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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2007

01-08-2007 | Short Communication

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

Authors: Eric Guedj, Serge Cammilleri, Cecile Colavolpe, David Taieb, Catherine de Laforte, Jean Niboyet, Olivier Mundler

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2007

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Abstract

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.
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Metadata
Title
Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia
Authors
Eric Guedj
Serge Cammilleri
Cecile Colavolpe
David Taieb
Catherine de Laforte
Jean Niboyet
Olivier Mundler
Publication date
01-08-2007
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2007
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0392-7

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