H magnetic resonance spectroscopy investigation of the anterior cingulate cortex and prefrontal cortex in chronic pain patients

We investigated the absolute concentration of N-acetylaspartate (NAA) in the anterior cingulated cortex (ACC), and prefrontal cortex (PFC) in chronic pain patients by proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS was performed with a 1.5T MR system on a voxel in the thalamus, ACC, and PFC bilaterally, in 48 chronic pain patients and 23 normal control subjects. We measured the absolute concentration of NAA using an LC-Model. There were 12 patients whose NAA concentration in the ACC or PFC was significantly, lower than the mean NAA concentration of the normal control subjects. Ten of these 12 patients needed a psychological approach. 1H-MRS suggests that NAA concentration in the ACC or PFC is associated with the necessity of a psychological approach. 1H-MRS may serve as a useful non-invasive tool for evaluating neural activity of the thalamus, anterior cingulated cortex, and prefrontal cortex in chronic pain patients.