BACKGROUND Chronic pain is pain greater than 3 months duration that may result from disease, trauma, surgery, or unknown origin. The overlap between the psychological, behavioural, and management aspects of pain suggest that limbic brain neurochemistry plays a role in chronic pain pathology. Proton magnetic resonance spectroscopy (1H-MRS) can evaluate in vivo brain metabolites including creatine, N-acetylaspartate, myo-inositol, choline, glutamate, glutamine, and gamma-aminobutyric acid in chronic pain; however, a comprehensive systemic review of metabolite expression patterns across all brain areas has yet to be performed. METHODS AND ANALYSIS Online databases including PubMed/MEDLINE, Google Scholar, EMBASE, the Cochrane Library, OVID, and PsycINFO will be searched for articles relating to 1H-MRS and chronic pain. Study inclusion criteria will include ages of between 18 and 65 years with a definite diagnosis of chronic pain, no comorbidities, clearly stated brain volumes of interest, and imaging protocols, with comparisons to healthy controls. Two reviewers will extract data relating to volumes of interest, metabolites, study participant demographics, diagnostic method and pain scores, treatments and duration of treatment, scanner information, 1H-MRS acquisition protocols, and spectral processing software. Where possible, volumes of interest will be reassigned as regions of interest consistent with known regional anatomical and functional properties to increase the power and relevance of the analysis. Statistical analyses will then be conducted using STATA. A central common pathway may exist for chronic pain due to the behavioural manifestations and management similarities between its different types. The goal of this systemic review is to generate a comprehensive neurochemical theory of chronic pain in different brain compartments. SYSTEMATIC REVIEW REGISTRATION This study is registered with PROSPERO CRD42018112640.

中文翻译：

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慢性疼痛疾病的磁共振波谱：综合慢性疼痛患者的解剖和代谢结果的系统评价方案。


背景技术慢性疼痛是持续时间超过3个月的疼痛，可能由疾病、创伤、手术或不明原因引起。疼痛的心理、行为和管理方面之间的重叠表明边缘脑神经化学在慢性疼痛病理学中发挥作用。质子磁共振波谱（1H-MRS）可以评估慢性疼痛中的体内脑代谢物，包括肌酸、N-乙酰天冬氨酸、肌醇、胆碱、谷氨酸、谷氨酰胺和γ-氨基丁酸；然而，尚未对所有大脑区域的代谢物表达模式进行全面的系统审查。方法和分析 将搜索在线数据库，包括 PubMed/MEDLINE、Google Scholar、EMBASE、Cochrane Library、OVID 和 PsycINFO，以查找与 1H-MRS 和慢性疼痛相关的文章。研究纳入标准将包括年龄在 18 岁至 65 岁之间、明确诊断为慢性疼痛、无合并症、明确说明感兴趣的脑容量和成像方案，并与健康对照进行比较。两名评审员将提取与感兴趣体积、代谢物、研究参与者人口统计、诊断方法和疼痛评分、治疗和治疗持续时间、扫描仪信息、1H-MRS 采集协议和光谱处理软件相关的数据。在可能的情况下，感兴趣的体积将被重新分配为与已知的区域解剖和功能特性一致的感兴趣区域，以提高分析的能力和相关性。然后将使用 STATA 进行统计分析。由于不同类型之间的行为表现和管理相似性，慢性疼痛可能存在一个中心共同途径。 本系统综述的目标是形成不同脑区慢性疼痛的全面神经化学理论。系统审查注册 本研究已在 PROSPERO CRD42018112640 上注册。