■转换障碍/功能性神经障碍(CD/FND)通常发生在神经系统中,并可能导致长期困扰,残疾和对医疗保健服务的需求。系统性低度炎症可能起作用,然而,致病机制尚不清楚。
■1)探讨建立和评估具有运动症状的CD/FND队列的可行性,涉及有生活经验的人(PPI)。2)产生关于细胞因子可能作用的概念证明,microRNA,运动CD/FND患者的皮质醇水平和神经认知症状。
■可行性研究。
■研究表明,尽管临床疾病负担和残疾很高,但患者仍积极参与。神经认知症状,童年不良经历(ACE)和当前生活事件。该研究提供了有关在这些患者中进行研究的可行性的有价值的知识,这将为未来的研究阶段提供信息。在样品中,IL6、IL12、IL17A的水平升高,IFNg,TNFa和VEGF-a,提示全身性低度炎症。此外,参与炎症和血管炎症的microRNAs分别与TNFa和VEGFa相关,为表观遗传机制提供概念证明。由于COVID-19的爆发,患者样本仅限于15例患者.
■这项研究在临床环境中进行是新颖的。这种创新,转化研究探讨了CD/FND患者与压力相关的SLI,以及旨在为该脆弱人群开发新的治疗方法的更大项目的可行性。鉴于积极的发现,有可能对CD/FND的疾病机制进行进一步研究。
BACKGROUND: Conversion disorder/functional neurological disorder (CD/FND) occurs often in neurological settings and can lead to long-term distress, disability and demand on health care services. Systemic low-grade inflammation might play a role, however, the pathogenic mechanism is still unknown.
OBJECTIVE: 1) To explore the feasibility to establish and assess a cohort of CD/FND with motor symptoms, involving persons with lived experience (PPI). 2) To generate proof of concept regarding a possible role for cytokines, microRNA, cortisol levels and neurocognitive symptoms in patients with motor CD/FND.
METHODS: Feasibility
study.
RESULTS: The
study showed active involvement of patients despite high clinical illness burden and disability, neurocognitive symptoms, childhood adverse experiences (ACE) and current life events. The
study provided valuable knowledge regarding the feasibility of conducting a
study in these patients that will inform future
study phases. In the sample there were elevated levels of IL6, IL12, IL17A, IFNg, TNFa and VEGF-a, suggesting systemic low-grade inflammation. Also, microRNAs involved in inflammation and vascular inflammation were correlated with TNFa and VEGFa respectively, suggesting proof of concept for an epigenetic mechanism. Owing to the COVID-19 outbreak, the patient sample was limited to 15 patients.
CONCLUSIONS: It is a novelty that this
study is conducted in the clinical setting. This innovative, translational study explores stress-related SLI in CD/FND patients and the feasibility of a larger project aiming to develop new treatments for this vulnerable population. Given the positive findings, there is scope to conduct further research into the mechanism of disease in CD/FND.