e85e65be677/EJP-22-49-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f7a/5763419/6419adf78f02/EJP-22-49-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f7a/5763419/7e85e65be677/EJP-22-49-g002.jpg

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本文引用的文献

[1]
Increased Low- and High-Frequency Oscillatory Activity in the Prefrontal Cortex of Fibromyalgia Patients.

Front Hum Neurosci. 2016-3-14

[2]
Altered Dynamic of EEG Oscillations in Fibromyalgia Patients at Rest.

Pain Med. 2016-6

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Semin Arthritis Rheum. 2014-8

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