Kwiatek R, Barnden L, Tedman R, Jarrett R, Chew J, Rowe C, Pile K
The Queen Elizabeth Hospital, Adelaide, Australia.
Arthritis Rheum. 2000 Dec;43(12):2823-33. doi: 10.1002/1529-0131(200012)43:12<2823::AID-ANR24>3.0.CO;2-E.
To determine whether regional cerebral blood flow (rCBF) is abnormal in any cerebral structure of women with fibromyalgia (FM), following a report that rCBF is reduced in the thalami and heads of caudate nuclei in FM.
Seventeen women with FM and 22 healthy women had a resting single-photon-emission computed tomography (SPECT) brain scan to assess rCBF and a T1-weighted magnetic resonance imaging (MRI) scan to enable precise anatomic localization. Additionally, all participants underwent 2 manual tender point examinations and completed a set of questionnaires evaluating clinical features. SPECT scans were analyzed for differences in rCBF between groups using statistical parametric mapping (SPM) and regions of interest (ROIs) manually drawn on coregistered MRI.
Compared with control subjects, the rCBF in FM patients was significantly reduced in the right thalamus (P = 0.006), but not in the left thalamus or head of either caudate nucleus. SPM analysis indicated a statistically significant reduction in rCBF in the inferior pontine tegmentum (corrected P = 0.006 at the cluster level and corrected P = 0.023 for voxel of maximal significance), with consistent findings from ROI analysis (P = 0.003). SPM also detected a reduction in rCBF on the perimeter of the right lentiform nucleus. No correlations were found with clinical features or indices of pain threshold.
Our finding of a reduction in thalamic rCBF is consistent with findings of functional brain imaging studies of other chronic clinical pain syndromes, while our finding of reduced pontine tegmental rCBF is new. The pathophysiologic significance of these changes in FM remains to be elucidated.
有报告称纤维肌痛（FM）患者丘脑和尾状核头部的局部脑血流量（rCBF）减少，本研究旨在确定FM女性患者的任何脑结构中rCBF是否异常。
17名FM女性患者和22名健康女性进行了静息状态下的单光子发射计算机断层扫描（SPECT）脑扫描以评估rCBF，并进行了T1加权磁共振成像（MRI）扫描以实现精确的解剖定位。此外，所有参与者均接受了2次手动压痛点检查，并完成了一系列评估临床特征的问卷。使用统计参数映射（SPM）分析SPECT扫描结果，以比较两组之间rCBF的差异，并在配准后的MRI上手动绘制感兴趣区域（ROI）。
与对照组相比，FM患者右侧丘脑的rCBF显著降低（P = 0.006），但左侧丘脑或双侧尾状核头部的rCBF未降低。SPM分析表明脑桥被盖下部的rCBF有统计学意义的降低（在簇水平校正P = 0.006，在最大意义体素处校正P = 0.023），ROI分析也得到了一致的结果（P = 0.003）。SPM还检测到右侧豆状核周边的rCBF降低。未发现与临床特征或疼痛阈值指标存在相关性。
我们发现丘脑rCBF降低与其他慢性临床疼痛综合征的功能性脑成像研究结果一致，而脑桥被盖部rCBF降低这一发现是新的。FM中这些变化在病理生理学上的意义仍有待阐明。
