Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia.

Guedj E, Cammilleri S, Colavolpe C, Taieb D, de Laforte C, Niboyet J, Mundler O.

Service Central de Biophysique et de Medecine Nucleaire, Assistance Publique des Hopitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France, eric.guedj@ap-hm.fr.

PURPOSE: Ketamine has been used successfully in various proportions of fibromyalgia (FM) patients. However, the response to this specific treatment remains largely unpredictable. We evaluated brain SPECT perfusion before treatment with ketamine, using voxel-based analysis. The objective was to determine the predictive value of brain SPECT for ketamine response.

METHODS: Seventeen women with FM (48 +/- 11 years; ACR criteria) were enrolled in the study. Brain SPECT was performed before any change was made in therapy in the pain care unit. We considered that a patient was a good responder to ketamine if the VAS score for pain decreased by at least 50% after treatment. A voxel-by-voxel group analysis was performed using SPM2, in comparison to a group of ten healthy women matched for age.

RESULTS: The VAS score for pain was 81.8 +/- 4.2 before ketamine and 31.8 +/- 27.1 after ketamine. Eleven patients were considered “good responders” to ketamine. Responder and non-responder subgroups were similar in terms of pain intensity before ketamine. In comparison to responding patients and healthy subjects, non-responding patients exhibited a significant reduction in bilateral perfusion of the medial frontal gyrus. This cluster of hypoperfusion was highly predictive of non-response to ketamine (positive predictive value 100%, negative predictive value 91%).

CONCLUSION: Brain perfusion SPECT may predict response to ketamine in hyperalgesic FM patients.

PMID: 17431615 [PubMed – as supplied by publisher]

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Folllowing Rick Usher's death in December 2008, at his request in September of that year, I had agreed, as his principal contributor and an experienced journalist, to run the FMS Global News service due to his heavy commitments to music and raising research funds through this avenue. Following his sad and sudden death I hope to continue his work as he would have wished.
This entry was posted in Analgesics, Article, Awareness, Back Pain, Britain, Chronic Multisymptom Illness, Chronic Myofacial Pain, Chronic Pain, Clinical, Clinical Pain, Drugs, Europe, Feeds, Fibrohugs, Fibrohugs News, Fibromyalgia, Fibromyalgia News, Fibromyalgia News Deutschland, Fibromyalgia News France, Fibromyalgia News Israel, Fibromyalgia News Jerusalem, Fibromyalgia News Korea, Fibromyalgia News Southeast Asia, Fibromyalia News Germany, FMS Global News, Global News, Health, Hypersensitivity, Invisible Illness, Medical, Medical Journals, Medical Research, Medical University, Multiple Chemical Sensitivity, Myofacial Pain Syndrome, Narcotics, News, News Australia, News Canada, News France, News India, News Ireland, News Israel, News Jerusalem, News Korea, News Montreal, News Norway, News Quebec, News Saskatchewan, News Scotland, News Spain, News Sweden, News UK, North Carolina, Ontario, Ontario Research and Development, Ottawa, Oxford, Pain, Pain Management, Pain Management Clinic, Pain Matrix, Pharmacologic, Pharmacological, Philadelphia, Physiology, Research, RSS, Stockholm, Swedish, Tenderpoints, Toronto, Universities, US, Virginia, World, World News, World Wide, Worldwide. Bookmark the permalink.

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