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【medical-news】大脑谷氨酸水平升高导致纤维肌痛

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Pain In Fibromyalgia Is Linked To Changes In Brain Molecule

ScienceDaily (Mar. 13, 2008) — Researchers at the University of Michigan Health System have found a key linkage between pain and a specific brain molecule, a discovery that lends new insight into fibromyalgia, an often-baffling chronic pain condition.

In patients with fibromyalgia, researchers found, pain decreased when levels of the brain molecule called glutamate went down. The results of this study, which appears in the journal Arthritis and Rheumatism, could be useful to researchers looking for new drugs that treat fibromyalgia, the authors say.

"If these findings are replicated, investigators performing clinical treatment trials in fibromyalgia could potentially use glutamate as a 'surrogate' marker of disease response," says lead author Richard E. Harris, Ph.D., research assistant professor in the Division of Rheumatology at the U-M Medical School's Department of Internal Medicine and a researcher at the U-M Chronic Pain and Fatigue Research Center.

The molecule glutamate is a neurotransmitter, which means it conveys information between neurons in the nervous system. When glutamate is released from one neuron, it diffuses across the space between cells, and then binds to receptors on the next neuron in line and causes the cell to become excited, or to be more active.

This molecule was suspected to play a role in fibromyalgia because previous studies had shown that some brain regions in fibromyalgia patients appear to be highly excited. One such region is the insula.

In functional magnetic resonance imaging (fMRI) studies, researchers at U-M had previously shown that the insula displays augmented activity in fibromyalgia, which means neurons in these patients are more active in this part of the brain. The U-M team hypothesized, Harris notes, that more activity among these neurons might be related to the level of glutamate in this region.

To gauge the linkage between pain and glutamate, the researchers used a non-invasive brain imaging techinique called proton magnetic resonance spectroscopy (H-MRS). H-MRS was performed once before and once following a four-week course of acupuncture or "sham" acupuncture.

Researchers used either acupuncture or sham acupuncture to reduce pain symptoms. The sham procedure involved using a sharp device to prick the skin in order to mimic real acupuncture sensations.

Following the four weeks of treatment, both clinical and experimental pain reported were reduced significantly. More importantly the reduction in both pain outcomes was linked with reductions in glutamate levels in the insula: patients with greater reductions in pain showed greater reductions in glutamate. This suggests that glutamate may play a role in this disease and that it could potentially be used as a biomarker of disease severity.

Because of the small number of participants in this study, further research should be conducted to verify the role of glutamate in fibromyalgia, Harris says.

The senior author of the study was Daniel J. Clauw, M.D., director of the U-M Chronic Pain and Fatigue Research Center. Other authors were Richard H. Gracely, Ph.D., and Seong-Ho Kim, M.D., of the U-M Department of Internal Medicine; Pia C. Sundgren, M.D., Ph.D., Yuxi Pang, Ph.D., and Myria Petrou, M.D., of the U-M Department of Radiology; Michael Hsu, M.D., of the U-M Department of Physical Medicine and Rehabilitation; and Samuel A. McLean, M.D., of the U-M Department of Emergency Medicine.

Funding came from a Department of Army grant, the National Institutes of Health, and the NIH National Center for Complementary and Alternative Medicine.

Reference: Arthritis and Rheumatism, March 2008, Volume 58, Issue 3, "Dynamic Levels of Glutamate within the Insula are Associated with Improvements in Multiple Pain Domains in Fibromyalgia."

http://www.sciencedaily.com/releases/2008/03/080310112658.htm

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2008-03-13 12:11 浏览 : 926 回复 : 2

