Department of Psychiatry, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Mol Pain. 2021 Jan-Dec;17:1744806921990946. doi: 10.1177/1744806921990946.
This study aimed to investigate distinct neurometabolites in the anterior cingulate cortex (ACC), right and left thalamus, and insula of patients with fibromyalgia (FM) compared with healthy controls using proton magnetic resonance spectroscopy (MRS). Levels of N-acetylaspartate (NAA), N-acetylaspartylglutamate (NAAG), total NAA (tNAA = NAA + NAAG), myo-inositol (ml), glutamine (Gln), glutamate (Glu), Glx (Glu + Gln), glycerophosphocholine (GPC), total choline (tCho = GPC + phosphocholine) and glutathione (GSH) levels relative to total creatine (tCr) levels including creatine (Cr) and phosphocreatine (PCr) and relative to Cr levels were determined in the ACC, right and left thalamus, and insula in 12 patients with FM and 13 healthy controls using MRS. In the ACC, NAA/tCr (P = 0.028) and tCho/tCr (P = 0.047) were higher in patients with FM. In the right and left insula, tNAA/tCr (P = 0.019, P = 0.007, respectively) was lower in patients with FM. Patients with FM showed lower levels of ml/Cr (P = 0.037) in the right insula than healthy controls. These findings are paramount to understand decisive pathophysiological mechanisms related to abnormal features in the brain and parasympathetic nervous systems in FM. We suggest that the results presented herein may be essential to understand hidden pathological mechanisms and also life system potential as protective and recovering metabolic strategies in patients with FM.
这项研究旨在使用质子磁共振波谱（MRS）比较纤维肌痛（FM）患者和健康对照者在前扣带回皮质（ACC）、右侧和左侧丘脑以及岛叶中的不同神经代谢物。使用 MRS 确定了 12 名 FM 患者和 13 名健康对照者在 ACC、右侧和左侧丘脑以及岛叶中 N-乙酰天冬氨酸（NAA）、N-乙酰天门冬氨酸谷氨酸盐（NAAG）、总 N-乙酰天冬氨酸（tNAA=NAA+NAAG）、肌醇（ml）、谷氨酰胺（Gln）、谷氨酸（Glu）、Glu+Gln（Glx）、甘油磷酸胆碱（GPC）、总胆碱（tCho=GPC+磷酸胆碱）和谷胱甘肽（GSH）与总肌酸（tCr）的相对水平，包括肌酸（Cr）和磷酸肌酸（PCr）以及与 Cr 水平的相对水平。在 ACC 中，FM 患者的 NAA/tCr（P=0.028）和 tCho/tCr（P=0.047）更高。在右侧和左侧岛叶中，FM 患者的 tNAA/tCr 更低（P=0.019、P=0.007）。FM 患者的右侧岛叶 ml/Cr 水平较低（P=0.037）。这些发现对于理解与 FM 中大脑和副交感神经系统异常特征相关的决定性病理生理机制至关重要。我们认为，本文提出的结果对于理解隐藏的病理机制以及作为 FM 患者保护和恢复代谢策略的生命系统潜力可能是必不可少的。
