Presentation: The Change of Regional Cerebral Glucose Metabolism in Fibromyalgia Patients after One-Year Duloxetine Treatment (2007)

1528 The Change of Regional Cerebral Glucose Metabolism in Fibromyalgia Patients after One-Year Duloxetine Treatment

PURPOSE: Regional cerebral glucose metabolism was found to increase in patients of primary fibromyalgia (FM) as compared to normal healthy people by 18F-fluorodeoxyglucose (FDG) -positron emission tomography (PET) scan previously1. Our goal was to monitor the changes in regional cerebral glucose metabolism in these patients after using duloxetine hydrochloride treatment for one year by FDG-PET scan.
METHODS: Eleven female primary FM patients, who were originally recruited for a 1-year safety study of duloxetine in patients with FM syndrome. Fibromyalgia impact questionnaire (FIQ) score was used to assess the clinical response. Patients were studies with FDG-PET in a blinded manner. These images were compared with those from 11 age-matched healthy controls before and after the treatment. Statistical parametrical mapping (SPM) analysis of regional 18F-FDG was performed to analyze the cortical and subcortical brain structure.
RESULTS: The mean age of FM patients and normal control were 38.5±11.8 and 40.1±9.2 years old (p=0.72). As compared with healthy controls, the images of PET scan after 1-year duloxetine treatment by using SPM method, an increased regional cerebral glucose metabolism was shown over thalamus (including pulvinar and ventral lateral nucleus) and left caudate body in FM patients (p< 0.001). A reduced metabolism over left temporal and anterior lobe of cerebellum was also demonstrated (p< 0.001). The clinical response from 1-year duloxetine was shown with a mean FIQ score reduction of 12.94 (p=0.01). The PET scan images as compared with that before treatment, increased regional cerebral metabolism was shown over frontal, temporal, parietal, limbic lobes (cingulate gyrus), and insula on both sides (p<0.005). Meantime, a reduced metabolism over cerebellum (anterior lobe), frontal (orbital gyrus), temporal (inferior and middle gyrus), lentiform nucleus on both side, and right limbic lobe (para-hppocampal gyrus) was noted (p< 0.05). However, there was no change of regional glucose metabolism over thalamus found.
CONCLUSIONS: FDG-PET scan findings in FM patients were significantly different from healthy controls by using SPM method. After duloxetine treatment, the changed glucose metabolism within the central nervous system can possibly explain the clinical improvement in FM patients.

 J.J. Chen, None; C. Huang, None; C. Kao, None; S. Sun, None; K. Yen, None; S. Su, None; J. Wang, None.