Department of Neuroradiology, Bellaria Hospital, Bologna, Italy.
AJNR Am J Neuroradiol. 2011 Oct;32(9):1585-90. doi: 10.3174/ajnr.A2550. Epub 2011 Jul 28.
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.
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.
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 = 0.730, P = .007) and between mIns/Cr in the right VLPFC and the VAS for pain (r = 0.607, P = .037) and the FIQ (r = 0.719, P = .008).
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.
越来越多的证据表明大脑参与了纤维肌痛（FM）的发生。本质子磁共振波谱（MRS）研究旨在验证假设，即 FM 患者在处理疼痛的某些大脑区域（额下回背外侧和丘脑）存在代谢改变。
12 例 FM 患者（30-54 岁；平均年龄 43.2 岁）和 12 例健康对照者（年龄和性别相匹配）接受了单次体素 MRS 检查，在 3T 磁共振成像扫描仪上进行。采用 PRESS 进行定位采集 MRS 谱。使用 LCModel 评估每个谱的原始数据。采用 t 检验评估组间脑代谢物的差异。Pearson 相关性检验代谢物比值与临床症状的关系。
双侧额下回背外侧的 Glx/Cr 和 Glu/Cr 比值在患者中明显高于健康对照组（P <.01）。丘脑内各组间代谢物无显著差异。左侧丘脑 Glu/Cr 与疼痛视觉模拟评分（VAS）呈正相关（r = 0.730，P =.007），右侧额下回背外侧 mIns/Cr 与疼痛 VAS（r = 0.607，P =.037）和纤维肌痛影响问卷（FIQ）（r = 0.719，P =.008）呈正相关。
额下回背外侧 Glu/Cr 水平升高的存在进一步支持了这样一种观点，即不同参与疼痛处理的大脑区域的复杂神经生理失衡是 FM 的基础。这些数据可能有助于诊断和开发更有效的药物治疗方法。
