PMS與自律神經系統活性下降有關


  January 4, 2008 — 新的研究結果顯示,經前症候群(PMS)女性的自律神經系統(ANS)活性顯著下降,且症狀嚴重的可能會使該關鍵調節系統功能永久低下。
  
  日本大阪國際佛教大學的研究者表示,該研究結果顯示,有PMS的女性,在生理週期黃體後期時的ANS活性相較於濾泡期顯著降低。
  
  這項研究結果也證實有經前焦躁異常(PMDD),這是最嚴重的症狀,ANS活性的下降是持續的,不論生理週期的分期。
  
  雖然造成這種現象的機轉仍然未明,目前的研究顯示,黃體期的ANS功能變化與出現在經前的、變化多端的身心與行為症狀有關。
  
  此外,作者寫道,當症狀變的嚴重,罹患PMDD的女性,交感迷走功能可能下降地更明顯,不論生理週期的分期。
  
  這項由Tamaki Matsumoto博士領導進行的研究,發表於12月20日的生物精神社會醫學期刊上。
  
  根據這項文獻,過去的研究已經證實身心症狀,例如憂鬱、焦慮、與慢性疲倦,其自律神經功能是改變的。
  
  然而,儘管高達90%懷孕年齡的女性都有多多少少的PMS,且預估有3%至5%女性有PMDD症狀,研究者表示,有關於PMS與ANS活性之間潛在關連的資訊卻很少。
  
  為了研究ANS活性在女性生理週期間是否改變,且與不同程度的經前症狀有關,研究者招募了62位20歲、30歲、與40歲前後且生理週期規律的女性。
  
  所有受試者都在生理週期的濾泡期與黃體期接受檢查。
  
  在這項檢查中,受試者接受尿液檢驗,以量測荷爾蒙濃度,而這些女性的生理情緒與行為症狀則是由生理週期憂傷問卷評估;根據這項檢驗,受試者被分為三組,分別是PMS、控制組與PMDD。
  
  ANS活性以心跳變化能光譜分析評估,研究者表示過去研究已經提供非侵入性ANS副交感神經部份評估方式。
  
  沒有PMS症狀所組成的控制組中,心跳變化參數並沒有任何差異;相反的,在黃體期末期有PMS症狀的女性,自主與副交感神經活性整體是下降的;被歸類為PMDD組的女性,ANS活性同樣顯著下降,不論生理週期的分期。
  
  研究者表示,需要未來的研究,來確認經前症狀與交感迷走功能週期性旁的生理精神社會因素複雜網絡,在病理學上的關連。
  
  作者表示無相關資金上的往來。

PMS Linked to Decreased Autono

By Caroline Cassels
Medscape Medical News

January 4, 2008 — New research shows that women with premenstrual syndrome (PMS) have significantly decreased autonomic nervous system (ANS) activity and that those with the most severe symptoms might have permanent depression of this key regulatory system.

Conducted by investigators at the International Buddhist University in Osaka, Japan, the study shows that women with PMS have significantly decreased ANS activity in the late-luteal phase of their menstrual cycle, compared with the follicular phase.

The results also suggest that among women with premenstrual dysphoric disorder (PMDD), who have the most severe symptoms, this decreased ANS activity is permanent regardless of menstrual-cycle phase.

Although the underlying pathophysiologic mechanisms remain unclear, the current study suggests that altered functioning of the ANS in the late-luteal phase is associated with diverse psychosomatic and behavioral symptoms appearing premenstrually.

"In addition, when the symptoms become more severe, as seen in women with PMDD, the sympathovagal function might be more depressed, regardless of the menstrual cycle," the authors write.

The study, which was led by Tamaki Matsumoto, PhD, was published online December 20 in BioPsychoSocial Medicine.

According to the paper, previous research has shown that autonomic function is altered in psychosomatic symptoms such as depression, anxiety, and chronic fatigue.

However, despite the fact that up to 90% of women of childbearing age experience at least some degree of PMS and 3% to 5% are estimated to have PMDD, the researchers note there is little information regarding the potential association of PMS and ANS activity.

To investigate whether ANS activity is altered during the menstrual cycle of women with different degrees of premenstrual symptomatology, the researchers recruited 62 women in their 20s, 30s, and 40s with regular menstrual cycles.

All subjects were examined during the follicular phase and again during the late-luteal phase of their cycle.

During these examinations, subjects underwent urine sampling to verify hormone levels, and their physical emotional and behavioral symptoms were assessed using the Menstrual Distress Questionnaire. On the basis of this testing, subjects were classified into 3 groups: PMS, control, and PMDD.

ANS activity was assessed using heart-rate variability power spectral analysis, which the researchers note has been shown in previous studies to provide comprehensive noninvasive assessment of the parasympathetic components of the ANS.

There were no differences in any of the heart-rate-variability parameters among women with no PMS who made up the control group. In contrast, women who experienced PMS symptoms in the late-luteal phase experienced an overall decrease in autonomic and parasympathetic nerve activity; those in the PMDD group experienced marked decreases in ANS activity, regardless of menstrual cycle phase.

The investigators note that further research is "needed to confirm an etiological association of premenstrual symptomatology with the complex web of bio-psycho-social factors around the menstrual cyclicity of sympathovagal function."

The authors have disclosed no relevant financial relationships.

Biopsychosoc Med. 2007; 20;1(1):24. Abstract

    
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