Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Health System, Domino's Farms, Lobby M, 24 Frank Lloyd Wright Dr., PO Box 385, Ann Arbor, MI, 48106, USA.
Michigan Medicine, Ann Arbor, MI, USA.
Curr Rheumatol Rep. 2019 Dec 5;21(12):67. doi: 10.1007/s11926-019-0870-5.
To review how peripheral inflammation in rheumatic disease influences the central nervous system. We consider recent studies of rheumatic disease that employ functional and structural neuroimaging in the context of inflammation, as well as recent studies considering how immunosuppressive therapy is associated with changes in brain function and structure.
The most compelling evidence thus far comes from studies of rheumatoid arthritis and indicates that higher levels of inflammation are associated with changes in cognitive, affective, and pain-processing brain regions, some of which may be rectified by anti-inflammatory treatment. Comorbid symptoms such as widespread pain and fatigue may also be associated with these changes. Inflammation may be associated with compensatory activation of brain regions to offset structural changes. This emerging line of evidence suggests that communication between the brain and immune system are an important and underappreciated aspect of inflammatory rheumatic disease.
探讨风湿性疾病外周炎症对中枢神经系统的影响。我们回顾了风湿性疾病的最新研究，这些研究在炎症背景下使用了功能和结构神经影像学，并考虑了免疫抑制治疗如何与大脑功能和结构的变化相关联。
迄今为止最有说服力的证据来自于类风湿关节炎的研究，表明更高水平的炎症与认知、情感和疼痛处理脑区的变化有关，其中一些变化可能通过抗炎治疗得到纠正。合并症状，如广泛疼痛和疲劳，也可能与这些变化有关。炎症可能与大脑区域的代偿性激活有关，以抵消结构变化。这一新兴的证据表明，大脑和免疫系统之间的通讯是炎症性风湿性疾病一个重要但尚未被充分认识的方面。
