title: 1H-MR spectroscopic detection of metabolic changes in pain processing brain regions in the presence of non-specific chronic low back pain.
abstract: 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 ((1)H-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.
authors.affiliation: Department of Diagnostic and Interventional Radiology I, Jena University Hospital, Jena, Germany. Alexander.Gussew@med.uni-jena.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Gussew
authors.forename: Reinhard
authors.initials: R
authors.lastname: Rzanny
authors.forename: Daniel
authors.initials: D
authors.lastname: Güllmar
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Scholle
authors.forename: Jürgen R
authors.initials: JR
authors.lastname: Reichenbach
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000032:analysis; D001921:Brain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D001923:Brain Chemistry; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D005260:Female; D018698:Glutamic Acid / Q000032:analysis; D005973:Glutamine / Q000032:analysis; D006801:Humans; D007294:Inositol / Q000032:analysis; D017116:Low Back Pain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D058748:Pain Perception / Q000502:physiology*; D055815:Young Adult
chemical_list: D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; D003401:Creatine; D002794:Choline