Neurologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany.
J Neurol. 2011 Jan;258(1):123-31. doi: 10.1007/s00415-010-5704-3. Epub 2010 Aug 25.
A close association between pain, depression and disability has been shown. However, the neurometabolic correlates of this association have been barely investigated in disease states. Episodic cluster headache is a severe headache syndrome and represents a suitable disease model for the investigation of episodic pain. The aim of this study was to explore the relationship between depression and disability as well as pain scores and brain metabolism in patients with cluster headache during the disease period with repetitive pain attacks, but outside an acute attack. Thirteen patients with cluster headache underwent 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission (FDG-PET) and completed questionnaires on depression and disability as well as a pain visual analogue rating scale (VAS). A positive correlation between the depression scores and glucose metabolism was observed in the insular cortex. A positive correlation between the pain disability scores and brain metabolism was detected in the amygdala. The same applied to the pain visual analogue rating scores. Our data underline the association between severe episodic pain, depression and disability. In addition to this clinical observation, our results stress the importance of the insula and amygdala in pain processing and suffering.
已经证明疼痛、抑郁和残疾之间存在密切关联。然而，在疾病状态下，这种关联的神经代谢相关性几乎没有被研究过。阵发性丛集性头痛是一种严重的头痛综合征，是研究阵发性疼痛的合适疾病模型。本研究旨在探讨丛集性头痛患者在反复发作性疼痛期但不在急性发作期时抑郁和残疾以及疼痛评分与大脑代谢之间的关系。13 名丛集性头痛患者接受了 2-[氟-18]-氟代-2-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET），并完成了抑郁和残疾问卷以及疼痛视觉模拟评分（VAS）。在岛叶皮层观察到抑郁评分与葡萄糖代谢之间存在正相关。在杏仁核中检测到疼痛残疾评分与大脑代谢之间存在正相关。疼痛视觉模拟评分也适用。我们的数据强调了严重阵发性疼痛、抑郁和残疾之间的关联。除了这种临床观察外，我们的结果还强调了脑岛和杏仁核在疼痛处理和痛苦中的重要性。
