Magnetic Resonance Spectroscopy In Evaluation Of Cerebral Chemical Changes In Fibromyalgia Patients

Fibromyalgia (FM) is a clinical syndrome defined by the presence of chronic widespread musculoskeletal pain and the presence of at least 11 of 18 body tender points that are representative of a possible enhanced sensitivity to painful stimulation and these features are often accompanied by other symptoms such as fatigue, poor sleep quality, loss of memory, and mood disturbance.The aim of this work; was to investigate the role of magnetic resonance spectroscopy to detect the differences in cerebral chemical changes between fibromyalgia patients and control subjects.Subjects and method; Thirty patients with primary fibromyalgia(27) female and( 3)males were selected from out patient clinic of Rheumatology and Rehabilitation Department,Faculty of Medicine , Zagazig University Hospitals.Patient with primary fibromyalgia fullfil the American collage of Rheumatology criteria for diagnosis of fibromyalgia (Wolfe et al., 1990).All patients and control subjects will undergo conventional structural MR imaging and additional 2D-chemical shift imaging (CSI) MR-spectroscopy sequences.Results; There are alteration in hippocampal metabolites in the brain of fibromyalgia patients as reduction of Rt hippocampal N-acetyl aspartate( NAA)and elevation of Rt hippocampal choline (cho), Rt and Lt hippocampal glutamate/glutamine (Glx), N-acetyl aspartate/creatinine (NAA/Cr), N-acetyl aspartate/choline (NAA/Cho) and left hipocampal choline/creatinine (Cho/Cr) ratio.Conclusion ;These findings outline the possible nature of FM as a systemic disorder that is mainly expressed through sensorineural dysfunction and abnormal neuroendocrine stress responses..