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Background:Chronic tension type headache(TTH),fibromyalgia syndrome(FMs)and major depression disorder (MDD) are all chronic diseases and have high morbidity.They often lead to poor quality of life even disability.The three diseases origin and pathogenesis is unclear, but they have many demographic and clinical similarities.The three diseases also have some similarities in pathological mechanisms.So we suspect whether chronicTTH, FMs and MDD are belong to a same spectrum disorder.Objective:We want to evaluate the common and the difference of the three diseases from clinic features and pathological mechanisms.Although we have not exhausted the list of possible mechanisms, we focused on 2 mechanistic possibilities (neuroendocrinesystem and inflammatory pathways).Methods: ChronicTTH, FMs and MDD patients were recruited from neurology clinic of the first affiliated hospital of Anhuimedical university.Meanwhile, healthy subjects were selected as controls.We compared the sleep quality, depression mood and cognitive function of all subjects.We analyze the alterations in the hypothalamus-pituitary-adrenal (HPA) axis, hypothalamus-pituitary-thyroid (HPT) axis at multiplelevels and GnRH, pro-inflammatory cytokines of chronic TTH, FMs and MDD patients.The serum levels of corticotrophin-releasinghormone (CRH), adrenocorticotropic hormone (ACTH),cortisol, thyrotrophin releasing hormone (TRH), thyroid stimulating hormone (TSH), total triiodothyronine(TT3), total thyroxine (TT4), gonadotrophin releasing hormone (GnRH), pro-inflammatory cytokinestumor necrosis factor-α (TNF-α) and interleukin-1β(IL-1β) were tested to reveal the change of neuroendocrinesystem and inflammatory pathways which are thought to be linked with these diseases.Results: Our results showed that compared to controls, the HAMD-D (17), PSQI scores were significant higher (P
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