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Fibromyalgia is a multidimensional chronic pain syndrome. It is thought to result
mainly from central nervous system dysfunction, but its working mechanism is not fully
understood. In this study, we applied multi-slice magnetic resonance spectroscopy
imaging (MRSI) to investigate the relationship between brain metabolite (e.g., combined
glutamate and glutamine, Glx; myo-inositol, mIno; and combined N-acetylaspartate and
N-acetylaspartylglutamate; tNAA) levels and the severity of multidimensional clinical/behavioral
metrics (e.g., pain catastrophizing, clinical pain severity, and evoked pain sensitivity)
in fibromyalgia patients (N=87). Fibromyalgia patients showed greater pain catastrophizing
and hyperalgesia compared with age-matched healthy controls (N=40). In fibromyalgia
patients, pain catastrophizing scale scores were positively correlated with Glx and
tNAA levels in the insular cortex, and were negatively correlated with mIno levels
in the posterior cingulate cortex (PCC). Clinical pain severity showed positive correlations
with Glx levels in the insular and PCC, and with tNAA levels in the anterior middle
cingulate cortex (aMCC), but negatively with mIno levels in the aMCC and thalamus.
The level of tNAA in the insular cortex, MCC, PCC, and thalamus, were negatively correlated
with evoked pain sensitivity. These results highlight the utility of MRSI in the understanding
of molecular mechanisms underlying multidimensional aspects of fibromyalgia. This
work was supported by the NIH (National Institute of Arthritis and Musculoskeletal
and Skin Diseases grant R01-AR064367, National Center for Complementary and Integrative
Health grants R01-AT007550, R61-AT009306, and P01-AT AT009965, and National Center
for Research Resources grants P41-RR14075, S10-RR021110, and S10-RR023043). Development
of MRSI pulse sequence and processing was funded by NIH/NCI grants K22CA178269 and
R01CA211080.
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© 2021 Published by Elsevier Inc.
