慢性广泛疼痛中的认知衰退和痴呆症:基于人口的纵向研究
Xue Jiang1,2,3,4, Elin Johansson4,5,6, Jo Nijs4,7,8
1Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.
Anesthesiology
|August 25, 2025
概括
慢性广泛疼痛 (CWP) 与认知障碍和痴呆症的风险增加有关. 大脑结构的变化和全身炎症可能解释了这种联系.
科学领域:
- 神经科学
- 公共卫生
- 老年学
背景情况:
- 慢性广泛疼痛 (CWP) 是普遍存在的,但它对认知和潜在机制的影响尚未完全理解.
- 初步研究表明慢性疼痛与认知衰退之间存在联系,因此需要进一步研究CWP的具体影响.
- 了解CWP对认知健康的影响的神经生物学基础对于制定有针对性的干预措施至关重要.
研究的目的:
- 调查慢性广泛疼痛 (CWP) 与痴呆和轻度认知障碍的风险之间的联系.
- 探索大脑结构和系统性炎症在CWP和认知表现之间的关系中的潜在调解作用.
- 通过使用CWP和无CWP个体的综合测试来分析认知表现.
主要方法:
- 基于人口的队列研究,使用英国生物库数据从188,594名参与者,随访时间为13年.
- 慢性广泛疼痛 (CWP) 定义为自我报告的全身疼痛≥3个月.
- 通过八项测试评估认知功能;通过住院病例记录确定痴呆和轻度认知障碍;从血液样本中分析全身炎症标志物.
主要成果:
- 患有慢性广泛疼痛 (CWP) 的人患轻度认知障碍 (HR [95%CI]: 2. 55 [1. 31 - 4. 97]) 和痴呆症 (1. 53 [1. 13 - 2. 0]) 的风险显著增加.
- 在CWP和痴呆症之间没有发现因果关系 (β = 1. 50,PAdjusted = 0. 076).
- 大脑结构体积 (例如,丘脑,岛皮层) 和系统性炎症标志物 (例如,淋巴细胞,血小板) 可能会调解CWP-认知性能联系,尽管由于时间不准确,建议谨慎解释.
结论:
- 慢性广泛疼痛 (CWP) 与认知障碍和痴呆症的风险显著增加有关.
- 大脑结构的改变和系统性炎症似乎介导了CWP和认知衰退之间的关系.
- 这些发现突显了在认知健康和痴呆症预防的背景下解决CWP的重要性.
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