Increased GABA in the periaqueductal grey of patients with chronic low back pain detected using 1H-magnetic resonance spectroscopy
Laura Sirucek1,2,3, Niklaus Zoelch4,5, and Petra Schweinhardt1,2
1Department of Chiropractic Medicine, Integrative Spinal Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland, 2University of Zurich, Zurich, Switzerland, 3Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland, 4Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland, 5Department of Psychiatry, Hospital of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
Preclinical studies suggest a role of altered γ-aminobutyric acid (GABA)ergic inhibitory tone in the periaqueductal grey (PAG), a key brain area for descending pain modulation, as mechanism contributing to chronic pain. The present 1H-magnetic resonance spectroscopy study investigated GABA, and glutamate/glutamine, concentrations in the PAG of patients with chronic low back pain (CLBP). Using a point resolved spectroscopy sequence with optimized frequency alignment, adequate spectral quality was achieved and increased GABA concentrations (p=0.027) identified in CLBP patients compared to pain-free controls. This finding supports dysregulations in descending pain modulation as factor contributing to chronic pain in humans.
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