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99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

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Abstract

Purpose

Neuro-imaging studies with 99mTc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. 99mTc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using 99mTc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients.

Methods

Eighteen hyperalgesic FM women (mean age 49 years, range 25–63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82±4 at the time of the SPECT study.

Results

Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices.

Conclusion

In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment.

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Authors and Affiliations

  1. Service Central de Biophysique et de Médecine Nucléaire, Assistance Publique des Hôpitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France

    Eric Guedj, David Taieb, Serge Cammilleri, David Lussato, Catherine de Laforte & Olivier Mundler

  2. Unité d’Etude et de Traitement de la Douleur, Clinique La Phocéanne, 143 route des 3 Lucs, 13012, Marseille, France

    Jean Niboyet

Authors
  1. Eric Guedj
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  2. David Taieb
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  3. Serge Cammilleri
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  4. David Lussato
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  5. Catherine de Laforte
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  6. Jean Niboyet
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  7. Olivier Mundler
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Corresponding author

Correspondence to Eric Guedj.

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Guedj, E., Taieb, D., Cammilleri, S. et al. 99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia. Eur J Nucl Med Mol Imaging 34, 130–134 (2007). https://doi.org/10.1007/s00259-006-0174-7

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  • DOI: https://doi.org/10.1007/s00259-006-0174-7

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