Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Mol Pain. 2021 Jan-Dec;17:17448069211012833. doi: 10.1177/17448069211012833.
This study aimed to investigate the levels of creatine (Cr) metabolites in the anterior cingulate cortex (ACC), thalamus, and insula of patients with fibromyalgia (FM) using proton magnetic resonance spectroscopy (MRS). The levels of Cr and phosphocreatine (PCr) relative to total Cr (tCr), which includes Cr and PCr, in the ACC, thalamus, and insula were determined using MRS in 12 patients with FM and in 13 healthy controls. The FM group had lower levels of PCr/tCr in the ACC and right insula compared to healthy controls. There was a negative correlation between Cr/tCr in the ACC and total pain levels (McGill Pain Questionnaire-Total; r = -0.579, p = 0.049) and between Cr/tCr in the left insula and affective pain levels (McGill Pain Questionnaire-Affective; r = -0.638, p = 0.047) in patients with FM. In addition, there were negative correlations between stress levels (Stress Response Inventory) and Cr/tCr in the right (r = -0.780, p = 0.005) and left thalamus (r = -0.740, p = 0.006), as well as in the right insula (r = -0.631, p = 0.028) in patients with FM. There were negative correlations between symptom levels of post-traumatic stress disorder (PTSD; PTSD checklist) and Cr/tCr in the right (r = -0.783, p = 0.004) and left thalamus (r = -0.642, p = 0.024) of patients with FM. These findings are paramount to understanding the decisive pathologies related to brain energy metabolism in patients with FM.
这项研究旨在使用质子磁共振波谱（MRS）研究纤维肌痛（FM）患者前扣带回皮质（ACC）、丘脑和脑岛中的肌酸（Cr）代谢物水平。使用 MRS 测定 12 例 FM 患者和 13 例健康对照者的 ACC、丘脑和脑岛中 Cr 和磷酸肌酸（PCr）与总 Cr（包括 Cr 和 PCr）的相对水平。FM 组的 ACC 和右侧脑岛的 PCr/tCr 水平低于健康对照组。FM 患者的 ACC 的 Cr/tCr 与总疼痛水平（McGill 疼痛问卷总评分；r=-0.579，p=0.049）呈负相关，左侧脑岛的 Cr/tCr 与情感性疼痛水平（McGill 疼痛问卷情感评分；r=-0.638，p=0.047）呈负相关。此外，FM 患者的右（r=-0.780，p=0.005）和左丘脑（r=-0.740，p=0.006）以及右脑岛（r=-0.631，p=0.028）的 Cr/tCr 与应激水平（应激反应量表）呈负相关。FM 患者右（r=-0.783，p=0.004）和左丘脑（r=-0.642，p=0.024）的 Cr/tCr 与创伤后应激障碍（PTSD）症状评分（PTSD 检查表）呈负相关。这些发现对于理解与 FM 患者大脑能量代谢相关的决定性病理学至关重要。
