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Comparative Study
. 2016 Nov;31(6):1171-1177.
doi: 10.3904/kjim.2015.196. Epub 2016 Mar 25.

A neurometabolite study of chronic daily headache in patients with systemic lupus erythematosus using magnetic resonance spectroscopy: comparison with fibromyalgia patients and healthy controls

Chang-Nam Son  1 , Sang-Hyon Kim  1 , Hyuk Won Chang  2 , Ji-Min Kim  1
Affiliations
Comparative Study

A neurometabolite study of chronic daily headache in patients with systemic lupus erythematosus using magnetic resonance spectroscopy: comparison with fibromyalgia patients and healthy controls

Chang-Nam Son et al. Korean J Intern Med. 2016 Nov.

Abstract

Background/aims: Neuropsychiatric systemic lupus erythematosus (SLE) includes a broad spectrum of neurologic and psychiatric manifestations. One of the most commonly observed neuropsychiatric symptoms is headache. However, the lack of specific clinical distinctions for headache in SLE has made it difficult to elucidate its pathophysiology. The aim of this study is to evaluate the neurometabolic changes using Proton Magnetic Resonance Spectroscopy (1H-MRS) in patients with SLE who suffer from chronic daily headache (CDH).

Methods: SLE and fibromyalgia patients with CDH and healthy controls were recruited (n = 9, n = 5, and n = 6, respectively). 1H-MRS metabolite ratios were evaluated in bilateral basal ganglia (BG) and bilateral peritrigonal white matter (PWM).

Results: 1H-MRS showed a significantly decreased N-acetylaspartate (NAA)/creatine (Cr) ratio in right BG in SLE patients with CDH compared to fibromyalgia patients with CDH and normal controls (p = 0.029 and p = 0.020, respectively). Left PWM NAA/Cr and choline/Cr ratios in SLE patients with CDH were lower than those in fibromyalgia patients with CDH (p = 0.019 and p = 0.029, respectively).

Conclusions: This study suggests the possibility that CDH in patients with SLE might be associated with neuronal dysfunction and neurometabolic changes.

Keywords: Headache disorders; Lupus erythematosus, systemic; Proton magnetic resonance spectroscopy.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Images illustrating voxel placement at the level of the basal ganglia and the peritrigonal white matter (A) and the spectral pattern of lupus patient with chronic daily headache in basal ganglia (B). NAA, N-acetylaspartate; Cr, creatine; Cho, choline.
See this image and copyright information in PMC

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