title: A neurometabolite study of chronic daily headache in patients with systemic lupus erythematosus using magnetic resonance spectroscopy: comparison with fibromyalgia patients and healthy controls.
abstract: OBJECTIVE
  Neuropsychiatric systemic lupus erythematosus (SLE) includes a broad spectrum of neurologic and psychiatric manifestations. One of the most commonly observed neuropsychiatric symptoms is headache. However, the lack of specific clinical distinctions for headache in SLE has made it difficult to elucidate its pathophysiology. The aim of this study is to evaluate the neurometabolic changes using Proton Magnetic Resonance Spectroscopy (1H-MRS) in patients with SLE who suffer from chronic daily headache (CDH).
  
  
  METHODS
  SLE and fibromyalgia patients with CDH and healthy controls were recruited (n = 9, n = 5, and n = 6, respectively).1H-MRS metabolite ratios were evaluated in bilateral basal ganglia (BG) and bilateral peritrigonal white matter (PWM).
  
  
  RESULTS
  1H-MRS showed a significantly decreased N-acetylaspartate (NAA)/creatine (Cr) ratio in right BG in SLE patients with CDH compared to fibromyalgia patients with CDH and normal controls (p= 0.029 andp= 0.020, respectively). Left PWM NAA/Cr and choline/Cr ratios in SLE patients with CDH were lower than those in fibromyalgia patients with CDH (p= 0.019 andp= 0.029, respectively).
  
  
  CONCLUSIONS
  This study suggests the possibility that CDH in patients with SLE might be associated with neuronal dysfunction and neurometabolic changes.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Chang-Nam
authors.initials: CN
authors.lastname: Son
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Sang-Hyon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyuk Won
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Ji-Min
authors.initials: JM
authors.lastname: Kim
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005356:Fibromyalgia / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D020773:Headache Disorders / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D055432:Metabolomics / Q000379:methods*; D011237:Predictive Value of Tests; D066244:Proton Magnetic Resonance Spectroscopy
chemical_list: D015415:Biomarkers
keywords: Headache disorders; Lupus erythematosus, systemic; Proton magnetic resonance spectroscopy