Metabolic Abnormalities in Pain-Processing Regions of Patients with
Fibromyalgia: A 3T MR Spectroscopy Study.
Feraco P, Bacci A, Pedrabissi F, Passamonti L, Zampogna G, Pedrabissi
F, Malavolta N, Leonardi M.
Department of Neuroradiology, Bellaria Hospital, Bologna, Italy; U.O.S
Reumatologia, Azienda Ospedaliera Universitaria Policlinico S.
Orsola-Malpighi, Bologna, Italy; Neuroimaging Research Unit, Institute
of Neurological Sciences, National Research Council, Catanzaro, Italy;
Clinica Reumatologica, Dipartimento di Medicina Interna, Universit=E0
degli Studi di Genova, Italy; and Dipartimento di Psicologia dello
Sviluppo e Socializzazione, Facolt=E0 di Psicologia, Universit=E0 di
Padova, Padova, Italy.
Abstract
BACKGROUND AND PURPOSE:
A growing body of evidence suggests the involvement of the brain in
FM. The purpose of this proton MRS study was to test the hypothesis
that there are metabolic alterations in some brain regions processing
pain (VLPFC and thalamus) in patients with FM compared with HC.
MATERIALS AND METHODS:
Twelve patients with FM (30-54 years of age; mean age, 43.2 years),
and 12 HC, matched for age and sex, underwent 1 session of
single-voxel MRS performed on a 3T MR imaging scanner. MRS spectra
were acquired with a PRESS for localization. The raw data from each
spectrum was evaluated with an LCModel. T tests were used to evaluate
differences of brain metabolites between groups. The Pearson
correlation tested the relationship of metabolite ratios and clinical
symptoms.
RESULTS:
Glx/Cr and Glu/Cr ratios within the VLPFC of both sides were
significantly higher in patients than in HC (P < .01). No significant
differences of metabolites between groups were found in the thalami.
Positive correlations were found between Glu/Cr in the left thalamus
and the VAS for pain (r =3D 0.730, P =3D .007) and between mIns/Cr in the
right VLPFC and the VAS for pain (r =3D 0.607, P =3D .037) and the FIQ (r
=3D 0.719, P =3D .008).
CONCLUSIONS:
The presence of elevated Glu/Cr levels in VLPFC strengthens the
opinion that a complex neurophysiologic imbalance of different brain
areas involved in pain processing underlies FM. These data may be
useful in the diagnosis and development of more effective
pharmacologic treatments.
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