摘要
纖維肌痛症是一種以廣泛性疼痛為特徵的慢性疾患，病人也多抱怨有疲倦、憂鬱、認知功能衰退、失眠等症狀。以流行病學的角度來說，纖維肌痛症的症狀嚴重度與個體所感受到的壓力嚴重度有相關性，焦慮症及創傷後壓力症候群亦是纖維肌痛症常見的共病症，故有些學者認為纖維肌痛症也可算是一種慢性壓力疾患。另一方面，動物實驗發現長期壓力會使海馬迴萎縮，臨床觀察研究亦有相似的發現，這或許可解釋壓力如何影響認知功能。本文將回顧相關文獻，先介紹纖維肌痛症與壓力的關聯性，再探討壓力如何影響認知功能。
參考文獻
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016;46:319-29.
McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med 1998;338:171-9.
McEwen BS. The neurobiology of stress: from serendipity to clinical relevance. Brain Research 2000;886:172-89.
Tak LM, Cleare AJ, Ormel J, et al. Meta-analysis and meta-regression of hypothalamic-pituitary-adrenal axis activity in functional somatic disorders. Biol Psychol 2011;87:183-94.
Heim C, Ehlert U, Hellhammer DH. The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology 2000;25:1-35.