Differential dopamine function in fibromyalgia.
Differential dopamine function in fibromyalgia.
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DOI：
10.1007/s11682-015-9459-4
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发表时间：
2016-09
影响因子：
3.2
通讯作者：
Yoder KK
中科院分区：
文献类型：
--
作者：
Albrecht DS;MacKie PJ;Kareken DA;Hutchins GD;Chumin EJ;Christian BT;Yoder KK
大约30%的美国人患有慢性疼痛障碍，如纤维肌痛（FM），它会导致使人衰弱的疼痛。许多用于慢性疼痛障碍的止痛药极易上瘾，临床疗效有限，并且不能治疗许多患者报告的认知症状。慢性疼痛的神经生物学基础在很大程度上是未知的，但有证据表明，在异常疼痛感知中改变了多巴胺能传递。我们试图表征FM患者的多巴胺（DA）系统。使用正电子发射断层扫描（PET）与[18F] FAL （FAL）来评估相对于基线任务的工作记忆挑战期间DA的变化，并测试基线D2/D3可用性与实验疼痛测量之间的关联。12名女性FM受试者和11名女性对照完成了研究程序。受试者在执行“2-back”任务时接受一次FAL PET扫描，在执行“0-back”（注意力控制，“基线”）任务时接受一次FAL PET扫描。与对照组相比，FM受试者在包括前扣带皮层在内的几个皮质区域的FAL结合电位（BP）基线较低。在FM受试者中，自我报告的自发性疼痛与左眶额皮质和海马旁回的FAL血压呈负相关。在FM和CON受试者中，基线BP与实验疼痛敏感性和耐受性显著负相关，尽管这些关联的空间模式在组间存在差异。这些数据提示，颞叶前叶功能异常可能与FM疼痛知觉加工的差异有关。DA在慢性疼痛的伤害感觉和认知加工中的功能意义有待进一步研究。
Approximately 30% of Americans suffer from chronic pain disorders, such as fibromyalgia (FM), which can cause debilitating pain. Many pain-killing drugs prescribed for chronic pain disorders are highly addictive, have limited clinical efficacy, and do not treat the cognitive symptoms reported by many patients. The neurobiological substrates of chronic pain are largely unknown, but evidence points to altered dopaminergic transmission in aberrant pain perception. We sought to characterize the dopamine (DA) system in individuals with FM. Positron emission tomography (PET) with [18F]fallypride (FAL) was used to assess changes in DA during a working memory challenge relative to a baseline task, and to test for associations between baseline D2/D3 availability and experimental pain measures. Twelve female subjects with FM and eleven female controls completed study procedures. Subjects received one FAL PET scan while performing a “2-back” task, and one while performing a “0-back” (attentional control, “baseline”) task. FM subjects had lower baseline FAL binding potential (BP) in several cortical regions relative to controls, including anterior cingulate cortex. In FM subjects, self-reported spontaneous pain negatively correlated with FAL BP in the left orbitofrontal cortex and parahippocampal gyrus. Baseline BP was significantly negatively correlated with experimental pain sensitivity and tolerance in both FM and CON subjects, although spatial patterns of these associations differed between groups. The data suggest that abnormal DA function may be associated with differential processing of pain perception in FM. Further studies are needed to explore the functional significance of DA in nociception and cognitive processing in chronic pain.