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使用磁共振波谱评估腰椎疾病引起的疼痛：初步报告。

Assessment of pain due to lumbar spine diseases using MR spectroscopy: a preliminary report.

作者信息

Yabuki Shoji, Konno Shin-ichi, Kikuchi Shin-ichi

机构信息

Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.

出版信息

J Orthop Sci. 2013 May;18(3):363-8. doi: 10.1007/s00776-013-0357-6. Epub 2013 Feb 27.

DOI:10.1007/s00776-013-0357-6
PMID:23443203
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3661905/
Abstract

BACKGROUND DATA

There is a considerable difference in pain perception among individuals. In patients with chronic pain, recent studies using fMRI, PET and SPECT have shown that functional changes mainly occurred in the anterior cingulate cortex (ACC), prefrontal cortex (PFC) and thalamus. Brain magnetic resonance spectroscopy (MRS) can evaluate brain chemistry by measuring metabolites such as N-acetyl aspartate (NAA). The purpose of this study was to analyze whether brain MRS could assess pain due to lumbar spine diseases.

METHODS

NAA levels were determined relative to the concentration of creatine/phosphocreatine complex (Cr) and choline (Cho), which is commonly used as an internal standard. The NAA/Cr and NAA/Cho ratios in the ACC, PFC and thalamus were compared between six patients with unilateral pain (left side) and six control patients without pain.

RESULTS

In the right thalamus (contralateral side to symptom), the NAA/Cr in the patients with pain was statistically significantly lower compared with the control patients (p < 0.05). Also, in the right thalamus, the NAA/Cho in pain patients was significantly lower compared with controls (p < 0.01). When considering just the right thalamus, there were statistically significant correlations between the numerical rating scale for pain (NRS) and NAA values.

CONCLUSIONS

Lumbar pain can be assessed indirectly by analyzing the decrease in NAA concentration in the thalamus.

摘要

背景数据

个体之间的疼痛感知存在相当大的差异。在慢性疼痛患者中，最近使用功能磁共振成像（fMRI）、正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）的研究表明，功能变化主要发生在前扣带回皮质（ACC）、前额叶皮质（PFC）和丘脑。脑磁共振波谱（MRS）可以通过测量诸如N-乙酰天门冬氨酸（NAA）等代谢物来评估脑化学。本研究的目的是分析脑MRS是否能够评估腰椎疾病引起的疼痛。

方法

相对于常用作内标的肌酸/磷酸肌酸复合物（Cr）和胆碱（Cho）的浓度来测定NAA水平。比较了6例单侧疼痛（左侧）患者和6例无疼痛对照患者ACC、PFC和丘脑中的NAA/Cr和NAA/Cho比值。

结果

在右侧丘脑（症状对侧），疼痛患者的NAA/Cr与对照患者相比在统计学上显著降低（p < 0.05）。同样，在右侧丘脑中，疼痛患者的NAA/Cho与对照相比显著降低（p < 0.01）。仅考虑右侧丘脑时，疼痛数字评定量表（NRS）与NAA值之间存在统计学上的显著相关性。

结论

通过分析丘脑中NAA浓度的降低可以间接评估腰痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/55fd7c89e753/776_2013_357_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/bdb15fa50189/776_2013_357_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/190565aef30b/776_2013_357_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/b58a1c13a347/776_2013_357_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/55fd7c89e753/776_2013_357_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/bdb15fa50189/776_2013_357_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/190565aef30b/776_2013_357_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/b58a1c13a347/776_2013_357_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fee/3661905/55fd7c89e753/776_2013_357_Fig4_HTML.jpg

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