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特发性环境不适中多感官知觉障碍的研究现状:系统综述。

Perspectives on multisensory perception disruption in idiopathic environmental intolerance: a systematic review.

机构信息

Department of Clinical Sciences and Translational Medicine, University of Rome'Tor Vergata', Via Montpellier, 1; E sud Tower, 00133, Rome, Italy.

University of Rome Tor Vergata, Rome, Italy.

出版信息

Int Arch Occup Environ Health. 2018 Nov;91(8):923-935. doi: 10.1007/s00420-018-1346-z. Epub 2018 Aug 7.

Abstract

PURPOSE

Multiple chemical sensitivity (MCS) also known as idiopathic environmental intolerance/illness (IEI) encompasses a cohort of subjective symptoms characterized by susceptibility to a wide spectrum of environmental compounds, causing symptoms involving various organs and a decrease in quality of life. The aim of this systematic review is to summarize evidence about MCS, with focus on indexed studies analyzing sensory pathway-related disorders.

METHODS

Medical databases were searched for English language articles related to the topic, published between 1965 and 2017 in academic, peer-reviewed journals. Particular focus was concentrated on articles depicting disturbances involving sensory organs. References of the relevant articles were examined to identify additional significant documents.

RESULTS

Fifty-eight studies were eligible for full text review. Of these, 34 studies met the selection criteria and were included in this analysis. Many variables, such as different diagnostic criteria, lack of homogeneous symptom questionnaires and the general incidence of personality traits in control subjects, biased studies as confounding factors. However, moderate evidences show that sensory pathways are somewhat altered, especially with respect to information processing in the limbic system and related cortical areas. Recent studies suggested the presence, in MCS cohorts, of attention bias, sensitization and limbic kindling, as well as recently revealed subclinical organic alterations along sensory pathways.

CONCLUSIONS

Evidences are consistent with MCS/IEI to be the result of a neural altered processing of sensorial ascending pathways, which combined with peculiar personality traits constitutes the underpinning of a multisensory condition needing multidisciplinary clinical approach.

摘要

目的

多种化学敏感性(MCS)也称为特发性环境不耐受/疾病(IEI),包括一组以对广泛环境化合物的敏感性为特征的主观症状,导致涉及各种器官的症状和生活质量下降。本系统评价的目的是总结关于 MCS 的证据,重点是分析与感觉通路相关障碍的索引研究。

方法

检索了医学数据库中 1965 年至 2017 年间以英文发表的与该主题相关的学术同行评议期刊文章。特别关注描述涉及感觉器官的障碍的文章。检查相关文章的参考文献以确定其他重要文件。

结果

58 项研究有资格进行全文审查。其中,34 项研究符合选择标准并纳入本分析。许多变量,例如不同的诊断标准、缺乏同质的症状问卷以及对照组中一般存在的人格特征,都会使研究产生偏倚,成为混杂因素。然而,中度证据表明感觉通路存在一定程度的改变,尤其是在边缘系统和相关皮质区域的信息处理方面。最近的研究表明,MCS 组中存在注意力偏向、敏化和边缘点燃,以及最近在感觉通路上发现的亚临床有机改变。

结论

证据表明 MCS/IEI 是感觉传入通路神经处理改变的结果,这种改变与特殊的人格特征相结合,构成了需要多学科临床方法的多感觉条件的基础。

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