کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6034400 | 1188754 | 2011 | 9 صفحه PDF | دانلود رایگان |

Reliable detection of metabolic changes in the brain in vivo induced by chronic low back pain may provide improved understanding of neurophysiological mechanisms underlying the manifestation of chronic pain. In the present study, absolute concentrations of N-acetyl-aspartate (NAA), creatine (Cr), total choline (tCho), myo-inositol (mI), glutamate (Glu) and glutamine (Gln) were measured in three different pain processing cortical regions (anterior insula, anterior cingulate cortex, and thalamus) of ten patients with non-specific chronic low back pain by means of proton MR spectroscopy (1H-MRS) and compared to matched healthy controls. Significant decrease of Glu was observed in the anterior cingulate cortex of patients. Patients also revealed a trend of decreasing Gln concentrations in all investigated brain areas. Reductions of NAA were observed in the patient group in anterior insula and in anterior cingulated cortex, whereas mI was reduced in anterior cingulated cortex and in thalamus of patients. Reduced concentrations of Glu and Gln may indicate disordered glutamatergic neurotransmission due to prolonged pain perception, whereas decrease of NAA and mI may be ascribed to neuron and glial cell loss. No significant changes were found for Cr. The morphological evaluation of anatomic brain data revealed a significantly decreased WM volume of 17% (p < 0.05) as well as a non significant trend for GM volume increase in the anterior insula of patients.
Research Highlightsâº1H-MRS provides a means of detecting chronic pain related metabolic changes in brain. âºDecreased Glu/Gln in pain patients' anterior cingulum (aCC) and insula (aI). âºEvidence for cell loss due to reduced NAA and mI in patients' aCC, aI and thalamus. âºReduced white matter volume in pain patients' aI and aCC. âºEvidence for gray matter volume increase in patients' aI.
Journal: NeuroImage - Volume 54, Issue 2, 15 January 2011, Pages 1315-1323