The Clinical Journal of Pain just published a case study that evaluates the impact of fibromyalgia on hippocampal brain metabolite ratios. Researchers at the Department of Family Medicine, Anesthesiology and Psychiatry at Louisiana State University's Biomedical Research Institute based this case study on the results of previous studies that used single voxel magnetic resonance spectroscopy (1H-MRS) to reveal an association between fibromyalgia and disruptions in hippocampal brain metabolite ratios in fibromyalgia patients with no psychiatric conditions. The hippocampus is an area of the brain located in the temporal lobes and near the amygdala. It is part of the limbic system and is involved in long-term memory (it's the first area to be affected by Alzheimer's Disease) as well as spatial navigation. It is extremely vulnerable to stress.
Exposure to stress is considered a risk factor for the development and exacerbation of fibromyalgia symptoms. Basic science has demonstrated the hippocampus to be exquisitely sensitive to the effects of stressful experience, which results in changes including alterations in metabolite content and frank atrophy.
The case study detailed in the report is of a 47-year old female fibromyalgia patient who, when evaluated, was shown to have a "profound depression of the ratio of N-acetylaspartate to creatine in her right hippocampus" when she participated in another study assessing brain metabolite disturbances in fibromyalgia. This irregularity had been diagnosed using single voxel proton magnetic resonance spectroscopy. The research team came up with an individualized treatment strategy based on the "physiological abnormalities associated with the disorder and symptoms that characterized the patient's unique clinical profile." What they discovered upon evaluating her after nine months of treatment was an "improvement in her clinical profile and normalization of the NAA/Cr ratio within her right hippocampus." The researchers concluded that:
Therapeutic strategies aimed at demonstrable lesions associated with fibromyalgia appear to represent rational targets for pharmacological intervention. The rationale for development of novel pharmacotherapies for this unusual disorder is discussed.
Study Details: Clin J Pain. 2009 Nov-Dec;25(9):810-4. PMID: 19851163.
2 comments:
Is it wrong of me that I read this:
... in fibromyalgia patients with no psychiatric conditions ...
... and I think "wow, they found some of those? I thought we were all crazy?" [/sarcasm]
In all seriousness, I think this is a very interesting development. New drug therapies are sorely needed.
Any time researchers find biochemical and neurological differences in FMS patients it just reinforces what we've all known all along: this is NOT a matter of emotional disturbances but a physical malady that needs further research.
Totally agree, Sherrie. Isn't it funny that people with diseases like diabetes or cancer are not suspected of having 'psychiatric conditions'? These are seen as physical diseases. And yet FM, depression, etc...things we can't 'see'...must have a psychological cause. Hmm....
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