Brain dysfunction in fibromyalgia and somatization disorder using proton magnetic resonance spectroscopy: a controlled study.
OBJECTIVE
To evaluate the brain metabolite patterns in patients with fibromyalgia (FM) and somatization disorder (STD) compared with healthy controls through spectroscopy techniques and correlate these patterns with psychological variables.


METHODS
Design. Controlled, cross-sectional study. Sample. Patients were recruited from primary care in Zaragoza, Spain. The control group was recruited from hospital staff. Patients were administered questionnaires on pain catastrophizing, anxiety, depression, pain, quality of life, and cognitive impairment. All patients underwent Magnetic Resonance Imaging and magnetic resonance spectroscopy (MRS).


RESULTS
A significant increase was found in the glutamate + glutamine (Glx) levels in the posterior cingulate cortex (PCC): 10.73 (SD: 0.49) for FM and 9.67 (SD: 1.10) for STD 9.54 (SD: 1.46) compared with controls (P = 0.043). In the FM + STD group, a correlation between Glx and pain catastrophizing in PCC (r = 0.397; P = 0.033) and between quality of life and the myo-inositol/creatine ratio in the left hippocampus (r = -0.500; P = 0.025) was found. To conclude Glutamate seems to be relevant in the molecular processes involved in FM and STD. It also opens the door for Proton MRS ((1) H-MRS) in STD and suggests that reducing glutamatergic activity through pharmacological treatment could improve the outcome of patients with FM and STD.


CONCLUSIONS
Glutamate seems to be relevant in the molecular processes involved in FM and STD. It also opens the door for Proton MRS ((1) H-MRS) in STD and suggests that reducing glutamatergic activity through pharmacological treatment could improve the outcome of patients with FM and STD.
Department of Radiology, Quirón Hospital, Zaragoza, Spain.
N
N
Fayed
E
E
Andres
G
G
Rojas
S
S
Moreno
A
A
Serrano-Blanco
M
M
Roca
J
J
Garcia-Campayo
D000328:Adult; D001921:Brain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005356:Fibromyalgia / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D059906:Neuroimaging; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D013001:Somatoform Disorders / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology
D005973:Glutamine; D018698:Glutamic Acid