The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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A neurometabolite study of chronic daily headache in patients with systemic lupus erythematosus using magnetic resonance spectroscopy: comparison with fibromyalgia patients and healthy controls

  • Son, Chang-Nam (Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center) ;
  • Kim, Sang-Hyon (Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center) ;
  • Chang, Hyuk Won (Department of Radiology, Keimyung University Dongsan Medical Center) ;
  • Kim, Ji-Min (Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center)
  • Received : 2015.06.29
  • Accepted : 2015.08.26
  • Published : 2016.11.01
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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

Acknowledgement

Supported by : Keimyung University Dongsan Medical Center

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