纤维肌痛综合征的破坏性代偿机制及其与药物的关联。

IF 1.7 4区 医学 Q4 NEUROSCIENCES Experimental Brain Research Pub Date : 2024-12-01 Epub Date: 2024-10-05 DOI:10.1007/s00221-024-06924-6
Fernanda M Q Silva, Kevin Pacheco-Barrios, Felipe Fregni
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引用次数: 0

摘要

纤维肌痛综合征(FMS)是一种慢性疾病,通常以广泛的肌肉骨骼疼痛和疲劳为特征,主要影响女性,其复杂性往往导致诊断不足,并使治疗效果复杂化。经颅磁刺激(TMS)指标是优化经颅磁刺激综合征治疗的潜在标志物,但证据有限。我们的研究旨在探讨通过 TMS 指标评估的皮质兴奋性和抑制性与 FMS 患者临床特征之间的关系。这项横断面研究采用了一项临床试验的基线数据,共有 108 名 FMS 患者参加,其中大部分为女性(88.8%),平均年龄为 47.3 岁(SD = 12.06)。我们的分析表明,皮层内短抑制(SICI)的降低与使用加巴喷丁类药物、尼古丁使用史和疲劳程度增加有关,这表明它与非疼痛性 FMS 特征的代偿机制有关。运动皮层内促进(ICF)的增加与疼痛严重程度的增加和FMS持续时间的缩短有关,这意味着它与慢性疼痛导致的感觉运动通路重组有关。此外,较高的静息运动阈值(rMT)与较低的疼痛调节效果(较低的条件性疼痛调节[CPM])相关,这表明疼痛代偿机制受到了破坏。鉴于 SICI 在反映大脑平衡机制方面的作用及其与疲劳(FMS 引起的行为变化的标志性特征)的关联,这些结果表明 FMS 很可能对大脑抑制功能产生有害影响,从而为 FMS 的机制提供了潜在的新见解。此外,加巴喷丁类和尼古丁等药物似乎会加剧这种代偿机制的破坏。
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Disruptive compensatory mechanisms in fibromyalgia syndrome and their association with pharmacological agents.

Fibromyalgia syndrome (FMS) is a chronic disorder characterized commonly by widespread musculoskeletal pain and fatigue, predominantly affecting women, with its complexity often leading to underdiagnosis and complicating treatment effectiveness. Transcranial magnetic stimulation (TMS) metrics are potential markers to optimize FMS treatments; however, evidence is limited. Our study aimed to explore the relationship between cortical excitability and inhibition, assessed through TMS markers, and clinical characteristics in patients with FMS. This presented cross-sectional study employed baseline data from a clinical trial with 108 FMS patients, mostly female (88.8%), and mean age of 47.3 years old (SD = 12.06). Our analysis showed that decreased short-intracortical inhibition (SICI) was associated with gabapentinoids use, nicotine history, and increased fatigue levels, suggesting its connection with compensatory mechanisms for non-painful FMS features. Increased motor intracortical facilitation (ICF) was linked with greater pain severity and shorter FMS duration, implying its relationship with a reorganization of sensorimotor pathways due to chronic pain. Additionally, higher resting motor threshold (rMT) was associated with less effective pain modulation (lower conditioned pain modulation [CPM]), indicating a disruption of pain compensatory mechanism. Given the role of SICI in indexing homeostatic brain mechanisms and its association with fatigue, a hallmark characteristic of FMS-induced behavioral changes, these results suggest that FMS likely has a deleterious effect on brain inhibitory function, thus providing a potential novel insight for FMS mechanisms. In addition, it seems that this compensatory mechanism's disruption is enhanced by pharmacological agents such as gabapentioids and nicotine.

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来源期刊
CiteScore
3.60
自引率
5.00%
发文量
228
审稿时长
1 months
期刊介绍: Founded in 1966, Experimental Brain Research publishes original contributions on many aspects of experimental research of the central and peripheral nervous system. The focus is on molecular, physiology, behavior, neurochemistry, developmental, cellular and molecular neurobiology, and experimental pathology relevant to general problems of cerebral function. The journal publishes original papers, reviews, and mini-reviews.
期刊最新文献
Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease. Investigations of motor performance with neuromodulation and exoskeleton using leader-follower modality: a tDCS study. Blood flow modulation to improve motor and neurophysiological outcomes in individuals with stroke: a scoping review. Disruptive compensatory mechanisms in fibromyalgia syndrome and their association with pharmacological agents. Transiently worse postural effects after vestibulo-ocular reflex gain-down adaptation in healthy adults.
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