Blood CRP levels are elevated in children and adolescents with functional neurological symptom disorder.

Autor: Kozlowska K; Department Psychological Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia. kkoz6421@uni.sydney.edu.au.; Brain Dynamics Centre, Westmead Institute of Medical Research, Westmead, NSW, Australia. kkoz6421@uni.sydney.edu.au.; Discipline of Psychiatry and Discipline of Child and Adolescent Health, University of Sydney Medical School, Sydney, NSW, Australia. kkoz6421@uni.sydney.edu.au., Chung J; Department of Clinical Biochemistry, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.; Discipline of Child and Adolescent Health, University of Sydney Medical School, Sydney, NSW, Australia., Cruickshank B; Department Psychological Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia., McLean L; Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Building 112, Cumberland Hospital Campus, Parramatta BC, Locked Bag 7118, Parramatta, NSW, 2124, Australia.; Brain and Mind Centre, and Discipline of Psychiatry, University of Sydney Medical School, Sydney, NSW, Australia., Scher S; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.; McLean Hospital, Belmont, MA, USA.; Discipline of Psychiatry, University of Sydney Medical School, Sydney, NSW, Australia., Dale RC; Discipline of Child and Adolescent Health, University of Sydney Medical School, Sydney, NSW, Australia.; Movement Disorder and Clinical Neuroimmunology Group, Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia., Mohammad SS; Discipline of Child and Adolescent Health, University of Sydney Medical School, Sydney, NSW, Australia.; Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia., Singh-Grewal D; Discipline of Child and Adolescent Health, University of Sydney Medical School, Sydney, NSW, Australia.; Department of Rheumatology, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.; Discipline of Child and Maternal Health, University of New South Wales, Sydney, NSW, Australia., Prabhuswamy MY; Department Psychological Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.; School of Medicine, Western Sydney University, Campbelltown, NSW, Australia., Patrick E; School of Mathematics and Statistics, University of Sydney, F07 - Carslaw Building, Sydney, NSW, 2006, Australia.; Westmead Institute for Medical Research, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: European child & adolescent psychiatry [Eur Child Adolesc Psychiatry] 2019 Apr; Vol. 28 (4), pp. 491-504. Date of Electronic Publication: 2018 Aug 24.
DOI: 10.1007/s00787-018-1212-2
Abstrakt: There is accumulating evidence that patients with functional neurological symptom disorder (FND) show activation of multiple components of the stress system-the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and brain regions involved in arousal- and emotion-processing. This study aims to examine whether the immune-inflammatory component of the stress system is also activated. C-reactive protein (CRP) blood titre levels were measured in 79 children and adolescents with FND. CRP values ≥ 2 mg/L suggest low-grade inflammation. CRP values > 10 mg/L suggest a disease process. Sixty-six percent of subjects (n = 52) had CRP titres ≥ 2 mg/L. The upward shift in the distribution of CRP levels suggested low-grade inflammation (median CRP concentration was 4.60 mg/L, with 75th and 90th percentiles of 6.1 and 10.3 mg/L, respectively). Elevated CRP titres were not explained by sex, pubertal status, BMI, or medical factors. Confounder analyses suggested that history of maltreatment (χ 2  = 2.802, df = 1, p = 0.094, φ = 0.190; β = 2.823, p = 0.04) and a diagnosis of anxiety (χ 2  = 2.731, df = 1, p = 0.098, φ = 0.187; β = 4.520, p = 0.061) contributed to elevated CRP levels. Future research will need to identify the origins and locations of immune cell activation and the pathways and systems contributing to their activation and modulation. Because functional activity in neurons and glial cells-the brain's innate effector immune cells-is tightly coupled, our finding of elevated CRP titres suggests activation of the immune-inflammatory component of the brain's stress system. A more direct examination of inflammation-related molecules in the brain will help clarify the role of immune-inflammatory processes in FND.
Databáze: MEDLINE
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