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Pain In Fibromyalgia Is Linked To Changes In Brain Molecule
纤维肌痛与大脑中分子改变有关
ScienceDaily (Mar. 13, 2008) — Researchers at the University of Michigan Health System have found a key linkage between pain and a specific brain molecule, a discovery that lends new insight into fibromyalgia, an often-baffling chronic pain condition.
ScienceDaily (2008年3月13)－密歇根大学健康系统的研究者们发现了疼痛和大脑特异分子间一个关键连接，这发现引导了对纤维肌痛的新的领悟，那是一种经常并且让人莫明其妙的慢性疼痛性疾病。
In patients with fibromyalgia, researchers found, pain decreased when levels of the brain molecule called glutamate went down. The results of this study, which appears in the journal Arthritis and Rheumatism, could be useful to researchers looking for new drugs that treat fibromyalgia, the authors say.
研究者发现，有纤维肌痛的患者，当大脑中叫作谷氨酸的分子水平降低时疼痛减轻。这个研究的结果，在关节炎与风湿病杂志发表，作者们说，可能对研究者为治疗纤维肌痛寻找新的药物有用。
"If these findings are replicated, investigators performing clinical treatment trials in fibromyalgia could potentially use glutamate as a 'surrogate' marker of disease response," says lead author Richard E. Harris, Ph.D., research assistant professor in the Division of Rheumatology at the U-M Medical School's Department of Internal Medicine and a researcher at the U-M Chronic Pain and Fatigue Research Center.
主要作者，U-M 医学院内科系统风湿病学分支和U-M 慢性疼痛和疲劳研究中心的研究助理教授，医学博士Richard E. Harris说,“如果这些发现重复，研究者在纤维肌痛的临床治疗试验中可以潜在地使用谷氨酸作为疾病反应的标记”
The molecule glutamate is a neurotransmitter, which means it conveys information between neurons in the nervous system. When glutamate is released from one neuron, it diffuses across the space between cells, and then binds to receptors on the next neuron in line and causes the cell to become excited, or to be more active.
谷氨酸分子是一种神经递质，这意味着，它在神经系统中的神经元间传递信息。当谷氨酸从一个神经元释放，它跨越细胞间的空隙弥散，然后与线上另一个神经元上的受体结合，并导致细胞变得兴奋或者更有活性。
This molecule was suspected to play a role in fibromyalgia because previous studies had shown that some brain regions in fibromyalgia patients appear to be highly excited. One such region is the insula.
这种分子被怀疑在纤维肌痛中起作用，因为先前的研究已经显示纤维肌痛患者的大脑许多区域呈现高度兴奋。其中一个区域是脑岛。
In functional magnetic resonance imaging (fMRI) studies, researchers at U-M had previously show n that the insula displays augmented activity in fibromyalgia, which means neurons in these patients are more active in this part of the brain. The U-M team hypothesized, Harris notes, that more activity among these neurons might be related to the level of glutamate in this region.
在磁共振机能成像研究中，U-M的研究者们先前已经显示纤维肌痛者的脑岛区显示增强的活动，这意味着这些患者的大脑中这部分的神经元更活跃。U-M团队猜测，Harris笔录，这些神经元的更多活性可能与这个区域的谷氨酸水平有关。
To gauge the linkage between pain and glutamate, the researchers used a non-invasive brain imaging techinique called proton magnetic resonance spectroscopy (H-MRS). H-MRS was performed once before and once following a four-week course of acupuncture or "sham" acupuncture.
为测量疼痛和谷氨酸间的联系，研究者们使用了一种叫做H-MRS的非侵入性大脑成像技术。在一个为期四周的针刺或者假针刺之前和之后各做一次H-MRS。
Researchers used either acupuncture or sham acupuncture to reduce pain symptoms. The sham procedure involved using a sharp device to prick the skin in order to mimic real acupuncture sensations.
研究者们用针刺或者假针刺来降低疼痛症状。假的过程是用一个尖锐的装置穿入皮肤来模拟真穿刺时的感觉。
Following the four weeks of treatment, both clinical and experimental pain reported were reduced significantly. More importantly the reduction in both pain outcomes was linked with reductions in glutamate levels in the insula: patients with greater reductions in pain showed greater reductions in glutamate. This suggests that glutamate may play a role in this disease and that it could potentially be used as a biomarker of disease severity.
经过四周的治疗，临床和试验组的疼痛均显示明显降低。更重要的是，两组疼痛降低的结果与脑岛中谷氨酸水平的降低相关：病人的疼痛降低越明显，谷氨酸降低越明显。这暗示，在这种疾病中谷氨酸起了作用，并且它可以潜在地用作疾病严重性地一个生物标记。

Because of the small number of participants in this study, further research should be conducted to verify the role of glutamate in fibromyalgia, Harris says.
Harris说，因为这项研究中地参与者数目较少，需要指导进一步的研究以证实纤维肌痛中的谷氨酸的角色。

2008-04-09 00:57

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编译：
纤维肌痛与大脑中分子改变有关
ScienceDaily (2008年3月13)－密歇根大学健康系统的研究者们发现了疼痛和大脑特异分子间一个关键连接，这发现引导了对纤维肌痛的新的领悟，那是一种经常并且让人莫明其妙的慢性疼痛性疾病。研究者发现，有纤维肌痛的患者，当大脑中叫作谷氨酸的分子水平降低时疼痛减轻。这个研究的结果，在关节炎与风湿病杂志发表，作者们说，可能对研究者为治疗纤维肌痛寻找新的药物有用。
主要作者，U-M 医学院内科系统风湿病学分支和U-M 慢性疼痛和疲劳研究中心的研究助理教授，医学博士Richard E. Harris说,“如果这些发现重复，研究者在纤维肌痛的临床治疗试验中可以潜在地使用谷氨酸作为疾病反应的标记”。
谷氨酸分子是一种神经递质，这意味着，它在神经系统中的神经元间传递信息。当谷氨酸从一个神经元释放，它跨越细胞间的空隙弥散，然后与线上另一个神经元上的受体结合，并导致细胞变得兴奋或者更有活性。这种分子被怀疑在纤维肌痛中起作用，因为先前的研究已经显示纤维肌痛患者的大脑许多区域呈现高度兴奋。其中一个区域是脑岛。在磁共振机能成像研究中，U-M的研究者们先前已经显示纤维肌痛者的脑岛区显示增强的活动，这意味着这些患者的大脑中这部分的神经元更活跃。U-M团队猜测，Harris笔录，这些神经元的更多活性可能与这个区域的谷氨酸水平有关。
为测量疼痛和谷氨酸间的联系，研究者们使用了一种叫做H-MRS的非侵入性大脑成像技术。在一个为期四周的针刺或者假针刺之前和之后各做一次H-MRS。研究者们用针刺或者假针刺来降低疼痛症状。假的过程是用一个尖锐的装置穿入皮肤来模拟真穿刺时的感觉。经过四周的治疗，临床和试验组的疼痛均显示明显降低。更重要的是，两组疼痛降低的结果与脑岛中谷氨酸水平的降低相关：病人的疼痛降低越明显，谷氨酸降低越明显。这暗示，在这种疾病中谷氨酸起了作用，并且它可以潜在地用作疾病严重性地一个生物标记。
Harris说，因为这项研究中地参与者数目较少，需要进行进一步的研究以证实纤维肌痛中的谷氨酸的角色。

2008-04-09 01:01

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