Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
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DOI：
10.1371/journal.pone.0198106
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发表时间：
2018-06-06
期刊：
影响因子：
3.7
通讯作者：
Alegre, Jose
中科院分区：
文献类型：
--
作者：
Cambras, Trinitat;Castro-Marrero, Jesus;Alegre, Jose
慢性疲劳综合征/肌痛性脑脊髓炎(CFS/ME)患者经常出现自主神经症状，这可能与下丘脑功能障碍有关。本研究旨在探讨CFS/ME患者和健康对照组在一年中的两个不同时间段的安静、活动和远端皮肤温度(DST)的昼夜节律模式及其与自我报告结果指标的关系。这项研究包括10名同时符合1994年疾控中心/福田定义和2003年加拿大CFS/ME标准的女性，以及10名年龄、性别和体重指数相匹配的健康对照组。使用自评量表评估疲劳、睡眠质量、焦虑和抑郁、自主神经功能和与健康相关的生活质量。ActTrust活动记录仪被用来记录活动、DST和光照强度，数据间隔在连续七天内为一分钟。睡眠变量通过动作图分析和主观睡眠日记获得。计算了昼夜节律变量和节律的频谱分析。采用线性回归分析评价节律变量与临床特征之间的关系。同样的受试者在冬季和夏季进行了录音。结果显示，活动记录仪测量的节律稳定性、睡眠潜伏期或觉醒次数在两组之间没有差异。然而，CFS/ME患者的日常活动量、活动节律的相对幅度和稳定性均低于对照组。CFS/ME患者DST对环境温度敏感，且仅在冬季夜间低于对照组。频谱分析显示24小时节律的相位和幅度没有差异，但二次谐波的功率(12h)显示了两组之间的差异(对照组的DST活动和峰值在午餐后下降，而CFS/ME患者则没有)，并与临床特征相关。这些发现提示昼夜节律和皮肤血管扩张剂反应可能在CFS/ME中起作用。
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) patients frequently show autonomic symptoms which may be associated with a hypothalamic dysfunction. This study aimed to explore circadian rhythm patterns in rest and activity and distal skin temperature (DST) and their association with self-reported outcome measures, in CFS/ME patients and healthy controls at two different times of year. Ten women who met both the 1994 CDC/Fukuda definition and 2003 Canadian criteria for CFS/ME were included in the study, along with ten healthy controls matched for age, sex and body mass index. Self-reported measures were used to assess fatigue, sleep quality, anxiety and depression, autonomic function and health-related quality of life. The ActTrust actigraph was used to record activity, DST and light intensity, with data intervals of one minute over seven consecutive days. Sleep variables were obtained through actigraphic analysis and from subjective sleep diary. The circadian variables and the spectral analysis of the rhythms were calculated. Linear regression analysis was used to evaluate the relationship between the rhythmic variables and clinical features. Recordings were taken in the same subjects in winter and summer. Results showed no differences in rhythm stability, sleep latency or number of awakenings between groups as measured with the actigraph. However, daily activity, the relative amplitude and the stability of the activity rhythm were lower in CFS/ME patients than in controls. DST was sensitive to environmental temperature and showed lower nocturnal values in CFS/ME patients than controls only in winter. A spectral analysis showed no differences in phase or amplitude of the 24h rhythm, but the power of the second harmonic (12h), revealed differences between groups (controls showed a post-lunch dip in activity and peak in DST, while CFS/ME patients did not) and correlated with clinical features. These findings suggest that circadian regulation and skin vasodilator responses may play a role in CFS/ME.