PT  - JOURNAL ARTICLE
AU  - Keisuke Watanabe
AU  - Shigeki Hirano
AU  - Kazuho Kojima
AU  - Kengo Nagashima
AU  - Hiroki Mukai
AU  - Takatoshi Sato
AU  - Minoru Takemoto
AU  - Koji Matsumoto
AU  - Takashi Iimori
AU  - Sagiri Isose
AU  - Shigeki Omori
AU  - Kazumoto Shibuya
AU  - Yukari Sekiguchi
AU  - Minako Beppu
AU  - Hiroshi Amino
AU  - Tomoki Suichi
AU  - Koutaro Yokote
AU  - Takashi Uno
AU  - Satoshi Kuwabara
AU  - Sonoko Misawa
TI  - Altered cerebral blood flow in the anterior cingulate cortex is associated with neuropathic pain
AID  - 10.1136/jnnp-2017-316601
DP  - 2018 Oct 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 1082--1087
VI  - 89
IP  - 10
4099  - http://jnnp.bmj.com/content/89/10/1082.short
4100  - http://jnnp.bmj.com/content/89/10/1082.full
SO  - J Neurol Neurosurg Psychiatry2018 Oct 01; 89
AB  - Objective To assess the cerebral blood flow (CBF) in patients with diabetic neuropathic pain, and its changes after duloxetine therapy.Methods Using iodine-123-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography (IMP-SPECT), we performed a cross-sectional study of 44 patients with diabetes, and compared CBF in those with (n = 24) and without neuropathic pain (n = 20). In patients with neuropathic pain, we also longitudinally assessed changes in CBF 3 months after treatment with duloxetine.Results IMP-SPECT with voxel-based analyses showed a significant increase in cerebral blood flow in the right anterior cingulate cortex and a decrease in the left ventral striatum in patients with neuropathic pain, compared with those without pain. After duloxetine treatment, volume of interest analyses revealed a decrease in cerebral blood flow in the anterior cingulate cortex in patients with significant pain relief but not in non-responders. Furthermore, voxel-based whole brain correlation analyses demonstrated that greater baseline CBF in the anterior cingulate cortex was associated with better pain relief on the numerical rating scale.Conclusions Our results suggest that the development of neuropathic pain is associated with increased activity in the anterior cingulate cortex, and greater baseline activation of this region may predict treatment responsiveness to pharmacological intervention.Trial registration number UMIN000017130;Results.