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Follow-up of pain processing recovery after ketamine in hyperalgesic fibromyalgia patients using brain perfusion ECD-SPECT

  • Eric GuedjEmail author
  • Serge Cammilleri
  • Cécile Colavolpe
  • Catherine de Laforte
  • Jean Niboyet
  • Olivier Mundler
Short communication

Abstract

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.

Keywords

Brain SPECT Voxel-based analysis Pain Fibromyalgia Ketamine 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Eric Guedj
    • 1
    Email author
  • Serge Cammilleri
    • 1
  • Cécile Colavolpe
    • 1
  • Catherine de Laforte
    • 1
  • Jean Niboyet
    • 2
  • Olivier Mundler
    • 1
  1. 1.Service Central de Biophysique et de Médecine NucléaireAssistance Publique des Hôpitaux de Marseille, Centre Hospitalo-Universitaire de la TimoneMarseilleFrance
  2. 2.Unité d’Etude et de Traitement de la DouleurClinique La PhocéanneMarseilleFrance

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