CEREBRAL METABOLISM IN PATIENT WITH FIBROMYALGIA: A 3 TESLA STUDY

PURPOSE Fibromyalgia (FM) is a chronic widespread pain condition that is thought to arise from augmentation of central neural activity. This study was carried out to investigate the dorsolateral prefrontal cortex (DLPFC) and thalamus metabolites level in patients with FM using proton magnetic resonance spectroscopy (1H-MRS) and to compare these findings with healthy controls (HC).METHODS Six female patients with FM, and 10 healthy age-matched female controls underwent one sessions of Single-voxel H-MRS performed on a General Electric 3.0 T MR scanner (GE, Milwaukee, WI). Patients and controls were receiving no medications known to affect cognitive functioning or central nervous system metabolites. H-MRS was used to assess metabolites level, in particular Glutamate plus Glutamine (Glx) and Glutamate (Glu) concentrations and their ratios on Creatine from both DLPFC and thalami. RESULTS Glx/Cr and Glu/Cr levels of both DLPFC, in particular in the left side, were significantly different between patients and controls (p < 0.01). While the NAA/Cr, Cho/Cr, Cho/Cr, mI/Cr, Gaba/Cr and Lac/Cr ratio showed no differences. No significant differences were found between metabolities and their ratios in both thalami. CONCLUSIONS Our data suggest that there are baseline differences in the variability of the brain metabolites concentrations between patients with FM and HC in DLPFC. The most significant difference were in Glx/Cr and Glu/Cr suggesting that this metabolites are implicated in pain perception. These findings provide direct evidence of abnormal brain chemistry in FM, which may be useful in diagnosis and future development of more effective pharmacological treatments.