PURPOSE: The aim of this study was to determine whether the follow-up of pain processing recovery in hyperalgesic fibromyalgia (FM) could be objectively evaluated with brain perfusion ethyl cysteinate dimer single photon computerized tomography (ECD-SPECT) after administration of ketamine. MATERIALS AND METHODS: We enrolled 17 hyperalgesic FM women patients (48.5 +/- 11 years, range 25-63). After treatment with subcutaneous ketamine, 11 patients were considered as "good responders", with a decrease in pain intensity, evaluated by visual analog scale (VAS), greater than 50%. On the other hand, six patients were considered as "poor responders". A voxel-based analysis of regional cerebral blood flow (rCBF) was conducted (p (voxel) < 0.001uc), in the two subgroups of patients, before and after treatment, in comparison to a group of ten healthy subjects, matched for age and gender. RESULTS: In comparison to baseline brain SPECT, midbrain rCBF showed a greater increase after ketamine in the responder group than in the nonresponder group (p (cluster) = 0.016c). In agreement with the clinical response, the change in midbrain rCBF after ketamine was highly correlated with the reduction of VAS pain score (r = 0.7182; p = 0.0041). CONCLUSION: This prospective study suggests that blockade of facilitatory descending modulation of pain with ketamine can be evaluated in the periaqueductal grey with brain perfusion SPECT.
PURPOSE: The aim of this study was to determine whether the follow-up of pain processing recovery in hyperalgesic fibromyalgia (FM) could be objectively evaluated with brain perfusion ethyl cysteinate dimer single photon computerized tomography (ECD-SPECT) after administration of ketamine. MATERIALS AND METHODS: We enrolled 17 hyperalgesic FMwomenpatients (48.5 +/- 11 years, range 25-63). After treatment with subcutaneous ketamine, 11 patients were considered as "good responders", with a decrease in pain intensity, evaluated by visual analog scale (VAS), greater than 50%. On the other hand, six patients were considered as "poor responders". A voxel-based analysis of regional cerebral blood flow (rCBF) was conducted (p (voxel) < 0.001uc), in the two subgroups of patients, before and after treatment, in comparison to a group of ten healthy subjects, matched for age and gender. RESULTS: In comparison to baseline brain SPECT, midbrain rCBF showed a greater increase after ketamine in the responder group than in the nonresponder group (p (cluster) = 0.016c). In agreement with the clinical response, the change in midbrain rCBF after ketamine was highly correlated with the reduction of VAS pain score (r = 0.7182; p = 0.0041). CONCLUSION: This prospective study suggests that blockade of facilitatory descending modulation of pain with ketamine can be evaluated in the periaqueductal grey with brain perfusion SPECT.
Authors: Eric Guedj; David Taieb; Serge Cammilleri; David Lussato; Catherine de Laforte; Jean Niboyet; Olivier Mundler Journal: Eur J Nucl Med Mol Imaging Date: 2006-08-25 Impact factor: 9.236
Authors: Jaakko W Långsjö; Elina Salmi; Kaike K Kaisti; Sargo Aalto; Susanna Hinkka; Riku Aantaa; Vesa Oikonen; Tapio Viljanen; Timo Kurki; Martti Silvanto; Harry Scheinin Journal: Anesthesiology Date: 2004-05 Impact factor: 7.892
Authors: Thorsten Giesecke; Richard H Gracely; Masilo A B Grant; Alf Nachemson; Frank Petzke; David A Williams; Daniel J Clauw Journal: Arthritis Rheum Date: 2004-02
Authors: F Wolfe; H A Smythe; M B Yunus; R M Bennett; C Bombardier; D L Goldenberg; P Tugwell; S M Campbell; M Abeles; P Clark Journal: Arthritis Rheum Date: 1990-02