核磁気共鳴スペクトロスコピー（MRS）を用いたCRPS の局所脳機能評価

概要

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　Recently brain imaging studies have shown that patients with chronic pain have an altered cortical processing of nociceptive inputs. We evaluated brain metabolites in patients with complex regional pain syndrome (CRPS) using MR spectroscopy.　Absolute concentrations of N-acetylaspartate (NAA) and choline (Cho) were measured in anterior cingulate (ACC) and prefrontal cortices (PFC) of patients and volunteers as matched control. Psychological aspects of patients were also evaluated with Hospital Anxiety and Depression (HAD) scale, in addition to the intensity of pain by visual analog scale.　In the ACC, CRPS patients had a significant decrease of NAA and a significant increase of Cho compared to the control. Furthermore, patients with anxiety scored by HAD scale had reduced NAA concentration in ACC compared to the patients without anxiety. In the PFC,there was a reduction of NAA in the patients compared with that in control. No correlation was observed between intensity of pain and these metabolites.　These results suggest that metabolite changes in ACC and PFC could reflect the pathogenesis of CRPS.
日本疼痛学会の論文