Medically Unexplained Symptoms Are Linked to Chronic Inflammatory Diseases: Is There a Role for Frontal Cerebral Blood Oxygen Content?

IF 2.2 4区医学 Q3 ENDOCRINOLOGY & METABOLISM Neuroimmunomodulation Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI:10.1159/000536204

Rainer H Straub, Dario Boschiero

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Abstract

Introduction: Patients often go to the physician with medically unexplained symptoms (MUS). MUS can be autonomic nervous system-related "unspecific" symptoms, such as palpitations, heart rhythm alterations, temperature dysregulation (hand, feet), anxiety, or depressive manifestations, fatigue, somnolence, nausea, hyperalgesia with varying pains and aches, dizziness, etc. Methods: In this real-world study, we investigated MUS in a cohort of unselected outpatients from general practitioners in Italy. It was our aim to increase the understanding of MUS by using principal component analyses to identify any subcategories of MUS and to check a role of chronic inflammatory diseases. Additionally, we studied cerebral blood oxygen (rCBO2) and associations with MUS and chronic inflammatory disease.

Results: Participants included 1,597 subjects (50.6 ± 0.4 years, 65%/35% women/men). According to ICD-10 codes, 137 subjects had chronic inflammatory diseases. MUS were checked by a questionnaire with a numeric rating scale and cerebral blood flow with optical techniques. The analyses of men and women were stratified. Psychological symptom severity was higher in the inflamed compared to the non-inflamed group (fatigue, insomnia in women and men; recent mood changes, daytime sleepiness, anxiety, apathy, cold hands only in women; abnormal appetite and heart rhythm problems only in men). Principal component analysis with MUS provided new subcategories: brain symptoms, gut symptoms, and unspecific symptoms. Brain and gut symptoms were higher in inflamed women and men. Chronic inflammatory diseases and pain were tightly interrelated in men and women (p < 0.0001). In women, not in men, average frontal rCBO2 content was higher in inflamed compared to non-inflamed subjects. In men, not in women, individuals with pain demonstrated a lower average frontal rCBO2 content compared to pain-free men. MUS did not relate to rCBO2 parameters.

Conclusion: This study shows close relationships between MUS and chronic inflammatory diseases but not between MUS and rCBO2 parameters.

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医学上无法解释的症状与慢性炎症性疾病有关--额叶脑血氧含量是否起作用？

导言：患者常常因医学上无法解释的症状（MUS）而就医。不明原因症状可能是与自主神经系统有关的 "非特异性 "症状，如心悸、心律改变、体温调节失常（手、脚）、焦虑等，也可能是抑郁表现、疲劳、嗜睡、恶心、痛觉减退、头晕等。方法在这项真实世界的研究中，我们调查了一组意大利全科医生门诊病人的 MUS。我们的目的是通过主成分分析来确定 MUS 的子类别，并检查慢性炎症性疾病的作用，从而加深对 MUS 的了解。此外，我们还研究了脑血氧以及与 MUS 和慢性炎症性疾病的关联。结果参与者包括 1597 名受试者（50.6+/-0.4 岁，65%/35% 为女性/男性）。根据 ICD-10 编码，137 名受试者患有慢性炎症性疾病。通过数字评分量表问卷和光学技术检查了 MUS。对男性和女性进行了分层分析。与非炎症组相比，炎症组患者的心理症状严重程度更高（女性和男性均有疲劳、失眠；仅女性有近期情绪变化、白天嗜睡、焦虑、冷漠、手冷；仅男性有食欲异常和心律问题）。利用 MUS 进行的主成分分析提供了新的子类别：脑部症状、肠道症状和非特异性症状。患有炎症的女性和男性的脑部和肠道症状较重。男性和女性的慢性炎症性疾病与疼痛密切相关（p

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来源期刊

Neuroimmunomodulation 医学-免疫学

CiteScore

3.60

自引率

4.20%

发文量

审稿时长

>12 weeks

期刊介绍： The rapidly expanding area of research known as neuroimmunomodulation explores the way in which the nervous system interacts with the immune system via neural, hormonal, and paracrine actions. Encompassing both basic and clinical research, ''Neuroimmunomodulation'' reports on all aspects of these interactions. Basic investigations consider all neural and humoral networks from molecular genetics through cell regulation to integrative systems of the body. The journal also aims to clarify the basic mechanisms involved in the pathogenesis of the CNS pathology in AIDS patients and in various neurodegenerative diseases. Although primarily devoted to research articles, timely reviews are published on a regular basis.