RESUMO
Proton magnetic resonance spectroscopy (1H-MRS) has shown inconsistent alterations in the brain metabolites of individuals with chronic pain. We used 3T 1H-MRS to investigate the brain metabolites in the anterior cingulate cortex and thalamus of 22 patients with chronic mild pain and no gait disturbance and 22 healthy controls. The chronic-pain group included patients with chronic low back pain and/or osteoarthritis but none suffering from hypersensitivity. There were no significant between group-differences in glutamate, glutamate plus glutamine (Glx), N-acetylaspartate, glycerophosphorylcholine (GPC), glutamine, creatine plus phosphocreatine, or myo-inositol in the anterior cingulate cortex, but the patients showed a significant decrease in GPC, but not other metabolites, in the thalamus compared to the controls. The GPC values in the patients' thalamus were significantly correlated with pain components on the Short-Form McGill Pain Questionnaire (SF-MPQ-2) and affective empathy components on the Questionnaire of Cognitive and Affective Empathy (QCAE). The GPC in the patients' anterior cingulate cortex showed significant correlations with cognitive empathy components on the QCAE. Myo-inositol in the controls' anterior cingulate cortex and Glx in the patients' thalamus each showed significant relationships with peripheral responsivity on the QCAE. These significances were not significant after Bonferroni corrections. These preliminary findings indicate important roles of GPC, myo-inositol, and Glx in the brain of patients with chronic mild pain.
Assuntos
Dor Crônica , Empatia , Giro do Cíngulo , Tálamo , Humanos , Giro do Cíngulo/metabolismo , Giro do Cíngulo/diagnóstico por imagem , Feminino , Masculino , Dor Crônica/metabolismo , Dor Crônica/diagnóstico por imagem , Pessoa de Meia-Idade , Tálamo/metabolismo , Tálamo/diagnóstico por imagem , Empatia/fisiologia , Adulto , Inositol/metabolismo , Espectroscopia de Prótons por Ressonância Magnética , Idoso , Ácido Glutâmico/metabolismo , Glutamina/metabolismo , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Medição da DorRESUMO
Proton magnetic resonance spectroscopy (1H-MRS) has shown inconsistent alterations in brain metabolites of adults with autism spectrum disorder (ASD). We investigated brain metabolites in the medial prefrontal cortex and amygdala of 24 drug-naive adults with ASD and no intellectual disability and 24 non-ASD control subjects, using 3 T 1H-MRS. Adults with ASD showed no significant differences from control in glutamate, glutamate plus glutamine, N-acetylaspartate, glycerophosphorylcholine plus phosphorylcholine, creatine plus phosphocreatine, or myo-inositol in either region. However, ASD subjects did show significant correlations of localized brain metabolites with autistic traits, empathy deficits, and personality traits using the Autism-Spectrum Quotient, Questionnaire of Cognitive and Affective Empathy, Interpersonal Reactivity Index, and NEO Personality Inventory-Revised. These findings should be taken as preliminary or exploratory.
RESUMO
A case in which radiotherapy was requested for bone metastases from prostate carcinoma after hormonal and radiation therapy and diagnosed as insufficiency fracture of the sacrum on bone scan was reported. A 78-year-old man underwent endocrine therapy with luteinizing hormone releasing hormone agonists and radical radiotherapy toward pelvis for prostate cancer. The onset of buttock pain started from the nine-month after the beginning of radiotherapy, and was diagnosed as sacrum metastasis by MRI, and radiotherapy was requested again for pain control. However, on bone scan, butterfly-like changed accumulation was noted, therefore sacrum insufficiency fracture was suspected. Addition of CT inspection and reconfirmation of MRI were performed, and bone metastases became negative, and serial observation was performed of the painkilling effect after that. No tumor marker rise was seen after five months without sigh of new bone metastases and the final diagnosis became insufficient fracture. In order to avoid unnecessary treatment, we think that the view of bone scintigram for diagnosis of sacrum insufficient fracture should be known.
Assuntos
Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/etiologia , Neoplasias da Próstata/radioterapia , Sacro/lesões , Medronato de Tecnécio Tc 99m , Idoso , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Humanos , Masculino , Neoplasias da Próstata/tratamento farmacológico , Cintilografia , Radioterapia/efeitos adversosRESUMO
In patients with lung cancer of the lower lobes and liver cancer, treatment volume including respiratory motion is an important therapeutic problem. We developed a voluntary breath-hold system using pictures and voice messages so as to reduce the excessive safety margin that covers respiratory motion. The system consists of two sets of monitor and speaker, and a computer and software for control without direct connection to a linear accelerator. When the patient repeatedly holds his or her breath in response to a picture and voice message, irradiation is manually performed and then proceeds intermittently. Although safety problems remain to be solved because of off-line, synchronized irradiation with our system is simple, inexpensive, and could be widely used. It also would be expected to reduce the tumor target volume around the diaphragm.