Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
The International Master Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
CNS Spectr. 2022 Jun;27(3):339-346. doi: 10.1017/S1092852920002114. Epub 2020 Dec 7.
Fibromyalgia (FM) is a chronic widespread pain syndrome. Although its mechanism remains relatively unknown, accelerated neurodegeneration in the brain has been reported in patients with FM. Sleep disturbance can increase the risk of neurocognitive disorders, which are associated with tau and beta-amyloid (Aβ) protein accumulation. We hypothesize neurodegeneration in patients with FM may be associated with sleep disturbance.
In this case-control study, we analyzed serum tau and Aβ levels and their association with symptom profiles for patients with FM, by recruiting 22 patients with FM and 22 age-matched healthy participants. The visual analog scale, Fibromyalgia Impact Questionnaire, pressure pain threshold test, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II, Beck Anxiety Inventory, and serum tau and beta-amyloid-42 (Aβ-42) levels were recorded. The Mann-Whitney test was conducted to compare questionnaire and protein level results between the groups. Pearson correlation test was conducted to investigate the correlation of questionnaire scores with tau and Aβ-42 levels in patients with FM. The significance level was set at P < .05.
Serum tau and Aβ-42 levels were significantly higher in patients with FM than in controls. A positive correlation between serum tau levels and PSQI scores was observed in patients with FM (r = 0.476, P = .025). We found that only sleep disturbance in patients with FM was significantly associated with higher serum tau levels among all symptom scores.
We suggest sleep disturbance may play a vital role in the pathomechanism of accelerated neurodegeneration in FM.
纤维肌痛(FM)是一种慢性广泛性疼痛综合征。尽管其机制尚不清楚,但据报道,FM 患者的大脑神经退行性变加速。睡眠障碍会增加神经认知障碍的风险,而神经认知障碍与tau 和β-淀粉样蛋白(Aβ)蛋白的积累有关。我们假设 FM 患者的神经退行性变可能与睡眠障碍有关。
在这项病例对照研究中,我们通过招募 22 名 FM 患者和 22 名年龄匹配的健康参与者,分析了 FM 患者的血清 tau 和 Aβ 水平及其与症状谱的关系。记录了视觉模拟量表、纤维肌痛影响问卷、压力疼痛阈值试验、匹兹堡睡眠质量指数(PSQI)、贝克抑郁量表-II、贝克焦虑量表以及血清 tau 和β-淀粉样蛋白-42(Aβ-42)水平。采用 Mann-Whitney 检验比较两组问卷和蛋白水平结果。采用 Pearson 相关检验探讨 FM 患者问卷评分与 tau 和 Aβ-42 水平的相关性。显著性水平设为 P <.05。
FM 患者的血清 tau 和 Aβ-42 水平明显高于对照组。FM 患者的血清 tau 水平与 PSQI 评分呈正相关(r = 0.476,P =.025)。我们发现,在所有症状评分中,只有 FM 患者的睡眠障碍与较高的血清 tau 水平显著相关。
我们认为睡眠障碍可能在 FM 中加速神经退行性变的发病机制中起重要作用。