December 21, 2007
Happy Holidays everyone.
Below please find the abstract for a fascinating study from France on using brain SPECT to predict positive and negative response to the anesthetic ketamine for the pain of fibromyalgia. The results are fascinating and correlate with other studies that show increased activity in the prefrontal cortex is usually associated with a good response to treatment for a number of conditions, such as depression and OCD, while low prefrontal activity is associated with conditions that are more difficult to treat, unless they are targeted more specifically.
Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia by E. Guedi and colleagues from the Assistance Publique des Hôpitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, Marseille, France. Eur J Nucl Med Mol Imaging.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.
A healthy brain is associated with a healthy, successful life. Strive to keep your brain healthy. Until next time, please know that success starts with a healthy brain. Failure is often the result of a brain gone wrong. The good news is that no matter how bad you have been to your brain it is never too late to change your brain and change your life. To your brain health,
Daniel Amen, MD
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I have had great success with ketamine for releaving me of pain associated with fibromyalgia. I used nasal spray. Unfortunately it lasted only a few months. i would be willing to discuss this with someone if needed. The effects were amazing, changing everything with me, back to when I was before fibromyalgia, age 14. I was smart and could relax.
I was very interested to know how the brian is effected for a woman with severe fibromyalgia? I have never done drugs and seldom ever have had a drink. BUT, I feel like my brian is foggy from the fobro I have, it is consuming all my body functions, I am now on lyrica for the pain. But this has totally controlled all aspects of my life. The pain is beyon believable. I would greatly like to know more, also is your therapy covered by Providence Medical Ins?
Thanks Tami Bellingham
tami@communitybroadband.com
541-788-3128
Central Oregon