Cingulate glutamate levels associate with pain in chronic pancreatitis patients
Aims: Emerging evidence show that patients with chronic pancreatitis (CP) and abdominal pain have structural and functional alterations in the central nervous system. The aim was to investigate cerebral metabolic signatures in CP and the associations to various risk factors/clinical characteristics...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | NeuroImage: Clinical |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221315821930275X |
| _version_ | 1819040621222952960 |
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| author | Tine Maria Hansen Janusiya Anajan Muthulingam Asbjørn Mohr Drewes Søren Schou Olesen Jens Brøndum Frøkjær |
| author_facet | Tine Maria Hansen Janusiya Anajan Muthulingam Asbjørn Mohr Drewes Søren Schou Olesen Jens Brøndum Frøkjær |
| author_sort | Tine Maria Hansen |
| collection | DOAJ |
| description | Aims: Emerging evidence show that patients with chronic pancreatitis (CP) and abdominal pain have structural and functional alterations in the central nervous system. The aim was to investigate cerebral metabolic signatures in CP and the associations to various risk factors/clinical characteristics and patient outcomes. Methods: Magnetic resonance spectroscopy was used to measure brain metabolites in the anterior cingulate cortex (ACC), insula, prefrontal cortex and the parietal region in patients with CP and healthy controls. Subgroup analyses based on disease characteristics (alcoholic etiology of CP, diabetes and opioid treatment) were performed. Finally, relations to abdominal pain symptoms and quality of life scores were explored. Results: Thirty-one patients with CP (mean age 58.5 ± 9.2 years) and 23 healthy controls (54.6 ± 7.8 years) were included. Compared to healthy controls, patients had increased glutamate/creatine (glu/cre) levels in the ACC (1.24 ± 0.17 vs. 1.13 ± 0.21, p = .045) and reduced parietal N-acetylaspartate/creatine (NAA/cre) levels (1.44 ± 0.18 vs. 1.54 ± 0.12, p = .027). Patients with alcoholic etiology of CP had significant lower levels of parietal NAA/cre as compared to patients without alcoholic etiology and healthy controls (p < .006). Patients with a high level of ACC glu/cre reported more severe abdominal pain than their counterparts with a low level of ACC glu/cre (pain score 4.1 ± 2.7 vs.1.9 ± 2.3, p = .039). Conclusions: Cerebral spectroscopy revealed novel and complementary information on central pain mechanisms and alcohol mediated toxic effects in patients with CP. Our data suggest that cingulate glutamate levels associate with the patients clinical pain symptoms, while parietal NAA levels more likely associate with an alcoholic etiology of CP. Keywords: Chronic pancreatitis, Magnetic resonance imaging, Spectroscopy, Glutamate, Pain, Metabolites |
| first_indexed | 2024-12-21T09:12:00Z |
| format | Article |
| id | doaj.art-ed021624ee724eb6ab8232a8301cd88b |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-21T09:12:00Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-ed021624ee724eb6ab8232a8301cd88b2022-12-21T19:09:13ZengElsevierNeuroImage: Clinical2213-15822019-01-0123Cingulate glutamate levels associate with pain in chronic pancreatitis patientsTine Maria Hansen0Janusiya Anajan Muthulingam1Asbjørn Mohr Drewes2Søren Schou Olesen3Jens Brøndum Frøkjær4Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, DenmarkMech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, DenmarkDepartment of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, Denmark; Centre for Pancreatic Diseases, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000 Aalborg, DenmarkDepartment of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, Denmark; Centre for Pancreatic Diseases, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000 Aalborg, DenmarkMech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 11, 9000 Aalborg, Denmark; Corresponding author at: Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.Aims: Emerging evidence show that patients with chronic pancreatitis (CP) and abdominal pain have structural and functional alterations in the central nervous system. The aim was to investigate cerebral metabolic signatures in CP and the associations to various risk factors/clinical characteristics and patient outcomes. Methods: Magnetic resonance spectroscopy was used to measure brain metabolites in the anterior cingulate cortex (ACC), insula, prefrontal cortex and the parietal region in patients with CP and healthy controls. Subgroup analyses based on disease characteristics (alcoholic etiology of CP, diabetes and opioid treatment) were performed. Finally, relations to abdominal pain symptoms and quality of life scores were explored. Results: Thirty-one patients with CP (mean age 58.5 ± 9.2 years) and 23 healthy controls (54.6 ± 7.8 years) were included. Compared to healthy controls, patients had increased glutamate/creatine (glu/cre) levels in the ACC (1.24 ± 0.17 vs. 1.13 ± 0.21, p = .045) and reduced parietal N-acetylaspartate/creatine (NAA/cre) levels (1.44 ± 0.18 vs. 1.54 ± 0.12, p = .027). Patients with alcoholic etiology of CP had significant lower levels of parietal NAA/cre as compared to patients without alcoholic etiology and healthy controls (p < .006). Patients with a high level of ACC glu/cre reported more severe abdominal pain than their counterparts with a low level of ACC glu/cre (pain score 4.1 ± 2.7 vs.1.9 ± 2.3, p = .039). Conclusions: Cerebral spectroscopy revealed novel and complementary information on central pain mechanisms and alcohol mediated toxic effects in patients with CP. Our data suggest that cingulate glutamate levels associate with the patients clinical pain symptoms, while parietal NAA levels more likely associate with an alcoholic etiology of CP. Keywords: Chronic pancreatitis, Magnetic resonance imaging, Spectroscopy, Glutamate, Pain, Metaboliteshttp://www.sciencedirect.com/science/article/pii/S221315821930275X |
| spellingShingle | Tine Maria Hansen Janusiya Anajan Muthulingam Asbjørn Mohr Drewes Søren Schou Olesen Jens Brøndum Frøkjær Cingulate glutamate levels associate with pain in chronic pancreatitis patients NeuroImage: Clinical |
| title | Cingulate glutamate levels associate with pain in chronic pancreatitis patients |
| title_full | Cingulate glutamate levels associate with pain in chronic pancreatitis patients |
| title_fullStr | Cingulate glutamate levels associate with pain in chronic pancreatitis patients |
| title_full_unstemmed | Cingulate glutamate levels associate with pain in chronic pancreatitis patients |
| title_short | Cingulate glutamate levels associate with pain in chronic pancreatitis patients |
| title_sort | cingulate glutamate levels associate with pain in chronic pancreatitis patients |
| url | http://www.sciencedirect.com/science/article/pii/S221315821930275X |
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