Changes in metabolites in the brain of patients with fibromyalgia after treatment with an NMDA receptor antagonist

Fayed, Nicolás ; Oliván, Bárbara (Universidad de Zaragoza) ; Lopez del Hoyo, Yolanda (Universidad de Zaragoza) ; Andrés, Eva ; Perez-Yus, Mari Cruz (Universidad de Zaragoza) ; Fayed, Alicia ; Angel, Luisa F. ; Serrano-Blanco, Antoni ; Roca, Miquel ; Garcia Campayo, Javier (Universidad de Zaragoza)

Resumen: The aims of this work were to evaluate whether the treatment of patients with fibromyalgia with memantine is associated with significant changes in metabolite concentrations in the brain, and to explore any changes in clinical outcome measures. Magnetic resonance spectroscopy was performed of the right anterior and posterior insula, both hippocampi and the posterior cingulate cortex. Questionnaires on pain, anxiety, depression, global function, quality of life and cognitive impairment were used. Ten patients were studied at baseline and after three months of treatment with memantine. Significant increases were observed in the following areas: N-acetylaspartate (4.47 at baseline vs. 4.71 at three months, p¿=¿0.02) and N-acetylaspartate+N-acetylaspartate glutamate in the left hippocampus (5.89 vs. 5.98; p¿=¿0.007); N-acetylaspartate+N-acetylaspartate glutamate in the right hippocampus (5.31 vs 5.79; p¿=¿0.01) and the anterior insula (7.56 vs. 7.70; p¿=¿0.033); glutamate+glutamine/creatine ratio in the anterior insula (2.03 vs. 2.17; p¿=¿0.022) and the posterior insula (1.77 vs. 2.00; p¿=¿0.004); choline/creatine ratio in the posterior cingulate (0.18 vs. 0.19; p¿=¿0.023); and creatine in the right hippocampus (3.60 vs. 3.85; p¿=¿0.007). At the three-month follow-up, memantine improved cognitive function assessed by the Cognition Mini-Exam (31.50, SD¿=¿2.95 vs. 34.40, SD¿=¿0.6; p¿=¿0.005), depression measured by the Hamilton Depression Scale (7.70, SD¿=¿0.81 vs. 7.56, SD¿=¿0.68; p¿=¿0.042) and severity of illness measured by the Clinical Global Impression severity scale (5.79, SD¿=¿0.96 vs. 5.31, SD¿=¿1.12; p¿=¿0.007). Depression, clinical global impression and cognitive function showed improvement with memantine. Magnetic resonance spectroscopy could be useful in monitoring response to the pharmacological treatment of fibromyalgia.

Idioma: Inglés

DOI: 10.1177/1971400919857544

Año: 2019

Publicado en: Neuroradiology Journal 32, 6 (2019), 408-419
ISSN: 1971-4009

Factor impacto SCIMAGO: 0.489 - Medicine (miscellaneous) (Q2) - Radiology, Nuclear Medicine and Imaging (Q3) - Neurology (clinical) (Q3)

Financiación: info:eu-repo/grantAgreement/ES/DGA/B17-17R
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/RD16-0007-0005

Tipo y forma: Article (Published version)

Área (Departamento): Área Psicología Social (Dpto. Psicología y Sociología)
Área (Departamento): Área Psicología Básica (Dpto. Psicología y Sociología)
Área (Departamento): Area Psiquiatría (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Psicolog.Evolut.Educac (Dpto. Psicología y Sociología)