Korean J Intern Med.  2016 Nov;31(6):1171-1177. 10.3904/kjim.2015.196.

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 CN
• Kim SH
• Chang HW
• Kim JM

• KMID: 2382867
• DOI: http://doi.org/10.3904/kjim.2015.196

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.

Keyword

Proton magnetic resonance spectroscopy; Lupus erythematosus, systemic; Headache disorders

MeSH Terms

Basal Ganglia
Fibromyalgia*
Headache
Headache Disorders*
Humans
Lupus Erythematosus, Systemic*
Lupus Vasculitis, Central Nervous System
Magnetic Resonance Spectroscopy*
Neurons
Proton Magnetic Resonance Spectroscopy
White Matter