纤维肌痛综合征(FMS)的发病机制尚不清楚。经颅超声检查显示抑郁症和焦虑症患者中脑中段的消声改变,提示中枢血清素能系统的影响。这里,我们评估了FMS的中脑中缝回声。
66例患者接受了经颅超声检查,其中53名是FMS患者(27名女性,26名男子),13名患有严重抑郁症和身体疼痛的患者(均为女性),和14名健康对照(11名女性,3名男子)。Raphe回声在视觉上分级为正常或低回声,并通过数字化图像分析进行量化,研究人员均对临床诊断不知情.
与健康对照组相比,FMS患者的定量中脑中缝回声较低(p<0.05),但与抑郁症和伴随身体疼痛的患者没有什么不同。疼痛和FMS症状负担与中脑中段回声以及抑郁症状的存在和严重程度无关。
我们发现FMS患者以及抑郁症和身体疼痛患者中脑中缝区的回声减少,独立于疼痛的存在或严重程度,FMS,和抑郁症状。在这种客观技术可能进入FMS和抑郁症的诊断算法之前,有必要进一步探索这种超声检查结果。
The pathogenesis of fibromyalgia syndrome (FMS) is unclear. Transcranial ultrasonography revealed anechoic alteration of midbrain raphe in depression and anxiety disorders, suggesting affection of the central serotonergic system. Here, we assessed midbrain raphe echogenicity in FMS.
Sixty-six patients underwent transcranial sonography, of whom 53 were patients with FMS (27 women, 26 men), 13 patients with major depression and physical pain (all women), and 14 healthy controls (11 women, 3 men). Raphe echogenicity was graded visually as normal or hypoechogenic, and quantified by digitized image analysis, each by investigators blinded to the clinical diagnosis.
Quantitative midbrain raphe echogenicity was lower in patients with FMS compared to healthy controls (p<0.05), but not different from that of patients with depression and accompanying physical pain. Pain and FMS symptom burden did not correlate with midbrain raphe echogenicity as well as the presence and severity of depressive symptoms.
We found reduced echogenicity of the midbrain raphe area in patients with FMS and in patients with depression and physical pain, independent of the presence or severity of pain, FMS, and depressive symptoms. Further exploration of this sonographic finding is necessary before this objective technique may enter diagnostic algorithms in FMS and depression.