Cortisol and Subjective Stress Responses to Acute Psychosocial Stress in Fibromyalgia Patients and Control Participants
Cortisol and Subjective Stress Responses to Acute Psychosocial Stress in Fibromyalgia Patients and Control Participants
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DOI：
10.1097/psy.0000000000000551
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发表时间：
2018-04-01
影响因子：
3.3
通讯作者：
Van Oudenhove, Lukas
中科院分区：
文献类型：
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作者：
Coppens, Eline;Kempke, Stefan;Van Oudenhove, Lukas
目的：下丘脑-垂体-肾上腺轴功能障碍可能在纤维肌痛(FM)的发病机制中起一定作用，但其在该疾病中的作用尚不清楚。此外，儿童早期逆境(ECA)在FM中很常见，但它们是否会缓和应激反应尚不清楚。因此，我们调查了FM和对照组对急性心理社会应激的皮质醇和主观反应，同时调整了ECA。方法：27名女性FM患者和24名年龄匹配的女性对照组分别在三级护理中心和通过广告招募。儿童创伤问卷用于测量ECA病史。结果：皮质醇反应有显著的主效应[F(1，43)=7.04，p=.011，FM较低]和ECA[F(1，43)=5.18，p=.028，ECA参与者较高]。排除有ECA(n=5)的对照组时，发现了显著的按时间分组的交互作用[F(6，39)=2.60，p=.032]，与对照组相比，FM组对应激源的反应迟钝(p=.037)。对于主观应激反应，FM组有显著的主效应[F(1，45)=10.69，p=.002，FM较高]和逐时交互效应[F(6，45)=2.05，p=.078，TSST前30分钟、TSST后30分钟和75分钟FM较高，FM恢复受损(TSST后即刻差异)]。结论：FM患者对TSST的皮质醇反应迟钝。与对照组相比，FM患者的主观压力水平更高，特别是在基线和从TSST恢复期间。在FM患者中，ECA病史与皮质醇或主观压力水平或对TSST的反应性无关。未来的研究应探讨FM患者下丘脑-垂体-肾上腺轴失调的机制。
Objective: Hypothalamic-pituitary-adrenal axis dysfunction may play a role in fibromyalgia (FM) pathogenesis but it remains understudied in this disorder. Furthermore, early childhood adversities (ECA) are common in FM, but whether they moderate stress reactivity is unknown. Hence, we investigated cortisol and subjective responses to acute psychosocial stress in FM and controls, while adjusting for ECA.Methods: Twenty-seven female FM patients and 24 age-matched female controls were recruited in a tertiary care center and through advertisements, respectively. The Childhood Trauma Questionnaire was used to measure ECA history. Salivary cortisol levels and subjective stress ratings were measured at multiple time points before and after the Trier Social Stress Test (TSST) was administered.Results: Significant main effects of group [F(1,43) = 7.04, p = .011, lower in FM] and ECA [F(1,43) = 5.18, p = .028, higher in participants with ECA] were found for cortisol responses. When excluding controls with ECA (n = 5), a significant group-by-time interaction was found [F(6,39) = 2.60, p = .032], driven by a blunted response to the stressor in FM compared with controls (p = .037). For subjective stress responses, a significant main effect of group [F(1,45) = 10.69, p = .002, higher in FM] and a trend toward a group-by-time interaction effect [F(6,45) = 2.05, p = .078, higher in FM 30 minutes before and 30 and 75 minutes after the TSST, and impaired recovery (difference immediately after -30 minutes after the TSST) in FM] were found.Conclusions: Blunted cortisol responsivity to the TSST was observed in FM patients compared with controls without ECA. FM patients had higher subjective stress levels compared with controls, particularly at baseline and during recovery from the TSST. In FM patients, ECA history was not associated with cortisol or subjective stress levels or with responsivity to the TSST. Future research should investigate the mechanisms underlying hypothalamic-pituitary-adrenal axis dysregulation in FM.